Cell population data in identifying active tuberculosis and community-acquired pneumonia.

Tingting Sun,Shaoli Deng,Bin Wu,Zhonglan Luo,Qing Huang,Jing Wang

doi:10.1515/med-2021-0322

Abstract

ObjectiveLeukocyte morphological parameters known as CPD (cell population data) is detected by hematology analyzer UniCel DxH800 with VCS technology. This study aimed to investigate the diagnostic efficacy of morphological changes in CPD parameters in distinguishing active tuberculosis from community-acquired pneumonia.MethodsFrom October 2018 to February 2019, 88 patients with active tuberculosis, 78 patients with community-acquired pneumonia, and 89 healthy controls were enrolled in this study. CPD was obtained using Unicel DxH800 analyzer for all whole blood samples, one-way ANOVA (non-parametric) and area analysis under ROC curve were performed.ResultsThe neutrophil mean conductivity (NMC), monocyte mean volume (MMV), monocyte mean conductivity (MMC), lymphocyte percentage (LY%), and monocyte percentage (MO%) were significantly higher in the active tuberculosis group than in the community-acquired pneumonia group. The white blood cell (WBC) count and neutrophil percentage (NE%) were significantly lower in the active tuberculosis group than in the community-acquired pneumonia group. The analysis of the area under the ROC curve proved that WBC count, neutrophil percentage (NE%), lymphocyte percentage (LY%), and monocyte percentage (MO%) did not achieve a higher area under the curve (AUC: 0.63, 0.71, 0.62, and 0.7, respectively). However, the AUC of NMC, MMV, and MMC in the CPD parameters was 0.951, 0.877, 0.98, respectively, and the simultaneous measurement of the three parameters was 0.99. The sensitivity and specificity were 98.5% and 91.1%, respectively.ConclusionThe combined diagnosis of NMC, MMV, and MMC could assist the clinical diagnosis of active tuberculosis and community-acquired pneumonia.

Highlights

Active tuberculosis (ATB) and community-acquired pneumonia (CAP) have similar symptoms, such as fever, cough, and expectoration; similarities are found in the imaging findings of pulmonary inflammation [1]
The values of the following 27 indicators were significantly higher in the ATB group compared with the CAP group (LY%, MO%, NMV-SD, neutrophil mean conductivity (NMC), NMC-SD, N-medium angle light scatter (MALS), N-MALSSD, N-upper medium angle light scatter (UMALS), N-lower medium angle light scatter (LMALS)-SD, N-lower angle light scatter (LALS)-SD, N-AL2, LMV-SD, LMC, LMC-SD, L-MALS,L-MALS-SD, L-UMALS, L-UMALSSD, L-LMALS-SD, L-LALS-SD, L-AL2-SD, monocyte mean volume (MMV), MMV-SD, monocyte mean conductivity (MMC), MMC-SD, M-MALS, M-UMALS; P < 0.05)
In the analysis of cell population data (CPD) parameters, there are 13 parameters with area under the curve (AUC) area above 0.8 (Table A2), of which three parameters (NMC, MMV, and MMC) achieved higher AUC compared with other parameters, which were 0.951, 0.877, and 0.98, respectively (Table 1)

Summary

Introduction

Active tuberculosis (ATB) and community-acquired pneumonia (CAP) have similar symptoms, such as fever, cough, and expectoration; similarities are found in the imaging findings of pulmonary inflammation [1]. The two diseases often cover each other’s symptoms. The symptoms of the first disease are more obvious, which may cause missed diagnosis and misdiagnosis of another disease. Distinguishing the two diseases clinically is still difficult [2]. A simple, fast, and accurate method is needed to distinguish ATB from CAP. The cell population data (CPD) can measure the inherent biological characteristics of more than 8,000 white blood cells simultaneously using the VCS technology of the blood analyzer UniCel DxH800.

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