JPH02304357A - Analysis of blood data - Google Patents

Abstract

PURPOSE:To exactly and efficiently inspect blood by inputting the data from a blood cell counter to an analyzing instrument and deciding that the presence of blasts or immature white blood cells is suspected by specific decision conditions. CONSTITUTION:The blood cell counter 1 dilutes and hemolyzes the blood, reduces the red blood cells and platelets, determines a white blood cell grain size distribution from a white blood cell sample, and inputs the same to the analyzing instrument 2. The instrument 2 sets the boundaries between ghost components and small-size particles, between the small-size and middle-size particles, as well as between the middle-size and large-size particles in the grain size distribution, designates the size of the particle having a peak value as XWCP, the particles having the peak values in the respective distribution areas as XSCP, XLCP, the number of the small-size and middle-size particles as SCC, MCC, the total number of the white blood cells as WBC and (a) to (m) as constants. The instrument decides that the presence of the blasts or immature white blood cells is suspended when one of the conditions of equation I to equation III is satisfied. The blood inspection is exactly and efficiently executed in this way.

Description

DETAILED DESCRIPTION OF THE INVENTION [Industrial Application Field] The present invention relates to a blood data analysis method for obtaining specimen information useful in clinical tests from data obtained by counting blood cells or the like.

[Conventional technology]

2. Description of the Related Art Hematology counting devices that count the number of white blood cells, red blood cells, etc. in blood are widely used in the field of clinical testing, and the obtained data is used as diagnostic data. The basic function of a blood cell counter is to obtain numerical data such as white blood cell count, red blood cell count, hemoglobin amount, and platelet count, but recently it has become possible to also obtain particle size distribution maps of white blood cells, red blood cells, and platelets. It is becoming. A particle size distribution diagram, for example, shows the size of particles on the horizontal axis (X-axis).
This is a graph showing the relationship between particle size and frequency, with frequency plotted on the vertical axis (Y-axis).

For example, the standard particle size distribution of white blood cells is represented by a particle size distribution diagram as shown in Section 5-1, and this particle size distribution curve shows various changes when there is an abnormality in the sample. Therefore, various abnormalities such as neutropenia, neutrophilia, lymphopenia, and lymphocytosis can be determined based on this particle size distribution map.

[Problem to be solved by the invention]

However, conventionally, such abnormalities have been determined by visually observing the particle size distribution map, and with this method, it is necessary to rely on experience, so the abnormality judgment may be uncertain. This results in individual differences and is inefficient. Furthermore, the representation format of particle size distribution is not necessarily uniform among multiple types of blood cell counters, and therefore particle size distribution charts are generally difficult to use.

By the way, white blood cells are made up of many types of particles.
Therefore, its content ratio varies greatly.

Therefore, when determining whether a specimen is abnormal, it is important to determine the white blood cell particle size distribution. When counting white blood cells, the white blood cell sample used is blood prepared by subjecting blood to pretreatment such as dilution and hemolysis to destroy red blood cells. In this case, the contents of the red blood cells are eluted and the red lf[1 bulb membrane is reduced in size, and the platelets are also reduced in size. This reduced red blood cell membrane and platelets become dish-forming components (ghost components). On the other hand, white blood cells are also reduced in size by the hemolytic treatment, but by performing this hemolytic treatment under certain conditions, lymphocytes are reduced to small particles, and single F group eosinophils, basophils, and blastocytes are reduced to medium-sized particles. Therefore, the neutrophil fii can be made into large particles. The ghost components are even smaller than the small particles, so by setting a boundary between them, the white blood cell count can be determined and the white blood cell size distribution can be determined.

In the leukocyte sample, for example, lymphoid immature cells are larger than mature lymphocytes, and jli F,
The particles are smaller than the . Moreover, neutrophil-based immature cells have a size intermediate between small particles and large particles, and the particles become larger as they mature. Therefore, when such immature leukocytes are present, a change is observed in the leukocyte particle size distribution. If such non-ψ1 leukocytes are present or if L17 buds distributed as medium-sized particles are present, adult T-cell leukemia or chronic myeloid leukemia (CML) is suspected.

Judgments of such abnormalities are made by referring to the number of medium-sized particles and particle size distribution charts, but when testing samples from Oharu, it is necessary to examine the samples with high cocoon weight, which are dominated by abnormalities. If the samples are screened in advance, inspection efficiency will be greatly improved.

