항암치료를 받고 있는 혈액종양질환 환자에서 CELL-DYN Sapphire CD61 표지 면역형광법을 이용한 혈소판측정의 유용성
Evaluation of Platelet count by the CELL-DYN Sapphire CD61 Immunoplatelet Method in Patients with Hematologic Diseases Receiving Chemotherapy
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배경: 자동혈구분석기는 높은 수준의 정밀도와 정확성으로 혈소판 수를 측정하나, 항암치료나 방사선 치료를 받고 있는 혈액종양환자에서는 높은 혈소판 수치를 보고하기도 한다. CELL-DYN Sapphire (Abbott, USA)는 전기저항및, 광산란을 이용하는 원리와 더불어 CD61을 이용한 면역형광법으로 혈소판 수를 측정하여, 정확한 혈소판 수치를 보고할 것으로 예상된다. 방법: CELL-DYN Sapphire (Abbott, USA)의 3가지 혈소판 분석 수행능력을 XE-2100 (Sysmex, Japan)과 비교하여 평가하였다. 항암치료 또는 방사선 치료를 받고 있는 혈액종양환자 중 일반혈액검사가 의뢰된 환자의 검체 111개를 대상으로 하였다. 결과: CELL-DYN Sapphire (Abbott)의 전기저항법, 광산란법, CD61 면역형광법은 XE-2100과 상관계수 0.99 이상으로 유의한 상관성을 보였다. 전기저항법, 광산란법, CD61 면역형광법에서 상이한 결과를 보이는 3검체를 대상으로 현미경을 이용한 수기법을 이용하여 혈소판 수를 측정하였고, 이는 CD61을 이용한 면역형광법으로 얻은 결과와 가장 근접하였다. 세포 조각은 그 크기가 혈소판과 비슷하거나 더 작기 때문에, 자동혈구분석기에서는 이들을 혈소판으로 측정하는 오류를 보인다. 결론: CELL-DYN Sapphire (Abbott)는 허용가능한 정밀도와 직선성을 보이며, XE-2100과 유의한 상관성을 보였다. 또한 혈소판 특이항체인 CD61을 이용함으로써, 다른 인자에 의한 간섭을 줄여 더 정확한 혈소판 수치를 보고할 수 있을 것으로 생각된다.
Abstract
Background: The automated hematologic analyzer has increased the precision and accuracy for platelet counting. However, spurious elevations of automated platelet counts occur occasionally in patients receiving chemotherapy or radiotherapy for solid organ tumors, leukemia, and other lymphomas. The CELL-DYN Sapphire analyzer (Abbott, USA) detects platelets with a CD61 monoclonal antibody and uses both impedance and optical technologies; thus, it is expected to present more accurate platelet counts. Methods: We evaluated platelet counts obtained with the CELL-DYN Sapphire impedance, optical, and CD61 methods and compared them with the results obtained with the XE-2100 analyzer (Sysmex, Japan). We analyzed 111 samples from hospitalized patients with various hematologic diseases, who were receiving chemotherapy or radiotherapy. Results: The results from the impedance, optical, and CD61 methods of CELL-DYN Sapphire and those from XE-2100 showed significant linearity, with correlation coefficients greater than 0.99. Three cases had significantly different platelet counts among the different methods used. Microscopic examination of these three cases showed very low platelet counts that corresponded with the low counts from the CD61 methods. It should be noted that because the automated blood counter assesses cell populations by their dimensions, many cellular fragments that were of the same size or smaller than platelets were thus counted as platelets. Conclusions: The CELL-DYN Sapphire analyzer has good precision, linearity and performance, comparable with the XE-2100 analyzer. As the CD61 methods of CELL-DYN Sapphire is specific for platelet, this method may reduce the interference from other blood components and count the exact platelet numbers.
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