Screening for malignant tumor cells in serous effusions with an automatic hematology analyzer using a novel...

Area of Science:

• Hematology
• Clinical Chemistry
• Oncology

Background:

• High false-positive rates of traditional high-fluorescence body fluid (HF-BF) parameters limit diagnostic accuracy for malignant tumor cells in body fluid (BF) samples.
• The Mindray BC-6800 Plus hematology analyzer offers a novel algorithm for improved screening of BF samples.

Purpose of the Study:

• To evaluate the diagnostic accuracy of a novel algorithm, malignant cell algorithm-body fluid (MA-BF), for screening malignant tumor cells in clinical BF samples.
• To compare the performance of MA-BF with the traditional HF-BF algorithm using the Mindray BC-6800 Plus analyzer.

Main Methods:

• A total of 220 BF samples were analyzed using the BC-6800 Plus in body fluid mode, divided into training and validation cohorts.
• A novel gating algorithm (MA-BF) was designed based on scatter plot analysis to identify aggregated cells with high fluorescence and side-scatter signals.
• Diagnostic accuracy was assessed using receiver operating characteristic (ROC) curve analysis, comparing MA-BF and HF-BF parameters.

Main Results:

• The traditional HF-BF parameters showed an Area Under the Curve (AUC) of 0.76 for absolute count (HF-BF#) and 0.70 for relative count (HF-BF%).
• The novel MA-BF algorithm established cutoff values of 0.006×10^9/L for MA-BF# and 0.2% for MA-BF% in the training cohort.
• In the validation cohort, MA-BF# achieved an AUC of 0.89 with 93% sensitivity and 78% specificity, outperforming HF-BF.

Conclusions:

• The MA-BF algorithm demonstrates superior diagnostic accuracy for detecting tumor cells in body fluid samples compared to the traditional HF-BF parameters.
• This novel algorithm offers a more reliable method for screening malignant cells in clinical body fluid analysis.