[Value of percentage of highly fluorescent lymphocytic cells for rapidly assessing septicemia in tumor patients].

OBJECTIVE: To evaluate the value of percentage of highly fluorescent lymphocytic cells (HFLC%) for rapidly assessing septicemia in tumor patients. METHODS: Blood samples were collected from 130 patients with tumors (60 septicemia patients and 70 non-septicemia patients) and 80 healthy controls. HFLC% was analyzed with Sysmex XE-5000, the level of C-reactive protein (CRP) measured with a commercially available turbidimetric immunoassay kit and the level of procalcitonin (PCT) determined with a semiquantitative chromatographic immunoassay kit. The diagnostic values of HFLC% and CRP in septicemia were evaluated with ROC analysis. RESULTS: The values of HFLC% and CRP were significantly higher in the septicemia group than those in the non-septicemia and healthy groups (0.30% (0.10%-0.70%) vs 0.10% (0-0.20%), 0.10% (0-0.20%) ; 80.3 (28.5-129.5) vs 3.3 (1.4-41.4) , 1.4 (0.6-2.5) mg/L, all P < 0.01) . The ROC-AUCs for HFLC% and CRP for a diagnosis of septicemia were 0.72 (sensitivity 71.7%, specificity 58.7%) and 0.92 (sensitivity 96.7%, specificity 82.0%). Both of them could judge septicemia better. Additionally, HFLC% was correlated with the levels of PCT and CRP (r = 0.637, 0.241, both P < 0.01). CONCLUSIONS: HFLC% may be used as a rapid and simple auxiliary indicator in the diagnosis of septicemia in patients with tumors. And it is conducive to make an early diagnosis of septicemia and avoid unnecessary use of antibiotics.

[Comparison of testing methods for reticulated platelets].

OBJECTIVE: To compare the accuracy, stability and sample cross-contamination of two independent methods of detecting the percentage of reticulated platelets in peripheral blood and establish a local normal reference range so as to provide methodological rationales in clinical laboratory. METHODS: The percentages of reticulated platelets in peripheral blood of a healthy population were measured by Sysmex XE-5000 blood cell analyzer with polymethyl oxazine staining and flow cytometer with thiazole orange staining respectively. The correlation between the results of two methods was analyzed by Spearman's nonparametric correlation. Information about stability was obtained from measurements of the percentages of reticulated platelets in peripheral blood at designated time points. The analyses of accuracy, sample cross contamination and local normal reference range were performed routinely. RESULTS: The coefficient of variation (CV) of data was lower (16.2%) than that from flow cytometer (35.1%). The sample cross-contaminations of two methods were the same at around 5%. The percentage of reticulated platelets in peripheral blood was stable and consistent whereas the results of flow cytometer fluctuated at different time points within 4 h after blood sampling. The correlation of results obtained from two methods was significant (P < 0.01, r(2) = 0.923). The local normal reference range was 1.0% - 7.5% for Sysmex XE-5000 versus 3.0% - 10.5% for flow cytometer. CONCLUSIONS: Fully automatic blood cell analyze is more advanced than flow cytometer for its simple operation and stable data. And the former is an ideal first-choice for detecting the percentage of reticulated platelets in peripheral blood.

Involvement of indoleamine 2,3-dioxygenase in impairing tumor-infiltrating CD8 T-cell functions in esophageal squamous cell carcinoma.

The indoleamine 2,3-dioxygenase-(IDO-) mediated microenvironment plays an important role in tumor immune escape. However, the inhibitory effects of IDO on the CD8(+) tumour-infiltrating lymphocytes (CD8(+) TILs) in esophageal squamous cell carcinoma (ESCC) have not been clarified yet. Here, we found that the level of IDO expression in ESCC tumor specimens correlated with a reduction in the number of CD8(+) TILs. Patients with high IDO expression and a low number of CD8(+) TILs had significantly impaired overall survival time. IDO expression and functional enzyme activity in ESCC cell lines could be induced by IFNγ. When exposed to the milieu generated by IDO-expressing Eca109 cells, the CD8(+) TILs were suppressed in proliferation, and their cytolytic functions against target tumor cells were lost. These results suggested that impairing CD8(+) TIL functions by IDO expressed in ESCC possibly contributed to the finding that patients with higher IDO expression have more aggressive disease progression and shorter overall survival time.

[Correlation factors of ethylenediaminetetraacetic acid-dependent pseudothrombocytopenia in cancer patients].

OBJECTIVE: To investigate the correlation factors of ethylenediaminetetraacetic acid-dependent pseudothrombocytopenia (EDTA-PTCP) in cancer patients. METHODS: The potential correlation factors of EDTA-PTCP such as gender, age, case history, tumor types, therapeutic drugs and duration of EDTA-PTCP from cancer patients were analyzed based on the patient records from October 2007 to September 2009 at our cancer center. RESULTS: A total of 49 EDTA-PTCP cases from a pool of 55 000 cancer patients were collected. No correlation was found with gender (male 49.0%, female 51.0%), concurrent hypertension (20.4%)/diabetes (10.2%) or cancer types (1 - 11 cases each type). EDTA-PTCP appeared at pre-therapy (n = 13) and post-therapy (n = 36). Eleven cases (30.6%) were chemotherapy, 5 cases (13.9%) were radiotherapy plus chemotherapy, 15 case (41.7%) were tumor resection, 5 cases (13.9%) were interventional therapy in 36 patients whose EDTA-PTCP appeared post-therapy. The most frequency use in chemotherapy patients was dexamethasone (87.5%, 14/16), and in surgery patients was penicillin antibiotics (75.0%, 15/20). And its frequency was once (n = 18) and more than twice (n = 31). If the subjects were divided into 2 groups of non-treatment plus surgery and chemotherapy plus intervention on the basis of treatment course, there was a significant difference between two groups in proportion of patients whose duration of EDTA-PTCP ≤ 2 weeks (89.3% vs 47.6%, χ(2) = 10.22, P < 0.01). CONCLUSIONS: The incidence of EDTA-PTCP in cancer patients may be associated with therapeutic drugs, but not probably with gender, concurrent hypertension/diabetes, tumor types or therapeutic regimens. Duration of EDTA-PTCP may be associated with the treatment course.