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Objective:According to the characteristics and common problems of hematology analysis in cancer patients, an autoverification scheme for cancer patients was formed, and the effectiveness and efficiency of the autoverification scheme were verified.Methods:The hematology review of international consensus and ourselves were respectively combined with Chinese multicenter autoverification rules to form two autoverification schemes. 10 063 blood samples (460 cases reviewed by microscope) were selected as the establishment group. Retrospective judgment was made in the instrument middleware, and various indexes such as autoverification pass rate and missed detection rate of different schemes were compared. By analyzing the data of missed cases one by one, the autoverification rules are adjusted according to the characteristics of diagnosis and treatment of cancer patients. By analyzing the platelet count variation range within 7 days in 19 300 cases, the Delta rules of platelet count were established. The platelet count Delta rules and the adjusted autoverification rules were combined to form the autoverification rules of our hospital and then combined with our hematology review rules to form the autoverification scheme of our hospital. The establishment group and verification group (10 876 cases, including 1 740 cases of microscopic examination) of the autoverification schemes were judged. The recognition function of Ethylenediaminetetraacetic acid-dependent pseudo thrombocytopenia (EDTA-PTCP) and PLT Delta check were programmed in the laboratory information system (LIS), and other rule judgment functions are performed in middleware. After four months of clinical trial application of 61 602 specimens, the effectiveness of our autoverification scheme was comprehensively evaluated.Results:The autoverification pass rates of international hematology review rules, our review rules, and Chinese multicenter autoverification rules are 46.36%, 52.26%, and the missed detection rates are 2.02%, 1.06%, respectively. The autoverification pass rates of our hospital autoverification scheme in the establishment group and the verification group are 51.19% and 52.78%, the missed detection rates are 0% and 0.03%, and the true positive rate are 100% and 99.95%, respectively. 56.06% of cases were passed automatically during the clinical trial application, and there were no missing cases, the true positive rate is 100%. The performance of our autoverification scheme is superior to the current autoverification schemes combined with mainstream hematology review rules and autoverification rules. The median time of TAT by autoverification was shortened by 15 minutes, and the 90th percentile time was shortened by 58 minutes, which was significantly lower than that of the same period last year. The marker function of "EDTA-PTCP" identified 31 special patients and 68 samples had been analyzed in total. After correction, the median increase of PLT was 76.5×10 9/L ( Z=-7.17, P<0.001). Conclusions:This study has established an autoverification scheme that combined by rules of hematology review and autoverification rules. It is suitable for cancer patients with high pass rate and very low rate of missed detection. This autoverification scheme can ensure the accuracy of the hematology analysis of cancer patients in our hospital and improve work efficiency.
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Objective@#To detect the levels of D-dimer (D-D) and fibrinogen (Fbg) in plasma of patients with malignant tumors, and to evaluate the diagnostic value of combined detection of D-D and Fbg.@*Methods@#The clinical data of 99 patients with malignant tumors were retrospectively analyzed, including 47 patients in DVT group and 52 patients in control group. DVT diagnosis was based on color Doppler or venography. The ROC curve was used to evaluate the diagnostic value of D-D, Fbg and the combination of D-D and Fbg for the malignant tumor patients with DVT.@*Results@#The D-D levels in the DVT group and the control group were 7.17 μg/ml and 4.25 μg/ml, respectively, and the Fbg levels were 4.01 mg/ml and 2.02 mg/ml, respectively, and the differences were statistically significant (all P<0.01). For the area under the ROC curve (AUC), specificity and sensitivity for diagnosing malignant tumors with DVT, D-D were 0.728, 62.50%, and 72.50%, respectively, and Fbg was 0.642, 65.50%, and 58.80%, respectively, and D-D+Fbg was 0.764, 83.30% and 59.00% respectively.@*Conclusions@#D-D and Fbg has a significantly high level in malignant tumor patients with DVT. The combined detection of D-D and Fbg has potential application value in the early diagnosis, early intervention and better prognosis for the malignant tumors patients with DVT.
