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Ocala, FL, United States

Tang H.,Zhejiang University | Jing J.,Zhejiang University | Bo D.,Jiangsu University | Xu D.,Cblpath Inc.
Archives of Pathology and Laboratory Medicine

Context.-The Coulter DxH 800 hematology analyzer can determine leukocyte numerical parameters (total leukocyte counts and differentials). It also measures intrinsic biophysical properties of these cells in their near-native state. These morphologic measurements are known as cell population data (CPD). Objective.-To study, for the first time, the biological variations of morphologic parameters or CPD and reinvestigate numerical parameters using the newest Coulter hematology analyzer. Design.-Forty adult volunteers (21 women, 19 men) were included. All participants maintained their normal lifestyles. Blood samples were drawn in duplicate by a single experienced phlebotomist and analyzed within 2 hours using a single analyzer. Before each batch analysis, the instrument quality controls were performed using the same lots of reagents. Results.-Within-subject (CVI) and between-subjects (CVG) biological variations for numerical parameters are smaller than previously reported. Cell population data have much smaller overall CVI and CVG compared to numerical parameters, suggesting that these parameters are less variable around the homeostatic set point intraindividually and interindividually. Index of individuality (ratio of CVI/CVG) for CPD was low. In addition, intraday and interday biological variations of all parameters are fairly constant. Conclusions.-These observations are clinically valuable. Data on CVI and analytical precision may be used to generate objective delta-check values for use in quality management. Comparing CVI and CV G on CPD may allow us to decide the utility of traditional population-based reference ranges. Documentation of CPD on biological variations is an essential prerequisite in the development of any new application clinically. Source

Zhu Y.,Nantong University | Shi J.,The Sixth Peoples Hospital of Nantong | Xu D.,Cblpath Inc. | Cao X.,Nantong University
Clinica Chimica Acta

Background: The morphological changes in activated neutrophils associated with antituberculosis drugs can be measured by volume, conductivity, and scatter (VCS) technology on the Coulter LH750 hematology analyzer. We conducted the current study to further validate the clinical usefulness of the neutrophil VCS parameters in predicting drug-induced neutropenia. Methods: Peripheral blood samples were collected from 52 patients with drug-induced neutropenia, 309 patients without any abnormal CBC, and 237 healthy controls. The mean neutrophil volume (MNV) with its distribution width (NDW) and the mean neutrophil scatter (MNS) were studied. Results: We observed a significant increase in the MNV and NDW as well as a significant decrease in the MNS in neutropenia patients approximately one week prior to development of neutropenia compared to healthy controls as well as to case controls. In addition, the delta MNV and delta MNS were respectively correlated well with delta absolute neutrophil counts when neutropenia occurred. The ROC curve analyses showed that the MNV NDW and MNS had larger areas under curves compared to conventional parameters. With a cutoff of 150.15 for the MNV, a sensitivity of 84.4% and specificity of 75.7% were achieved prior to neutropenia. Conclusion: The neutrophil VCS parameters may be clinically useful as potential hematological indicators for predicting antituberculosis drug-induced neutropenia. © 2016 Elsevier B.V.. Source

Sireci A.N.,Columbia University | Crapanzano J.P.,Columbia University | Mansukhani M.,Columbia University | Wright T.,Columbia University | And 4 more authors.
Diagnostic Cytopathology

Objective: The aim of the study was to determine if the ThinPrep Imaging System (T1S) improves the positive predictive value (PPV) of atypical glandular cell (AGC) diagnosis for identifying HPV-related squamous and/or glandular lesions over manual screening (MS), and if human papilloma virus (HPV)-DNA testing improves the diagnostic yield. Materials and Methods: 85 ThinPrep cervical cytology specimens with a diagnosis of AGC by TIS (n = 51) and MS (n = 34) were retrieved. The diagnoses were correlated with corresponding histologic follow-up and high risk (HR)-HPV testing results. Results: The PPV of AGC by TIS and MS for HPV-related squamous lesions were similar. In the MS group, more cases of glandular pathology were identified, however only three represented adenocarcinoma in-situ (AIS), and the remaining ten were endometrial carcinomas (EMCA). Conclusions: TIS and MS are comparable in the detection of AGC representing squamous histology and the addition of HPV DNA testing does not differentially improve performance. Although the MS group harbored more glandular pathology, the differences in the detection of AIS were not statistically significant. © 2009 Wiley-Liss, Inc. Source

Wang F.,Peking Union Medical College | Xu D.,Cblpath Inc. | Cui W.,Peking Union Medical College
Clinica Chimica Acta

Background: CD45 is universally expressed on nucleated hematopoietic cells in healthy individuals with variable intensities. Although down-regulation of CD45 expression is commonly seen in immature B-cell neoplasm, loss of CD45 expression is rarely observed in mature B-cell lymphoproliferative disorders. Case report: A 64-y old man was presented with fatigue and night sweat in July 2013. Physical examination revealed right axillary lymphadenopathy without splenohepatomegaly. The lymph node was sent for flow cytometry and histomorphologic evaluation. Flow cytometric analysis revealed the presence of CD45. + and CD45. - cell populations. The CD45. + population (42%) comprised mainly unremarkable CD3. + T cells. However, the CD45. - population (35%) showed CD19. +, CD20. +, and CD10. + immunophenotype with monotypic surface Lambda immunoglobulin light chain expression. Immunohistochemical studies performed on tissue section revealed that neoplastic lymphoid nodules were positive for CD20, BCL-6 and BCL-2 with low proliferation index by Ki-67 staining, but again negative for CD45. FISH analysis confirmed the presence of IGH/BCL2 rearrangement. Follicular lymphoma (grade 1) with negative CD45 expression was diagnosed. Conclusions: Loss of CD45 expression has been reported, but all cases documented were large B cell lymphoma (LBCL). To the best of our knowledge, this is the first case of low grade follicular lymphoma with lack of CD45 expression. We report this case because of not only its rarity but also to raise awareness that loss of CD45 expression can occur in LBCL as well as in low grade B-cell lymphomas. © 2015 Elsevier B.V.. Source

Zhu Y.,Nantong University | Cao X.,Nantong University | Xu D.,Cblpath Inc.
Laboratory Hematology

The Beckman Coulter LH 750 with VCS technology can determine intrinsic biophysical properties of peripheral leukocytes in their "near native state." We investigated the possibility of the LH 750 to detect morphologic changes in lymphocytes/monocytes in hepatitis B virus (HBV) infection. The VCS data from 37 active HBV patients, 140 HBV carriers, and 655 controls were analyzed. We observed significant increases in lymphocyte volume (LV) and the lymphocyte volume SD (LV-SD), and a significant decrease in lymphocyte conductivity (LC) in HBV infection, compared with controls. Similar changes in monocyte volume and conductivity were also observed. A simplified parameter, the Lymph-Index (calculated as [LV LV-SD]/ LC]) is proposed. The Lymph-Index was significantly increased in HBV carriers compared with controls (13.86 ± 2.73 versus 11.83 ± 1.36; P < .001). The increase was more pronounced in patients with active HBV infection (18.84 ± 3.88 versus 11.83 ± 1.36; P < .0001). With a cutoff value of 18.2 for the Lymph-Index, a 91.7% sensitivity and a 95.7% specificity were achieved in diagnosing active HBV infection. This overall sensitivity and specificity were superior to those of the individual lymphocyte/monocyte VCS parameters. In conclusion, VCS parameters can reflect the morphologic changes of lymphocytes/monocytes in HBV infection and may be useful clinically to aid in identifying HBV infection in a population with a high HBV prevalence. © 2011 Carden Jennings Publishing Co., Ltd. Source

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