[1]刘婷婷,杜 芳,贺 莹,等.应用数字病理技术对脑脊液检验三种方法收集细胞效率及形态比较研究[J].现代检验医学杂志,2023,38(04):148-153.[doi:10.3969/j.issn.1671-7414.2023.04.027]
　LIU Tingting,DU Fang,HE Ying,et al.Comparative Study of Cerebrospinal Fluid Cell Collection Rates and Influence on Morphological Detection of Three Methods Using Digital Pathological Technology[J].Journal of Modern Laboratory Medicine,2023,38(04):148-153.[doi:10.3969/j.issn.1671-7414.2023.04.027]
点击复制

应用数字病理技术对脑脊液检验三种方法收集细胞效率及形态比较研究()
分享到：

《现代检验医学杂志》[ISSN:/CN:]

卷:
第38卷
期数:
2023年04期
页码:
148-153
栏目:
研究简报·实验技术
出版日期:
2023-07-15

文章信息/Info

Title:
Comparative Study of Cerebrospinal Fluid Cell Collection Rates and Influence on Morphological Detection of Three Methods Using Digital Pathological Technology
文章编号:
1671-7414（2023）04-148-06
作者:
刘婷婷1; 杜 芳1; 贺 莹1; 边 婷1; 周慧敏1; 易招师2; 李晓娜1; 李 雯1
（1. 空军军医大学第一附属医院神经内科，西安 710032；2. 江西省儿童医院神经内科，江西南昌 330006）
Author(s):
LIU Tingting1;  DU Fang1;  HE Ying1;  BIAN Ting1;  ZHOU Huimin1;  YI Zhaoshi2;  LI Xiaona1;  LI Wen1
（1. Department of Neurology, the First Affiliated Hospital of Air Force Military Medical University, Xi’an 710032, China; 2. Department of Neurology，Jiangxi Children’s Hospital, Jiangxi Nanchang 330006,China）
关键词:
数字病理;  脑脊液;  细胞学;  血液系统肿瘤
分类号:
R446.14
DOI:
10.3969/j.issn.1671-7414.2023.04.027
文献标志码:
A
摘要:
目的　运用数字病理技术比较三种不同沉淀法对脑脊液（cerebrospinal fluid，CSF）细胞的收集率，同时探究形态学收集效果，为临床选择合适的检验方法提供依据。方法　募集2020 年7 ～ 10 月在空军军医大学第一附属医院细胞学研究室送检的CSF 标本122 例，通过显微镜扫描细胞玻片，HALO 软件对细胞定量分析比较自然沉淀法、赛默飞Cytospin-4 及粟氏FMMU-6 的细胞离心沉淀法的细胞收集率。并利用CSF 中病理性细胞阳性检出情况验证三种方法的形态学收集效果。结果　FMMU-6 和Cytospin-4 的离心沉淀法细胞完整度、形态较自然沉淀法更好，收集率均高于自然沉淀法，差异具有统计学意义（F=12.50 ～ 182.56，均P ＜ 0.01）。当WBC ≤ 10×106/L，11×106/L ≤WBC ≤ 50×106/L 及51×106/L ≤ WBC ≤ 100×106/L 时进行收集率比较，FMMU-6[41.6% (22.70%，64.40%)，53.42%(39.80%，75.12%)，49.57%(44.80%，75.55%)] 较Cytospin-4 [8.00%(2.80%，17.23%)，41.05%(29.34%，50.37%)，30.84%(17.48%，39.63%)] 更好，差异具有统计学意义（z=8.07，2.51，2.61，均P ＜ 0.01），细胞数越少，FMMU-6 的优越性越好。当101×106/L ≤ WBC ≤ 500×106/L 时二者比较差异无统计学意义（z=1.40, P=0.91）。并对其中36 例细胞计数正常的血液系统肿瘤患者查找CSF 病理性细胞，共检出阳性5 例（13.9%），其中FMMU-6 检出5 例（13.9%），Cytospin-4 检出3 例（8.3%），自然沉淀法检出1 例（2.8%）。结论　离心沉淀法的细胞收集效率明显优于传统自然沉淀法，同时两种离心沉淀法中，FMMU-6 具有更好的优越性, 且对CSF 中血液系统恶性肿瘤细胞的形态学检测效果更好。
Abstract:
Objective　To compare the cell collection rates of three methods in cerebrospinal fluid (CSF) by digital pathological technology while exploring the effect of morphological collection to provide a basis for clinical selection of appropriate methods. Methods　122 CSF were collected from the cytology laboratory in the Department of Neurology of the First Affiliated Hospital of Air Force Military Medical University from July to October 2020. Through scanning microscopy and HALO software was used to compare the efficiency of three universal methods in cell collection: spontaneous cell sedimentation, cell centrifugation based on FMMU-6 and Cytospin-4, and further verified by the detection of confirmed central nervous system involvement hematology neoplasm. Results　The cell integrity, morphology and collection rates by centrifugal precipitation of FMMU-6 and Cytospin-4 were better than spontaneous cell sedimentation. The collection rate differed statistically from the natural precipitation method（F=12.50 ～ 182.56，all P ＜ 0.01）. Different groups compared, the FMMU-6 was better and there were statistically significant differences between FMMU-6[41.6%(22.70%, 64.40%), 53.42%(39.80%, 75.12%), 49.57%(44.80%, 75.55%)] and Cytospin - 4[8.00%(2.80%, 17.23%), 41.05% (29.34%, 50.37%), 30.84%(17.48%, 39.63%)] when WBC ≤ 10×106/L, 11×106/L ≤ WBC ≤ 50×106/L and 51×106/L ≤ WBC ≤ 100×106/L, (z=8.07，2.51，2.61，all P<0.01). With fewer cells, the superiority of FMMU-6 was more evident than the other, and there was no statistical difference when 101×106/L ≤ WBC ≤ 500×106/L (z=1.40, P=0.91). In addition, 36 patients with confirmed hematological neoplasm （WBC ≤ 10×106/L）were examined for CNS pathologic cells, including 5 cases detected (13.9%) with FMMU-6, 3 cases(8.3%) with Cytospin-4, and 1 case (2.8%) with spontaneous cell sedimentation. Conclusion　The cell centrifugation method’s cell collection efficiency was better than that of the spontaneous cell sedimentation method. Among the two centrifugation precipitation methods, FMMU-6 offers significant superiority and had a better morphological detection effect on hematological malignancies in CSF with normal cell count.