An object of the present invention is to provide a blood test system that enables easy determination of the presence of blast cells or immature leukocytes, thereby greatly improving the efficiency of blood testing. The objective is to provide a method for analyzing data.

[Means to solve the problem]

In the blood data analysis method of the present invention, blood is diluted and hemolyzed to reduce red blood fJ and platelets, turn lymphocytes into small particles, and reduce the size of table tennis and eosinophilia.

A white blood cell sample was prepared with basophils and blast cells as medium-sized particles and neutrophils f and d as large particles, and from this white blood sample I, g, white blood cell sample was prepared. Particle size distribution is required.

In this white group r;) particle size distribution, there are boundaries between the ghost component consisting of the reduced red blood I, y and platelets and small particles, a boundary between small particles and medium particles, and a boundary between medium particles and large particles. Set each boundary and set the particle size of each boundary to XWl, respectively.

Let XT,,XT,. Further, the size of the particle that takes the peak value in the white group f, y particle size distribution is defined as XWCP, and the size of the particle that takes the peak value in each distribution region of small particles and medium particles is respectively xscp.

X1. CP. Further, the number of small particles and the number of medium particles are respectively SCC and MCC, and the total number of white blood cells is WB C.
shall be. Using these, the following (a), ([1), (c)
, (d).

(The possibility of the existence of blast cells or white groups f and g is determined according to the determination conditions expressed in the ladle.

(() X T l --X W L
>a and scc>1. Or X5CP>c (b) MCC>d and XTt>e and XT2-XT,>f (c) X T + < B and XT2>h and X T , < X W CP < X T g (d)
WBC-SCC>j and XLCP<k and XT, -XWL>0 and XT2-XT, = 0 (ne) W B C> rn and XT, -XWL=0 However, a, b, c, d, e, r, g, h, j.

k and m are constants. Above (a), (u), (c), (
When at least one of the judgment conditions (d) and (f) is satisfied, it is determined that there is a suspicion that blast cells or immature leukocytes are present.

[Effect]

According to the configuration of the present invention, the white blood cell sample is subjected to dilution and hemolytic treatment, thereby reducing the size of red blood Lff and platelets.1. : Lymphocytes are considered to be relatively small particles, neutrophils are considered to be relatively large particles, monocytes,
Eosinophils, basophils, and blastocytes are intermediate-sized particles. The particle size distribution of such a leukocyte sample is determined.

In the particle size distribution of this white blood cell sample, ghost components consisting of red blood cell membranes and platelets that have been reduced in size due to cold blood treatment are
Small particles (Lymph I, )) appear in the region of even smaller particles. and small particles.

Mountains appear in the particle size distribution curve for each of medium-sized particles and large particles (neutrophils). The classification of these particles is based on the valley (minimum point) between the distributions of each particle in the particle size/li curve.
This is done by setting boundaries.

In the leukocyte sample, the lymphoid immature cells are:
It is larger than an adult lymphocyte, and smaller than a relatively small cell among medium-sized particles.

In addition, neutrophil-based immature cells have a size intermediate between medium-sized particles and large-sized particles, and the more mature the cells, the larger they are. Therefore, if such immature leukocytes are present, changes will occur in the leukocyte particle size distribution such that the position where the boundary is set is different from the particle size distribution of a normal leukocyte sample. In addition, blast cells are medium-sized particles;
When these germs are present, the number of medium-sized particles increases and a significant change appears in the white blood cell particle size distribution.

In this invention, determination regarding the possibility of the presence of blast cells or immature leukocytes is performed in five cases. That is, the first case is when there are lymphoid-based immature cells (Fig. 6), and the second case is when there are some neutrophil-based immature cells (Fig. 7). The third case is when the number of neutrophil-based immature cells is increased compared to the second case (Fig. 8), and the peak in the white blood cell particle size distribution is in the distribution area of medium-sized particles. This is the case when it exists.

Furthermore, in the fourth case, the number of neutrophil-based immature cells has increased even more than in the third case, and as a result, in the particle size distribution curve of the white blood cell sample, there are two peaks corresponding to medium-sized particles and one corresponding to large particles. This is the case when the particle size distribution curve becomes bimodal with two peaks (FIG. 9). Fifth, the number of medium-sized particles increases due to the presence of buds, resulting in a unimodal particle size distribution curve (Figure 1O).

