High-fluorescent cells as a rapid screening tool for malignant effusions.

Area of Science:

• Hematology
• Oncology
• Clinical Chemistry

Background:

• Elevated high-fluorescent cells (HFCs) in serous effusions are indicative of tumor cells.
• Automated hematology analyzers offer potential for rapid diagnostic assessments.

Purpose of the Study:

• To assess the diagnostic utility of HFC detection for differentiating benign from malignant serous effusions.
• To evaluate HFCs using the Sysmex XN-10 analyzer in body fluid mode.

Main Methods:

• Analyzed 978 serous effusion samples (pleural, ascitic, pericardial) from June 2023 to June 2024.
• Measured absolute (HFC#) and percentage (HFC%) of HFCs using Sysmex XN-10.
• Assessed carcinoembryonic antigen (CEA) and lactate dehydrogenase (LDH) levels.
• Utilized receiver operating characteristic (ROC) curves for performance evaluation.

Main Results:

• Malignant effusions showed significantly higher HFC#, HFC%, and CEA levels (P < 0.001).
• HFC#, HFC%, CEA, and LDH were independently associated with malignancy.
• CEA demonstrated the highest diagnostic performance (AUC = 0.817), followed by HFC% (AUC = 0.727) and HFC# (AUC = 0.703).
• Combined HFC and CEA analysis outperformed CEA alone.

Conclusions:

• HFCs possess significant diagnostic value for identifying malignant serous effusions.
• HFC analysis, particularly with CEA, serves as an effective auxiliary screening tool.
• HFCs, based on nucleic acid characteristics, offer a rapid laboratory parameter for malignancy assessment.