摘要
目的回顾性分析血细胞分析仪白细胞异常散点图对高球蛋白血症的提示作用。方法回顾性分析2019年7月至2024年5月北京协和医院检验科血细胞分析仪上因异常淋巴细胞报警,进而白细胞计数WPC通道高于WNR通道,且WPC散点图中出现异常图形的患者临床资料。体外添加试剂,镜下观察对血液干扰作用。结果共筛选出32例资料完整的病例,华氏巨球蛋白血症(Waldenstrom’s macroglobulinemia,WM)16例、多发性骨髓瘤(multiple myeloma,MM)7例、原发性或者自身免疫疾病伴发的冷球蛋白血症(cryoglobulinemia,CG)9例。以IgMκ型M蛋白血症、I型冷球蛋白血症为主。体外实验使用WPC通道溶血剂作用后,受干扰标本出现大小不等、形态呈不规则的细胞团样物质。结论高球蛋白血症患者WPC通道散点图中出现特异性“三角形”样图形,与血清中异常免疫球蛋白与试剂作用有关,若初次就诊患者出现类似干扰需警惕高球蛋白血症,并应提示临床进一步排查原发病。
Objective To retrospectively analyze the informative role of abnormal scatter plots of white blood cells(WBC)from the Sysmex XN hematology analyzer in patients with hyperglobulinemia.Methods A retrospective analysis was conducted with the clinical dataset of patients from July,2019 to May,2024,who had alarms of showing a higher WBC count in the WPC channel than in the WNR channel on the Sysmex XN hematology analyzer and also exhibited typical patterns in the WPC scatter plot.Additionally,peripheral blood samples from three patients were selected for in vitro experiments to verify the cause of the abnormal patterns.Results A total of 32 cases of patients with complete records were screened,including 16 cases of Waldenstr m’s macroglobulinemia(WM),7 cases of multiple myeloma(MM),and 9 cases of cryoglobulinemia(CG)associated with primary or autoimmune diseases.The predominant types were IgMκ-type M proteinemia or cold agglutinin syndrome.In vitro experiments using WPC channel hemolytic reagents showed that the interfered samples contained irregularly shaped cell cluster-like substances with various degrees of sizes.Conclusion A specific“triangular”pattern in the WPC channel scatter plot of patients with hyperglobulinemia can be related to the interaction between abnormal immunoglobulins in the serum and reagents.If similar interference is detected in first-time admitted patients,hyperglobulinemia should be suspected,and further investigations into the underlying causing disease should be recommended to clinicians.
作者
于连辉
黄嫄
李建英
王欣
王庚
黄媛
秦绪珍
YU Lianhui;HUANG Yuan;LI Jianying;WANG Xin;WANG Geng;HUANG Yuan;QIN Xuzhen(Department of Clinical Laboratory,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences,Beijing 100730,China)
出处
《标记免疫分析与临床》
2025年第5期971-975,共5页
Labeled Immunoassays and Clinical Medicine
基金
国家自然科学基金资助项目(编号:62331025)
中央高水平医院临床科研业务费资助(编号:2022-PUMCH-B-124)。
关键词
白细胞散点图
冷球蛋白
免疫球蛋白
高球蛋白血症
White blood cell scatter diagram
Cryoglobulin
Immunoglobulin
Hyperglobulinemia