In the first case (Figure 6), the immature cells of the lymphoid lineage are larger than their mature cells, so the trough between the distribution of small particles and the distribution of medium particles in the particle size distribution curve is formed shifting to the larger particle side than in the normal case. Therefore, the boundary (T,) set at the valley is set closer to the large particle side than in the normal case. This means that the particle sizes at the boundary (ridge) between the GoI/S component and the small particle and the boundary (T, ) between the small particle and the medium particle are respectively expressed as XWL and XT, and the constant is d. , XT, −XWL>a. Furthermore, when young lymphoid cells are present, the number of small particles SCC increases, or the peak in the distribution area of small particles (SCP) appears closer to the large particles than usual. Therefore, along with the above formula, the size of the particle that takes the peak value in the distribution area of small particles is expressed as
5CP, b.

If scc>b or X5CP>c holds, where C is a constant, the presence of lymphoid immature cells is suspected.

In the second case (FIG. 7), the number of medium-sized particles increases due to the presence of immature cells of the neutrophil lineage. Neutrophil blast cells are medium-sized particles, but neutrophil immature cells become larger as they grow. Therefore, when young neutrophil cells are present, medium-sized particles, which are distributed slightly toward the large-sized particles, increase. Therefore, the boundary (T t ) between the medium-sized particles and the large-sized particles is set to be shifted toward the large-sized particles side compared to the normal case. Furthermore, in the particle size distribution curve, if the boundary (T,) between small and medium particles is set at the same position as in the normal case, this boundary (T,) and the boundary (T,) between medium and large particles The width between
The number of medium-sized particles is MCC, the particle size at the boundary (T2) between medium-sized particles and large particles is XT, and d, e,
If f is a constant, MCC>d, XTz>e, and x"rz -XT,>f hold, then the presence of neutrophil Ly immature cells is suspected.

In the third case of L (FIG. 8), the number of medium-sized particles increases due to an increase in neutrophil-based immature cells. However, in this case, the particle size distribution curve of the leukocyte sample is still trimodal. Therefore, in this case, the boundary (T, ) between the small particles and the medium particles is set to be shifted to the small particle side compared to the normal case, and the boundary (T2) between the medium particles and the large particles is set to the large particle side. It is set by moving to the side. moreover,
The peak of the particle size distribution (WCP) is in the distribution region of medium-sized particles.

Therefore, the determination condition for this third case is g.

If h is a constant and the size of the particle that takes the peak value in the particle size distribution is xwcp, it can be expressed as XTI <g and XT, >h and XT, <XWCP<XTz. ,
The presence of immature neutrophil cells is suspected.

In the fourth case (Figure 9), the number of medium-sized particles increases due to the increase in neutrophil-based immature cells, and the particle size distribution curve changes to 2111.
It becomes monosexual. The conditions for this are XT,-XWL>0 and XTz-XT,=0. Also, the number of medium-sized particles is increasing, but in this case it is not possible to calculate the number of medium-sized particles and the number of large particles separately, so the number of small particles SC is calculated from the white blood cell count WBC.
The condition is that the value obtained by subtracting C is larger than a certain value. Furthermore, the particle size corresponding to the peak (LCP) formed on the large particle side (i.e., the distribution area of medium and large particles) from the boundary (T1) between small and medium particles is within the range of medium particles. becomes. Therefore, let the particle size at the peak (LCP) be XLCP,
, k as a constant, and if the previous two equations hold true, and if WBCSCC>j and XLCP<k hold true, an increase in the number of young neutrophil cells is suspected.

In the fifth case (FIG. 10), the particle size distribution becomes unimodal due to the presence of blast cells. The conditions for this are the boundary (T,
, Ti) are not set, and the necessary and sufficient condition is that XT, -XWL case0 holds true. That is, the boundary (T'l) between the small particles and the medium particles coincides with the boundary (WL) between the ghost component and the small particles. In addition, the presence of germs is a case of chronic myelogenous leukemia, etc., and therefore the number of white blood cells is abnormally high. therefore,
If WBC>m holds true with m as a constant, the existence of sprouts is suspected.

In this invention, determinations are made regarding each of the first to fifth cases, and if any of the determination conditions is satisfied, it is determined that the presence of blast cells or immature leukocytes is suspected.

