RESUMO
Objective:To explore the diagnostic value and problems of artificial intelligence (AI) bone marrow cell recognition technology in the detection of minimal residual disease (MRD) of leukemia.Methods:A total of 65 cases with minimal residual disease of leukemia confirmed by flow cytometry from the Hematology Medical Center of Xinqiao Hospital affiliated to the Army Medical University (AMMU) from November 1 to December 31, 2020 were collected. The bone marrow Wright′s staining smears were obtained, and all bone marrow smears were scanned and classified automatically without artificial intervention by the analysis system based on Artificial Intelligence platform (morphogo). AI-MRD was defined to positive when the proportion of primary cells was more than 3%. According to the number of AI automatic recognition cells, the cases were divided into 18 cases of less than 500 (L500), 35 cases of 500 to 1900 (between 500 and 1900, B1900), and 12 cases of more than 1900 (M1900), no overlap or omission between groups. Kappa consistency test was performed on the results of artificial intelligence test and the results of flow cytometry for minimal residual disease of leukemia (MFC-MRD) in each group. The receiver operating characteristic curve (ROC) of the artificial intelligence test results of each group of patients was drawn based on the MFC-MRD results, and the sensitivity, specificity and accuracy of the area under the curve (AUC) value and AI results were calculated.Results:After grouping according to the number of cells automatically recognized by AI, the detection results of L500 group were MFC-MRD+/AI-MRD+7 cases, MFC-MRD+/AI-MFC-2 cases, MFC-MRD-/AI-MRD+6 cases, MFC-MRD-/AI-MRD-3 cases; In B1900 group, MFC-MRD+/AI-MRD+13 cases, MFC-MRD+/AI-MFC-6 cases, MFC-MRD-/AI-MRD+6 cases, MFC-MRD-/AI-MRD-10 cases; The results of M1900 group were MFC-MRD+/AI-MRD+5 cases, MFC-MRD+/AI-MFC-0 cases, MFC-MRD-/AI-MRD+1 case, MFC-MRD-/AI-MRD-6 cases. Taking MFC-MRD as the determination standard, the sensitivity of AI-MRD detection in L500 group, B1900 group and M1900 group was 53.8%, 68.4% and 83.3%, the specificity was 60%, 62.5% and 100%, the accuracy was 55.6%, 65.7% and 91.7%, and the AUC value were 0.568 P=0.654, 0.678 P=0.069,1.000 P=0.000. Conclusions:This study preliminarily explored the diagnostic value and problems of AI bone marrow cell recognition in the detection of minimal residual disease of leukemia. It was confirmed that when 3% of the proportion of blasts in AI cell classification is set>3% as the positive threshold of AI-MRD, the consistency between AI and MFC-MRD detection increases with the increase of the number of cells recognized by AI.
RESUMO
Objective:To explore the effect of artificial intelligence teaching-picture system in training the bone marrow cell morphological reading ability of clinical medical students.Methods:A total of 110 five-year undergraduate students were divided into experimental group (artificial intelligence picture teaching method) and control group (traditional teaching method) in the bone marrow cell morphology reading ability training. On the basis of multimedia teaching, the experimental group was given the teaching by using the bone marrow cell morphology picture storage and transmission system for retrieval, learning and computer adaptive test. Then objective evaluation of image recognition ability and questionnaire were used to compare the teaching effect.Results:The image recognition ability was significantly better in the experimental group than in the control group [(89.6±5.7) vs. (81.4±4.9), P<0.01]. Furthermore, the experimental group showed more obvious advantages in cell morphology recognition [(74.7±4.0) vs. (68.7±4.9)] and diagnosis of hematological diseases [(14.9±3.0) vs. (12.9±2.4)] than the control group (both P<0.01). Questionnaire survey showed that the students expressed their affirmation and support for the artificial intelligence teaching-picture system in the bone marrow cell morphological reading ability training. Conclusion:The application of artificial intelligence teaching-picture system can greatly improve the teaching effect, mobilize students' learning enthusiasm and expand learning resources, which is worthy of further promotion and application.
RESUMO
Objective@#Chronic graft-versus-host disease (cGVHD) is a major long-term complication after allogeneic hematopoietic stem cell transplantation (allo-HSCT) . It is important to study the changes of serum biomarkers expression in patients for early diagnosis and treatment.@*Methods@#The expression levels of five serum protein markers (IL-1b, IL-16, CXCL9, CCL19, CCL17) in patients with or without cGVHD after allo-HSCT were detected by liquid suspension microarray.@*Results@#Compared with the control group without cGVHD, the expression levels of CXCL9 and CCL17 in serum of patients with cGVHD were significantly increased (P<0.05) . CCL17 was correlated with the severity of cGVHD (P<0.001) . CXCL9 was significantly increased in the serum of patients with skin lesion (P<0.01) , and CCL17 was significantly expressed in cGVHD patients with liver as the target organ (P<0.01) .@*Conclusion@#The combination of CXCL9 and CCL17 can be used as serum biomarkers of cGVHD, which has certain reference value in assisting the diagnosis and evaluation of cGVHD severity.
