Plasma cell quantification in bone marrow by computer-assisted image analysis
Plasma cell quantification in bone marrow by computer-assisted image analysis
复制标题
DOI：
10.14670/hh-21.951
复制
发表时间：
2006-09-01
影响因子：
2
通讯作者：
Dirnhofer, S.
中科院分区：
文献类型：
--
作者：
Went, P.;Mayer, S.;Dirnhofer, S.
背景：根据WHO分类定义，多发性黑素瘤的诊断标准主要和次要包括骨髓浆细胞计数的不同类别：从10-30%组到> 30%组等于从次要标准到主要标准的转变，而< 10%组对诊断没有帮助。因此，骨髓浆细胞分数对于浆细胞异常患者的分类和最佳临床管理至关重要。本研究的目的是(i)建立一个能够定量骨髓浆细胞的数字图像分析系统，（ii）评估骨髓环内的两种定量技术，即计算机辅助数字图像分析和常规光显微镜评估。对所得结果的观察者间变异进行比较。材料与方法：87例患者纳入研究，其中多发性骨髓瘤28例，意义不明的单克隆γ病29例，反应性胞浆增多症30例。H&E-和cd138染色载玻片中的浆细胞由两名研究人员使用光显微镜估计和计算机辅助数字分析进行定量。结果集与等级相关系数相关。根据WHO骨髓浆细胞含量标准对患者进行分类（1组：0-10%，2组：11-30%，3组：> 30%），并采用kappa统计学对结果进行比较。结果：与光显微镜评价相比，使用计算机辅助图像分析系统获得的cd138染色玻片结果的一致性程度更高（corr.coeff.=0.782），从个体内（corr.coeff.=0.960）和个体间结果相关性（corr.coeff.=0.899）可以看出。分类结果的观察者间一致性（SM/PW: kappa 0.833）处于高范围。结论：计算机辅助图像分析显示骨髓浆细胞定量具有较高的再现性。当浆细胞数量较低时，这可能对诊断、临床管理和预后至关重要，这使得精确定量变得困难。
Background: Minor and major criteria for the diagnosis of multiple meloma according to the definition of the WHO classification include different categories of the bone marrow plasma cell count: a shift from the 10-30% group to the > 30% group equals a shift from a minor to a major criterium, while the < 10% group does not contribute to the diagnosis. Plasma cell fraction in the bone marrow is therefore critical for the classification and optimal clinical management of patients with plasma cell dyscrasias. The aim of this study was (i) to establish a digital image analysis system able to quantify bone marrow plasma cells and (ii) to evaluate two quantification techniques in bone marrow trephines i.e. computer-assisted digital image analysis and conventional light-microscopic evaluation. The results were compared regarding inter-observer variation of the obtained results.Material and methods: Eighty-seven patients, 28 with multiple myeloma, 29 with monoclonal gammopathy of undetermined significance, and 30 with reactive plasmocytosis were included in the study. Plasma cells in H&E- and CD138-stained slides were quantified by two investigators using light-microscopic estimation and computer-assisted digital analysis. The sets of results were correlated with rank correlation coefficients. Patients were categorized according to WHO criteria addressing the plasma cell content of the bone marrow (group 1: 0-10%, group 2: 11-30%, group 3: > 30%), and the results compared by kappa statistics.Results: The degree of agreement in CD138-stained slides was higher for results obtained using the computer-assisted image analysis system compared to light microscopic evaluation (corr.coeff.=0.782), as was seen in the intra- (corr.coeff.=0.960) and inter-individual results correlations (corr.coeff.=0.899). Inter-observer agreement for categorized results (SM/PW: kappa 0.833) was in a high range.Conclusions: Computer-assisted image analysis demonstrated a higher reproducibility of bone marrow plasma cell quantification. This might be of critical importance for diagnosis, clinical management and prognostics when plasma cell numbers are low, which makes exact quantifications difficult.