〔Example〕

FIG. 1 is a block diagram showing the overall configuration for implementing an embodiment of the present invention. Data from the blood T:li counter 1 is input to the data analysis device 2 as a serial signal. In the data analysis device 2, the serial signal is input to the data communication circuit 4 via the line driver 3 and converted into a parallel signal. This parallel signal is C
It is manually operated by a calculation means 7 having a PU (central processing unit) 5 and a memory 6. In this calculating means 7, the data from the blood cell counter 1 is analyzed, and the results are printed out to a printing device 9 via a human output interface 8, and are also printed out on a CRT (condensed wire tube), liquid crystal display, etc. The information is displayed on the display device IO.

The contents outputted to the printing device 9 or the display device 10 include detection data from the blood cell counting device 1 and various messages based on the analysis results. These messages include: ■ Abnormal message, which indicates that there is clearly an abnormality in the sample, ■ Suspect message, which indicates that there is a high possibility that an abnormality exists in the sample, and ■ Normal message, which indicates that the sample is normal with a high degree of accuracy. There are action messages that instruct the next action to be taken in response to the messages, and (1) the above messages (2) to (2).

The calculation means 7 is prepared with messages (1) to (3) corresponding to each of white blood cells, red blood cells, and platelets, and the suspect messages regarding white blood cells will be explained in more detail below.

Regarding white blood cells, the following suspects are available.

(al RBCIntr,: red blood cells are white blood cells) It is possible that the count value is affected.

(b) EO/'BASO/Bj! a s L s
:Good M ball.

There is a suspicion that either halophilic 7S cells or blast cells are increasing.

(C) MONO/EO/B l a s L s
: There is a suspicion that there is an increase in single cells, eosinophils, or blast cells.

(dl 1ncr, Monocytes: An increase in monocytes is suspected.

(e) BfasLs/Itnm, Canes: The presence of blasts or immature leukocytes is suspected.

(fl Reac L, I-y m p
h: The presence of 3% type lymphocytes is suspected.

(gl 1mm, Neu't, /le r LSh
ifL: non-v1 neutrophil LF is present, nuclear left shift (Lef
L 5hift) is suspected.

(hl NRBC/PI-T Cffiumps/
Fib.

InLf: Either nucleated red blood cells, platelet collection, or fibrin precipitation is present, which is suspected to be affecting the white blood cell count.

(il NRB C: The presence of nuclear red blood cells is suspected.

ω Incr, EO: An increase in eosinophils is suspected.

(k) Large Cells: The presence of large leukocytes is suspected.

CITI) T2Miss-3et: A setting error in boundary T2 is suspected (boundaries 1 and 2 will be described later).

This example describes (e) °'BffiasL.
This is related to the determination when outputting the suspect message "s/[mrn, Ce1ls".

The counting of white blood cells, red blood cells, and platelets in the blood counting device 1 and the data processing thereof are performed according to the following procedure.

First, the blood collected from the specimen is subjected to (IL coagulation treatment) and subjected to blood cell counting. The sample subjected to this 111 treatment is introduced into a detection section having micropores, and blood cells are counted.

In the case of white-faced samples, dilution and hemolytic treatment destroy red blood cells that interfere with white blood cell counting.

That is, the contents of the red blood cells are eluted, the red blood cell membrane is reduced in size, and the platelets are further reduced in size. In the hemolytic treatment, white blood cells also shrink, but since they have a nucleus, they remain as particles. By performing this hemolytic treatment under certain conditions, the lymphocytes in the white blood cell sample are made into relatively small particles, the neutrophils are made into relatively large particles, and other monocytes and eosinophils are made into intermediate particles. It can be a particle of any size.

Furthermore, eosinophils can be formed into slightly larger particles than eosinophils.

White blood subjected to such hemolytic treatment 1. Samples for red blood cells and platelets that are not subjected to blood cell processing are introduced into the red blood cell system detection section inside the blood cell counter 1, and samples for red blood cells and platelets that are not subjected to blood cell processing are introduced to the red blood cell system detection section. Each detection unit has, for example, a first chamber and a second chamber separated by a partition wall in which micropores are formed,
A sample is allowed to pass through the micropores, and a change in impedance between the first chamber and the second chamber when the particles pass is detected. This change in impedance corresponds to the size of particles passing through the micropores, and therefore the size of particles passing through the micropores can also be detected. The particle size distributions of white blood cells, red blood cells, and platelets can be obtained by performing analog/digital conversion on the signals from such a detection unit and adding up digital values.