RESUMO
Objective To explore the characteristics of morphology and immunology in acceleration phase and blastic phase of chronic myelogenous leukemia(CML).Methods Seventy-three cases of CML-BP bone marrow specimens were respectively conducted the morphology and related cell chemical dyeing observation for determining the FAB type.Flow cytometry was used to detect series immunological related antigens.Results Among 73 cases of FAB typing,there were 44 cases of CML-AML,21 cases of ALL and 8 cases.21 cases CML-ALL patients In the immunophenotyping by flow cytometry,among 21 cases of CML-ALL,there were 19 cases of B-ALL,2 cases of T-ALL,moreover 12 cases contained myeloid marker.Among 8 cases CML-HAL,the immunophenotypes were 6 cases of B+-My and 2 cases of T+ My.Among 44 cases CML-AML,15 cases contained T cell marker,and 2cases contained B cell marker,other cases had no cross-lineage expression.Among 73 cases of CML-BP,29 cases conducted the flow cytometry detection in the acceleration phase,in which 16 cases urgently changed to AML,and 13 cases to non-AML(9 cases of ALL and 4 cases of HAL).Among non-AML cases,2 cases had the simultaneous existence of myeloid primitive cells and precursor lymphocyte in the acceleration phase and other 9 cases were myeloid primitive cell or accompanied by lymphocyte marker.Conclusion Flow cytometry has a certain implication role for the direction and differentiation diagnosis of CML-BP.
RESUMO
Objective To understand the current situation and requirements of laboratory quality control of blood diseases in Chongqing .Methods A self‐designed questionnaire was designed ,and the investigation was carried out in 60 hospitals of Chongqing district .The main contents of the investigation were related to the instruments of work environment ,the regulations ,the conditions of the personnel ,etc .Results A total of 60 questionnaires were distributed ,57 questionnaires were valid .In the study ,only 14 .04%laboratories were the blood disease specialist laboratory ,most hospitals could complete the basic inspection items .66 .67% hospitals had all the experimental procedures and SOP documents .Most of staffs were with intermediate professional titles and undergraduate education .A total of 35 .08% experimental equipments with the value of over 5 million RMB ,45 .61% equipments had a special in‐spection records .About 45 .61% test reports would refer to the clinical performance ,and had a strict signing guideline .Most of the research objects reflected the problems ,including the backward equipments and the lack of personnel ,and hoped to set up telemedi‐cine indemnity system and carry out further education .Conclusion The overall quality of the laboratory for blood diseases in Chongqing is better ,it is recommended to strengthen the full quality control ,to establish emergency system ,and to improve the quality and level of laboratory .
RESUMO
Objective To investigate the potential of stromal cells from human umbilical cord blood cultured in vitro to secrete hematopoietic growth factors. Methods The expressions of hematopoietic growth factors of stromal cells from human umbilical cord blood and bone marrow were detected by ELISA kits at different time points. Results Stromal cells from human umbilical cord blood could secrete thrombopoietin (TPO), granulocyte-macrophage colony stimulating factor (GM-CSF) and stem cell factor (SCF). The peak levels of TPO and SCF were found at 7 d after culture in vitro, but then the levels of these factors decreased gradually. Stromal cells from human umbilical cord blood secreted more SCF and GM-SCF, but less TPO than human bone marrow stromal cells. Conclusion Our results demonstrate that stromal cells from human umbilical cord blood could sustain hematopoiesis by secreting multiple types of hematopoietic growth factors such as TPO, GM-CSF, and SCF.
RESUMO
Objective To investigate the gene expression of connexin43(Cx43) and its effect on gap junction intercellular communication(GJIC) of acute leukemia bone marrow stromal cells(ALBMSCs).Methods After ALBMSCs were transfected by recombinant adenovirus Ad-Cx43-GFP,the expression of report gene GFP and the transfection efficiency were monitored by fluorescent microscopy.RT-PCR,Western blot and immunocytochemical method were used to detect the mRNA and protein expressions of Cx43.Dye transfer procedure was performed to examine the GJIC function.Results After transfected by Ad-Cx43-GFP for 24 h,the expression of GFP in ALBMSCs was detected by fluorescent microscopy and the transfection efficiency was(82.7?2.16)%;The mRNA and protein expressions of Cx43 in ALBMSCs transfected by Ad-Cx43-GFP were higher than those not transfected by Ad-Cx43-GFP(P
RESUMO
AIM: To investigate the effect of vascular cell adhesion molecule-1(VCAM-1) modified human umbilical cord blood stromal cells(hUCBSCs) on the expansion of hematopoietic stem cells/progenitor cells in vitro.METHODS: After the VCAM-1-pcDNA3.1(+) eukaryotic expression vector was constructed successfully,the recombinant vector was transfected into hUCBSCs via liposome mediation.The expression of the VCAM-1 was detected by semiquantitative RT-PCR and immunocytochemistry.The expansion abilities of hematopoietic cell in vitro under different conditions were compared,including cytokine stimulation,hUCBSCs feeder layer and VCAM-1 modified hUCBSCs feeder layer etc.The effect on hematopoietic reconstitution of different expanded hematopoietic cell groups was compared after CFU-GM,CFU-E and CFU-Mg semi-solid culture were proceed,respectively.RESULTS: The positive clone and NeoR gene detection proved that recombinant vector had been transfected into hUCBSCs.The results of semiquantitative RT-PCR and immunocytochemistry manifested that VCAM-1 was high expressed not only at transcriptional level in the stable-transfected hUCBSCs(P