淋巴细胞参数在识别外周血浆细胞中的应用价值

摘要：目的?探讨淋巴细胞相关参数在筛查外周血浆细胞中的应用价值。方法?收集上海长征医院2019年5月至2020年4月镜检发现浆细胞的28例患者的外周血标本作为浆细胞组，同期镜检发现异型淋巴细胞(87例)或异常淋巴细胞(27例)患者的外周血标本作为病例对照组，140例体检者外周血标本作为健康人对照组；比较上述4组淋巴细胞相关参数，即侧向散射光强度(LY-X)、侧向荧光强度(LY-Y)、前向散射光强度(LY-Z)、侧向散射光分布宽度(LY-WX)、侧向荧光分布宽度(LY-WY)、前向散射光分布宽度(LY-WZ)的差异；采用ROC曲线评价淋巴细胞参数在筛查浆细胞中的效能；并比较浆细胞组淋巴细胞参数与外周血浆细胞百分比的相关性。结果?浆细胞组6个淋巴细胞参数与健康人对照组差异均有统计学意义(P均<0.01)，浆细胞组LY-WZ高于异型淋巴细胞组和异常淋巴细胞(P均<0. 01)。以健康人对照组为参照，LY-X和LY-WZ识别浆细胞的ROC曲线下面积(AUCROC)分别为0.922、0.962;以异型淋巴细胞组为对照，LY-WZ识别浆细胞的AUCROC为0.712；以异常淋巴细胞值为参照，AUCROC为0.785。LY-Z与浆细胞百分比相关，Person相关系数为0.591(P<0.01)。结论?淋巴细胞参数在筛查外周血浆细胞中具有一定价值。

Application of lymphocyte positional parameters in screening peripheral blood plasma cell

Objective To investigate the significance of lymphocyte positional parameters in screening peripheral blood plasma cell. Methods In total 28 patients with circulating plasma cells, admitted to Changzheng Hospital from May 2019 to April 2020, were selected as research subjects for a retrospective analysis. Meanwhile, 140 healthy individuals who underwent physical examination were selected as the control group. We compared all lymphocyte positional parameters between the two groups. Correlation analysis was performed between lymphocyte positional parameters and the circulating plasma cell percentage, M protein, results of biochemical tests. Results There was significant difference between the plasma cell group and control group for 6 lymphocyte positional parameters(P_LY-X<0.001,P_LY-Y=0.002,P_LY-Z=0.010 P_LY-WX=0.003,P _LY-WY <0.001,P_LY-WZ<0.001). The lymphocyte positional parameters LY-X and LY-WZ had high sensitivity and specificity in screening plasma cell, with the ROC area under curve (AUC) being 0.922 and 0.962, respectively. The pooled AUC of the two indicators was 0.972. And the test had a sensitivity of 92.9% and specificity of 95.9%. LY-Y had significant linear correlation with the IgM(p<0.01). Pearson correlation of 0.817 (n=22,95% confidence interval [CI], 0.60,0.92). LY-Z had significant linear correlation with the circulating plasma cell percentage(p<0.01). Pearson correlation of 0.626(n=24, 95%CI 0.30 ,0.82). Conclusion The lymphocyte positional parameters have been suggested as useful means to screening peripheral blood plasma cell.