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Objective To detect the levels of D-dimer (D-D) and fibrinogen (Fbg) in plasma of patients with malignant tumors, and to evaluate the diagnostic value of combined detection of D-D and Fbg. Methods The clinical data of 99 patients with malignant tumors were retrospectively analyzed, including 47 patients in DVT group and 52 patients in control group. DVT diagnosis was based on color Doppler or venography. The ROC curve was used to evaluate the diagnostic value of D-D, Fbg and the combination of D-D and Fbg for the malignant tumor patients with DVT. Results The D-D levels in the DVT group and the control group were 7.17 μg/ml and 4.25 μg/ml, respectively, and the Fbg levels were 4.01 mg/ml and 2.02 mg/ml, respectively, and the differences were statistically significant (all P<0.01). For the area under the ROC curve (AUC), specificity and sensitivity for diagnosing malignant tumors with DVT, D-D were 0.728, 62.50％, and 72.50％, respectively, and Fbg was 0.642, 65.50％, and 58.80％, respectively, and D-D +Fbg was 0.764, 83.30％ and 59.00％ respectively. Conclusions D-D and Fbg has a significantly high level in malignant tumor patients with DVT. The combined detection of D-D and Fbg has potential application value in the early diagnosis, early intervention and better prognosis for the malignant tumors patients with DVT.
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Objective To investigate the clinical significance of the serum sialic acid (SA) detection for the diagnosis and therapy monitoring in liver cancer patients.Methods Patients and healthy people of Chinese academy of medical science cancer hospital from January 2011 to October 2012,were enrolled,including 221 liver cancer patients (183 primary hepatic carcinoma patients and 38 metastatic hepatic carcinoma patients),117 benign liver disease patients and 150 healthy people.The concentration of serum SA were tested by ROCHE P800.The intra-assay and inter-assay coefficient of variation (CV) of SA kit were evaluated by use of low and high concentration samples,measured for 5 days and 4 times each day.Receiver operating characteristic (ROC) curve were used to determine the cut-off of SA using data of 183 cases of primary liver cancer and 150 healthy controls.The area under the curve (ROC-AUC) were used to evaluate the diagnostic value of SA.The changes of serum SA level in 103 cases of primary hepatic carcinoma patients were monitored before therapy and at the 1 st day,7 th day,14 th day,1 st month,3rd month,6 th month and 9 th month after treatment.SPSS16.0 was used to analyse the results.Results The intra and inter-day CVs for low level sample were 2.4％ and 3.2％ respectively,and for high level sample were 2.2％ and 3.1％.The cut-off value of the serum SA was 659 mg/L for liver cancer,the sensitivity and specificity was 63.4％ (1 16/183) and 94.7％ (142/150) respectively.The serum SA level of liver cancer group [(726 ± 173) mg/L] was higher than that of liver benign disease patients group [(552 ± 128) mg/ L] and healthy controls group [(599 ± 62) mg/L,U values were 1832.52 and 887.00,P ＜ 0.01].The serum SA level were tracked in 103 cases of primary hepatic carcinoma patients during therapy period.The serum level of SA elevated to [(817 ± 193) mg/L,t =-3.272,P ＜ 0.05] at I st week after treatment and kept at high level until late in 1st month after treatment [(782 ±173) mg/L,t =-2.694,P＜0.05].In the 3rd month,the SA level decreased to that of pretreatment [(662 ± 138) mg/L,t =1.225,P ＞ 0.05].In the 6th months,the SA level declined to [(615 ± 144) mg/L,t =1.999,P ＜0.05],as well as the level of healthy control group.There were 85 cases of hepatic carcinoma patients with decreased SA level compared with that of pretreatment,and the coincidence rate was 82.5％ (85/103),the Kappa value was 0.79.There were 5 cases of patients with hepatic carcinoma relapse after treatment in 9 th months and the SA levels increased significantly to (939 ± 175) mg/L.Conclusion The serum SA has significant values possibly in the diagnosis and therapy monitoring in liver cancer patients.