Improving performance of recently introduced flow cytometry‐based approach of malignant cell screening in serous cavity effusion

Abstract

Introduction Microscopy has been recognized as the “gold‐standard” cellular analysis of serous cavity effusion. However, this method is time‐consuming, labor‐intensive, and requires accomplished skills. Here, we investigated the efficiency of hematology analyzer in screening malignant cells in serous cavity effusion. Methods A total of 991 serous cavity effusion samples and 370 validation specimens collected from different departments were sent to the clinical laboratory for routine cell count using the automated hematology body fluid (BF) mode and exfoliative cytology simultaneously. High‐fluorescent cells (HFCs) were measured as the relative count (HF%) and absolute count (HF#) by BF mode. Receiver operating characteristic curve analysis was combined with scattergram rules to screen malignant cells. Results HF# and HF% in malignant samples (subgroup) were significantly higher than those in benign samples, and the HF# and HF% levels were different between ascites and pleural effusion (PE). The area under the curve values were also different between ascites and PE. Positive of malignant cells was very high when the ascites or PE sample touching Rule 1 positive and either Rule 2 negative or positive. The cutoff levels of HF# were 5.5 HFC/μL on the basis of Rules 1 and 2 negative, whereas 83.5 HFC/μL on the basis of Rule 1 negative but Rule 2 positive in ascites. By contrast, the cutoff levels of HF% were 0.55 HFC/100 WBC on the basis of Rules 1 and 2 negative, whereas 4.95 HFC/100 WBC on the basis of Rule 1 negative but Rule 2 positive in PE. Conclusions Serous cavity effusion will be increasingly analyzed using the automated hematology analyzer BF mode in the future because of its rapidness and convenience. The combined application of HFC with scattergram rules is a feasible and useful approach to screen malignant cells in serous cavity effusion.

High Fluorescent Cells on Automated Body Fluid Analysis as Discriminator for Malignant Cell Detection

“…The total WBC count in this study was higher for malignant BFs than nonmalignant ones. The finding is similar to studies by Huang et al, 23 Xu et al, 24 Labaere et al, 25 and Sun et al 26…”

“…The total WBC count in this study was higher for malignant BFs than nonmalignant ones. The finding is similar to studies by Huang et al, 23 Xu et al, 24 Labaere et al, 25 and Sun et al 26 As per ROC analysis, the HF% cutoff of 5.5% equivalent to HF cell count of 15.70/µL should yield good sensitivity and Huang et al, 23 Xu et al, 24 and Larruzia et al 28 had higher cutoff value determination than this study. The use of automated analyzer is mainly as a screening tool, whereas the cytological examination remains the gold standard.…”

Clinical application of an algorithm to screen for malignant cells in body fluids using an automated hematology analyzer

“…In this study, 7% (2/30) of all malignant cases had to this issue (Table 1), suggesting that reliance on the HF‐BF criterion alone for screening is risky. Samples with very low levels of malignant cells escaped detection and did not show an elevated HF‐BF count 21,22 . Because this criterion did not sufficiently meet the purpose of complete screening, 4 an algorithm was constructed by applying low‐resolution microscopic screening to samples that did not exceed the Youden index of the absolute value of HF‐BF to avoid missing malignant samples.…”

A Microfluidic Dielectric Spectroscopy System for Characterization of Biological Cells in Physiological Media

“…Cell screening is a method for observing living cells and evaluating cell physiology to discover cell properties and fate. This method has been widely employed for drug discovery [1,2], diagnostic purposes [3][4][5], biological molecules detection [4], and microbial species detection [6,7]. The traditional procedure for screening is based on microtiter plates, in which tests are conducted on 96-well plates.…”