【摘要】 目的评估采用XN-900形态报警和结构参数用于筛检外周血中Sezary细胞的可行性和有效性。方法分别采用光学显微镜,XN-9000血细胞分析仪和流式细胞术(FCM)对21例Sezary综合征患者(sezary syndrome,SS)和三个对照组(皮肤T细胞淋巴瘤对照组48例、慢性淋巴组织增生性B细胞疾病(CLPD)对照组55例、正常人对照组45例)进行检测,采用对照分析法对Sysmex xn-9000分析生成的淋巴细胞结构参数(ly-x,ly-y,ly-z)及"Blast/Abn Lympho(原始/异常淋巴)"报警进行对比分析,采用受试者工作曲线(ROC)来确定ly-x和ly-z的最佳触发筛查Sezary细胞的临界值,对"Blast/Abn Lympho(原始/异常淋巴)"报警提示和结构参数(ly-x和ly-z)的各种组合筛检规则的诊断效能指标进行评估。结果 Sezary综合征组淋巴细胞结构参数ly-x和ly-z分别为89.80(87.55~91.52)和73.60(69.10~74.32),明显高于皮肤T细胞淋巴瘤对照组、CLPD组和正常人对照组(U=37,40,44,55,38,41,均P<0.05);ly-x与Sezary细胞数量正相关,ly-z与大Sezary细胞存在正相关(r=0.248,0.198,P<0.05);采用ROC曲线确定ly-x和ly-z筛查Sezary细胞的临界值分别为≥86和≥68,将上述三个指标组合起来(即"报警Blast/Abn Lympho≥100,ly-x≥86且ly-z≥68)的灵敏度和特异度分别为100%和92.1%,可获得最好的筛检Sezary细胞诊断效能。结论采用血细胞分析仪所产生的"Blast/Abn Lympho(原始/异常淋巴)"报警提示和结构参数(ly-x,ly-z)组合规则可在外周血中Sezary细胞筛检中获得较高的特异度和敏感度,可用于疑似SS样本的复片筛检。更多还原

【Abstract】 Objective To evaluate the performance alarms and parameters generated by hematology analyzer during detection of circulating sezary cells of peripheral blood smears. Methods Blood samples from patients with Sezary syndrome(n=21)were studied with Sysmex XN-9000 analyzer,and compared to patients with benign or tumoral skin lesions(n= 48) and patients with chronic lymphoproliferative B-cell diseases(n=55) and normal person(n =45) used as control. Results In present series,the value of structural lymphoid parameters(ly-x and ly-z) and the alarm Blast/Abn Lympho were statistically higher in Sezary cases than in control cases(U=37,40,44,55,38,41,all P<0. 05). Screening Sezary cells critical values of ly-x and ly-z determined by ROC curve were greater than or equal to 86 and was more than or equal to 68. The combination of above three indexes up(i. e. "alarm Blast/Abn Lympho>100,ly-x=86 and ly-z>68) sensitivity and specificity respectively for 100% and 92. 1%,in order to get the best screening Sezary cells diagnostic efficiency. In addition,the value of ly-x was associated to the count of circulating Sezary cells and value of ly-z to the presence of large Sezary cells,both parameters described as prognostic factors. Conclusion The combination of alarm Blast/Abn Lympho and structural parameters(ly-x/ly-z/ly-y) may allow to define rule of blood slide review to screen circulating Sezary cells.更多还原