A simple screening method for the diagnosis of chronic myeloid leukemia using the parameters of a complete blood count and differentials
A simple screening method for the diagnosis of chronic myeloid leukemia using the parameters of a complete blood count and differentials
复制标题
DOI：
10.1016/j.cca.2018.08.038
复制
发表时间：
2019-02-01
影响因子：
5
通讯作者：
Miyachi, Hayato
中科院分区：
文献类型：
--
作者：
Ogasawara, Atsushi;Matsushita, Hiromichi;Miyachi, Hayato
背景资料：本研究旨在建立一种简便、经济的全血细胞计数（CBC）和分类计数筛查慢性粒细胞白血病（CML）的方法。方法：对CML和非CML患者的CBC、分类计数和中性粒细胞碱性磷酸酶（NAP）评分进行受试者工作特征（ROC）曲线分析，确定有效的临界值。结果：白细胞计数的ROC曲线下面积（AUC）最大（0.909），白细胞计数的ROC曲线下面积（AUC）最小（0.909），白细胞计数的ROC曲线下面积（AUC）最大（0.909）。在分类的绝对计数中，嗜碱性粒细胞的AUC最高（0.982），其次是未成熟粒细胞（IG）（0.975），其临界值分别为0.43 x 10（9）/L和0.46 x 10（9）/L。NAP评分的AUC为0.963，临界值为122。在验证中，来自96例病例的280份样本中嗜碱性粒细胞绝对计数升高，其中包括22例CML病例。相反，在516例患者的1310份样本中，绝对IG计数升高，其中仅包括17例CML患者。3例初治CML患者的资料在CML发病时连续分析，其嗜碱性粒细胞计数在IG标准之前一直符合。结论：嗜碱性粒细胞绝对计数是筛查CML的有效方法。
Background: This study aimed to develop a simple and inexpensive method using the complete blood count (CBC) and differentials to screen for chronic myeloid leukemia (CML).Methods: The receiver operating characteristic (ROC) curves of each CBC parameter, differential and the neutrophil alkaline phosphatase (NAP) score using CML and non-CML cases were generated to determine effective cut-off values. They were applied to the review of randomly-selected 45,608 samples for validation.Results: The leukocyte count showed the highest area under the ROC curve (AUC) value (0.909) among the CBC parameters. In the absolute counts of differentials, the AUC was the highest in basophils (0.982), followed by immature granulocytes (IGs) (0.975), which had cut-off values of 0.43 x 10(9)/L and 0.46 x 10(9)/L, respectively. The AUC of the NAP score was 0.963 at a cut-off value 122. In the validation, the absolute basophil counts were elevated in 280 samples from 96 cases, including 22 CML cases. In contrast, the absolute IG counts were elevated in 1310 samples from 516 cases, including only 17 CML cases. Three newly-diagnosed CML cases whose data were analyzed sequentially at the CML onset consistently met the basophil criteria before the IG criteria.Conclusions: The absolute basophil count is effective for screening for CML.