高荧光强度细胞对浆膜腔积液诊断的价值

Evaluation of high fluorescence intensity cells for diagnosis of serous effusion

目的探讨XN20全自动血细胞分析仪体液模式中高荧光强度细胞对浆膜腔积液良恶性的诊断价值。方法应用XN20血细胞分析仪体液模式分析103份浆膜腔积液标本中高荧光强度细胞绝对值(HF-BF#)和高荧光强度细胞百分率(HF-BF%),以病理脱落细胞学检查结果为金标准,比较良、恶性浆膜腔积液中HF-BF#及HF-BF%的差异及其对积液性质判断的效能。结果在77份良性浆膜腔积液标本中,HF-BF#中位数为12/μl,HF-BF%中位数为2.4%,而在26份恶性浆膜腔积液标本中,HF-BF#中位数为139.5/μl,HF-BF%中位数为13.4%,2组数据比较差异均有统计学意义(P <0.0 001)。采用ROC曲线分析HF-BF#及HF-BF%对肿瘤细胞的检出效能,HF-BF#的AUC为0.866,而HF-BF%的AUC为0.809;HF-BF#及HF-BF%最佳诊断界值分别为62.0/μl、5.5%,由此得出的Youden指数分别为0.60、0.50,此时二者的灵敏度分别为69.2%、80.8%,特异度分别为90.9%、68.8%。结论高荧光强度细胞的绝对值及百分率对浆膜腔积液良恶性的鉴别诊断具有一定价值,但该模型的诊断效能还需要更多的样本进行验证。

Objective To analyze the value of high fluorescence intensity cells-body fluid model（HF-BF） in serous effusion. Methods The absolute value of HF-BF（HF-BF#） and HF-BF percentage（HF-BF%） from 103 samples of serous effusion were tested by automatic hematology analyzer Sysmex XN 20 using body fluid mode. The difference between benign and malignant serous effusion and the diagnostic value of HF-BF# and HF-BF% for tumor cells were analyzed. Results The median of HF-BF# in benign serous effusion group was 12/μ l and the HF-BF% was 2.4%. The median of HF-BF# in malignant serous effusion group was 139.5/μ l and the HF-BF% was 13.4%. Both of the HF-BF# and HFBF% in malignant sample were significantly higher than those of benign samples. The differences were statistically significant（P〈0.0 001）. To analyze the tumor detection value of HF-BF# and HF-BF% with ROC curve, the AUC was 0.866 and 0.809 respectively. When the cutoff value of HF-BF# and HF-BF% was 62.0/μ l and 5.5%, the Youden index were 0.60 and 0.50 respectively. Using the cut-off value, the sensitivity of HF-BF# and HF-BF% were 69.2% and 80.8% respectively, and the specificity were 90.9% and 68.8% respectively. Conclusion HF-BF# and HF-BF% are helpful for the diagnosis of benign and malignant serous effusion. However, this model needs further validation with more samples.