XE-5000血细胞分析仪对恶性胸腹水的检测结果探讨

Value of XE-5000 hematology analyzer in differentiating malignant and benign pleural fluid and ascites

  • 摘要: 目的 探讨Sysmex XE-5000血细胞分析仪对胸腹水中肿瘤细胞的分析结果、最佳诊断界值以及诊断效率。方法 收集2017年5月- 2018年5月80份兰州大学第一医院住院患者的胸腹水标本,其中男性44例,女性36例,年龄21 ~ 88岁。有非恶性标本40例,包括肝硬化11例,肺源性心脏病7例,肺炎6例,其他消化道疾病6例,慢性肾衰2例及其他8例;被证实为恶性标本40例,包括肺癌19例,肝癌6例,乳腺癌6例,卵巢癌2例,膀胱恶性肿瘤2例及其他恶性肿瘤5例。采用Sysmex XE-5000血细胞分析仪检测80例标本的高荧光强度细胞值(high fluorescence intensity cell value,HF-BF),采用受试者工作特征(ROC)曲线判定HF-BF对恶性胸腹水中肿瘤细胞的识别能力及最佳诊断界值。结果 恶性胸腹水HF-BF值分布范围:35×106/L ~ 2 892×106/L,中位数88×106/L;非恶性胸腹水HF-BF值分布范围:0×106/L ~ 34×106/L,中位数14.5×106/L;恶性与非恶性胸腹水的高荧光强度细胞绝对值差异有统计学意义(P=0.042),而二者的高荧光强度细胞百分比差异无统计学意义(P=0.246)。ROC曲线分析曲线下面积0.632,良恶性的最佳诊断界值为39.5×106/L,此界值下灵敏度为65%,特异性为67.5%,阳性似然比为100%,阴性似然比为51.85%。结论 Sysmex XE-5000血细胞分析仪体液模式可作为恶性胸腹水的筛查指标,阳性标本应结合胸腹水生化、脱落细胞检查、肿瘤标记物及影像学等结果进一步明确诊断。

     

    Abstract: Objective To investigate the diagnostic efficiency of high fluorescence intensity cell value (HF-BF) of tumor cells in pleural fluid and ascites for cancer by XE-5000 hematology analyzer. Methods Eighty pleural fluid and ascites specimens were collected from inpatients in the First Hospital of Lanzhou University from May 2017 to May 2018, including 44 males and 36 females with age ranging from 21 to 88 years. Of the 80 cases, there were 40 non-malignant specimens, including 11 cases of cirrhosis, 7 cases of pulmonary heart disease, 6 cases of pneumonia, 6 cases of other digestive tract diseases, 2 cases of chronic renal failure and 8 cases of other diseases; And another 40 malignant specimens included 19 cases of lung cancer, 6 cases of liver cancer, 6 cases of breast cancer, 2 cases of ovarian cancer, 2 cases of bladder cancer and 5 cases of other malignant tumors. XE-5000 hematology analyzer was applied to detect HF-BF of the 80 specimens, and the optimal threshold of HF-BF to diagnose malignant tumor were determined by ROC curve. Results The range of HF-BF value in malignant pleural fluid and ascites was 35×106/L to 2 892×106/L with the median of 88×106/L, and it was 0 to 34×106/L (median, 14.5×106/L) in non-malignant pleural fluid and ascites, with statistically significant difference (P=0.042); however, there was no significant difference in the percentage of high fluorescence intensity cells (HF-BF%) between the two groups (P=0.246). The area under ROC curve of HF-BF of tumor cells in pleural fluid and ascites was 0.632, and the optimal diagnostic threshold was 39.5×106/L with the sensitivity, specificity of 65% and 67.5%, respectively. Conclusion HF-BF can be used as a screening index for malignant pleural fluid and ascites. Positive samples should be further diagnosed combining the results of biochemistry tests of pleural fluid and ascites, exfoliated cell examination, tumor markers and radiography.

     

/

返回文章
返回