参考文献/References:

[1] RANSOHOFF R M, KIVISAKK P, KIDD G. Three or more routes for leukocyte migration into the centralnervous system[J]. Nature Reviews Immunology, 2003, 3(7): 569-581.
[2] BUCCISANO F, MAURILLO L, DEL PRINCIPE M I, et al. Prognostic and therapeutic implications of minimal residual disease detection in acute myeloid leukemia[J]. Blood, 2012, 119(2): 332-341.
[3] LENK L, ALSADEQ A, SCHEWE D M. Involvement of the central nervous system in acute lymphoblastic leukemia: opinions on molecular mechanisms and clinical implications based on recent data[J]. Cancer and Metastasis Reviews, 2020, 39(1): 173-187.
[4] DEAK D, GORCEA-ANDRONIC N, SAS V, et al. A narrative review of central nervous system involvement in acute leukemias[J]. Annals of Translational Medicine, 2021, 9(1): 68.
[5] 中国抗癌协会血液肿瘤专业委员会. 中华医学会血液学分会白血病淋巴瘤学组. 中国成人急性淋巴细胞白血病诊断与治疗指南(2021 年版)[J]. 中华血液学杂志, 2021, 42(9): 705-716. Hematology Oncology Committee，Chinese Anti-Cancer Association，Leukemia & Lymphoma Group， Chinese Society of Hematology,Chinese Medical Association. Chinese guidelines for diagnosis and treatment of adult acute lymphoblastic leukemia (2021)[J]. Chinese Journal of Hematology, 2021, 42(9): 705-716.
[6] 中华医学会血液学分会白血病淋巴瘤学组．中国成人急性髓系白血病（非急性早幼粒细胞白血病）诊疗指南（2021 年版）[J]．中华血液学杂志，2021，42(8):617-623． Leukemia & Lymphoma Group，Chinese Society of Hematology，Chinese Medical Association. Chinese guidelines for the diagnosis and treatment of adult acute myeloid leukemia (not APL)(2021) [J]. Chinese Journal of Hematology, 2021, 42(8): 617-623.
[7] 中国临床肿瘤学会指南工作委员会组织. 中国临床肿瘤学会(CSCO) 淋巴瘤诊疗指南-2019[M]．北京：人民卫生出版社, 2019. Guidelines Committee of Chinese Society of Clinical Oncology. Guidelines of Chinese Society of Clinical Oncology(CSCO) Lymphoid Malignancies[M]. Beijing：People’s Medical Publishing House, 2019.
[8] 许绍强, 周道银, 吴茅, 等．脑脊液细胞形态学检验中国专家共识(2020)[J]. 现代检验医学杂志, 2020,35(6): 9-11, 77. XU Shaoqiang, ZHOU Daoyin, WU Mao, et al. Consensus of Chinese experts on cellular morphological examination of cerebrospinal fluid (2020)[J]. Journal of Modern Laboratory Medicine, 2020, 35(6): 9-11, 77.
[9] 粟秀初．影响脑脊液细胞玻片离心沉淀检查法质量的原因分析及其预防策略[J]. 中国现代神经疾病杂志, 2018, 18(7): 467-469． SU Xiuchu. Analysis of reasons impairing the quality of cerebrospinal fluid cell slide centrifugal sedimentation examination method and its preventive measures[J]. Chinese Journal of Contemporary Neurology and Neurosurgery, 2018, 18(7): 467-469.
[10] 何俊瑛, 孔繁元, 郭力．临床脑脊液细胞学诊断[M].石家庄：河北科学技术出版社, 2007． HE Junying, KONG Fanyuan, GUO Li. Clinical cerebrospinal fluid cytology[M]. Shijiazhuang: Hebei Science and Technology Publishing House, 2007.
[11] 粟秀初, 孔繁元. 神经病学- 第4 卷- 神经系统临床脑脊液细胞学[M]. 北京: 人民军医出版社, 2001. SU Xiuchu, KONG Fanyuan. Neurology-Volume 4-Neurologic clinical CSF cytology[M]. Beijing： People’s Military Medical Publishing House, 2001.
[12] 何文军, 李曼, 李涛, 等．基于血细胞形态识别的自动检测系统的研发[J]. 现代检验医学杂志, 2019,34(2): 104-108. HE Wenjun, LI Man, LI Tao, et al. Study on automatic detection system base on blood cell morphology recognition[J]. Journal of Modern Laboratory Medicine, 2019, 34(2): 104-108.
[13] MARLETTA S, PANTANOWITZ L, SANTONICCO N, et al. Application of digital imaging and artificial intelligence to pathology of the placenta[J]. Pediatric and Developmental Pathology, 2023, 26(1): 5-12.
[14] BILAL M, NIMIR M, SNEAD D, et al. Role of AI and digital pathology for colorectal immuno-oncology[J]. British Journal of Cancer, 2023, 128(1): 3-11.
[15] ISNALDI E, RICHARD F, DE SCHEPPER M, et al. Digital analysis of distant and cancer-associated mammary adipocytes [J]. Breast, 2020, 54: 179-186.
[16] GREWAL R K, CHETTY M, ABAYOMI E A, et al. Use of flow cytometry in the phenotypic diagnosis of hodgkin’s lymphoma[J]. Cytometry. Part B, Clinical Cytometry, 2019, 96(2): 116-127.
[17] MICESKA S, ?KOF E, NOVAKOVI? S, et al. Cytopathological assessment is an accurate method for identifying immunophenotypic features and BRCA1/2 mutations of high-grade serous carcinoma from ascites[J]. Cancer Cytopathology, 2023, 131(3): 188-197.

