Image-based Automated Counting of Plasma Cells and Marrow Cellularity in Core Marrow Biopsies

浆细胞(PC)是一种白细胞，通常负责产生抗体。当PC癌变时，它们会积聚在骨髓中，在那里它们会干扰正常血细胞的产生并破坏骨骼。这些癌症中最具侵袭性的是多发性骨髓瘤，这是美国第二常见的血液系统恶性肿瘤，占所有癌症的1%。在诊断这些癌症和确定肿瘤负荷方面，最有价值的程序之一是骨髓检查。这一过程包括抽吸和骨活检，病理学家检查显微准备并估计存在PC的数量。这一数字目前是诊断前列腺癌和评估治疗反应的必要标准。然而，目前用于PC定量的显微方法缺乏精密度。抽吸物中的计数受到血液污染的影响，基于骨组织准备的评估有些主观，充其量是半定量的。此外，骨髓细胞总数，这是有价值的评估许多血液疾病，是半定量的评估。为了方便这些计数并提高准确度和精密度，我们开发了基于数字图像的软件来执行骨髓活检中PC和骨髓细胞密度的快速定量。该软件的初步评估提供了出色的结果，我们正在进行额外的测试，以进一步验证它。用于PC的类似方法可以扩展到其他细胞类型的分析，如白血病细胞、淋巴细胞或其他谱系的细胞。

Plasma cells (PC) are a type of white blood cell that is normally responsible for producing antibodies. When PC become cancerous they accumulate in the bone marrow, where they interfere with the production of normal blood cells and destroy bone. The most aggressive form of these cancers is called Multiple Myeloma, which is the second most common hematological malignancy in the U.S. and constitutes 1% of all cancers. One of the most valuable procedures used in the diagnosis of these cancers and determination of tumor load is a bone marrow examination. This procedure consists of obtaining aspirates and bone biopsies where pathologists examine microscopic preparations and estimate the number of PC present. This number is currently a required criterion for diagnosis of PC neoplasias and also evaluation of response to therapy. However, current microscopic methods for the quantitation of PC lack precision. The counts in the aspirates are affected by blood contamination and estimations based on bone tissue preparations are somewhat subjective and at best semi-quantitative. Also, the total marrow cellularity, which is valuable in assessing numerous hematologic conditions, is evaluated semi-quantitatively. To facilitate these counts and improve accuracy and precision, we developed digital image-based software to perform a rapid quantitation of PC and marrow cellularity in bone marrow biopsies. The initial evaluation of this software provided excellent results and we are performing additional testing to further validating it. A similar approach used for PC could be extended to the analysis of other cell types such as leukemic cells, lymphocytes, or cells of other lineages.