相似文献/References:

[1]黄海林,王海平,张 倩,等.昆明地区儿童脑脊液细菌培养阳性结果分析[J].现代检验医学杂志,2016,31(04):151.[doi:10.3969/j.issn.1671-7414.2016.04.044]
　HUANG Hai-lin,WANG Hai-ping,ZHANG Qian,et al.Analysis of Positive Culture of Cerebrospinal Fluid in Children of Kunming Area[J].Journal of Modern Laboratory Medicine,2016,31(04):151.[doi:10.3969/j.issn.1671-7414.2016.04.044]
[2]武 琪a,陈 亮b,张宝华c.帕金森病患者血清和脑脊液褪黑素水平变化及其临床意义[J].现代检验医学杂志,2017,32(05):90.[doi:10.3969/j.issn.1671-7414.2017.05.017]
　WU Qia,CHEN Liangb,ZHANG Bao-huac.Changes and Clinical Significance of Melatonin in Blood and Cerebrospinal Fluid of Patients with Parkinson's Disease[J].Journal of Modern Laboratory Medicine,2017,32(04):90.[doi:10.3969/j.issn.1671-7414.2017.05.017]
[3]刘辰庚,梁 巍,王培昌.成年人脑脊液CK,AST,LDH和GPx活性检测对脑血管病的鉴别诊断价值[J].现代检验医学杂志,2018,33(05):4.[doi:10.3969/j.issn.1671-7414.2018.05.002]
　LIU Chen-geng,LIANG Wei,WANG Pei-chang.Differential Diagnostic Value of CK,AST,LDH and GPx Activity in Adults Cerebrospinal Fluid of Cerebrovascular Diseases[J].Journal of Modern Laboratory Medicine,2018,33(04):4.[doi:10.3969/j.issn.1671-7414.2018.05.002]
[4]孟凡飞,罗小舸,熊 琦,等.抗N- 甲基-D- 天冬氨酸受体脑炎的筛查及临床分析[J].现代检验医学杂志,2020,35(01):29.[doi:10.3969/j.issn.1671-7414.2020.01.008]
　MENG Fan-fei,LUO Xiao-ge,XIONG Qi,et al.Screening and Clinical Analysis of Anti-N-Methyl-D-AspartateReceptor Encephalitis[J].Journal of Modern Laboratory Medicine,2020,35(04):29.[doi:10.3969/j.issn.1671-7414.2020.01.008]

备注/Memo

备注/Memo:
基金项目： 空军军医大学第一附属医院2019 年度学科助推计划（编号：XJZT19MJ21）：PCT 通过抑制海马神经发生参与脓毒症后认知功能损伤的研究。
作者简介： 刘婷婷（1987-），女，硕士研究生，助理研究员，主要从事脑脊液细胞形态学及免疫学研究，E-mail：miracle6tt@163.com。
通讯作者：李雯(1982-)，女，医学博士，副主任医师，主要从事神经系统感染性疾病的研究，E-mail: wwyy0929@126.com。
更新日期/Last Update: 2023-07-15