The standard distribution state of particles in the white surface Li sample after the final blood treatment is shown in FIG. Ghost component G (reduced red blood cell membrane and platelets) is present in the Shirogumi tX sample.
, small particles SC (such as lymphocytes), medium-sized particles MC (such as monocytes, 5 eosinophils, basophils, and bud fop), and large particles LC (such as neutrophils) each have variations in size. It's mixed. The particle size distribution obtained from a leukocyte sample having such a distribution is a composite of the above-mentioned components, and the particle size distribution diagram is shown in FIG. 3.

The reference symbol βl corresponds to the small particles SC1, the medium particles MC and the large particles LC, respectively.

The mountains shown in g2.13 are formed.

There is a boundary W at the valley part (minimum point) of such a particle size distribution curve.
l7. T1. By setting Tz, it becomes possible to count the number of small, 5, medium, and large particles in white blood cells. When the particle size distribution curve does not have a valley, a boundary may be set at an inflection point.

Normally, the particle size of lymphocytes is 54 to 60.
(fl) (often 54 (A1.)), and neutrophils have a peak distribution between 156 and +84 (fN).

In terms of medium-sized particle MC, table tennis tends to be relatively small,
Also, the acid taste is biased towards relatively large species. Furthermore, basophils and blastocytes are widely distributed throughout almost the entire distribution area of medium-sized grains 7-MC. This can be determined by observing a smear of the saliva of an abnormal specimen that contains a large amount of each particle, and by creating a white blood cell particle size distribution map of the blood of this abnormal specimen. In addition, each inner plate f4 is
This can also be confirmed by obtaining the particle size distribution of each white blood cell after dispersing i-cells.

Generally, the valley of the particle size distribution moves under the influence of the frequency of adjacent particle groups. That is, for example, particle A
Assume that the particle size distribution of a particle group including particles B and particles B, which are larger than particles A, is as shown in FIG.

However, the reference sign! The mountain indicated by A is due to particle A and is referenced 7! The mountain indicated by B is due to particle B.# Also, in Figure 4 [+], (2), the frequency of particle B is different, and the frequency of particle B is higher in the case shown in Figure 4 and 1 (2). There are many.

As is clear from the comparison in Figure 4 (+3.
shift towards the distribution. In other words, when the frequency of the particles is constant, it is possible to determine whether the frequency of the grain B increases or decreases based on the software of the valley (2).

Furthermore, due to the increase in the frequency of the particles B, the frequency at the valley V becomes a high value. This also applies to the determination of increase or decrease in the number of particles B]! can be made standard.

FIG. 5 shows an example of a typical particle size distribution for a leukocyte sample. The horizontal axis is the particle size, and the vertical axis is the relative frequency (%) with the peak of the distribution as 100. The boundaries WL, T, ,T are set in the valleys between the distributions of the ghost component G, small white blood cells SC1, medium white blood cells MC, and large white blood cells LC, respectively.

Numerical data regarding this leukocyte test f4 are as follows.

White blood cell count 63 XIO2/μp Small white blood cell ratio 36.8% Medium white blood cell ratio 10.0% Large white blood cell ratio 53.2% Small white blood cell count 23 XIO”/μp Medium white blood cell count 6 XIO”/μ2 Human-shaped white blood cell count 34 xlO''/μl Each data regarding the sample for white blood cell group y is given from the blood cell counter 1 to the data analysis device 102 along with each data regarding the red blood cell and platelet samples.

White blood cells are composed of many types of particles, and their content ratios vary widely. Furthermore, depending on the disease, cells that do not normally appear may appear. Therefore, the particle size distribution of the leukocyte sample is highly variable, and abnormalities such as various diseases can be determined from the particle size distribution of the leukocyte sample. For example, in cases such as adult T-cell leukemia (ATL), immature lymphoid EJ cells appear, and in cases of chronic myeloid leukemia (CML) and leukomytoid reactions, blast cells appear; Due to such an abnormality, the particle size distribution curve of the leukocyte sample greatly deviates from the normal particle size distribution curve.

In the following, in the above-mentioned suspect message, "Blas L s71mm" shown in (e).

The procedure until "Celes'" is output will be explained.

This suspicion message indicates that blast cells or immature leukocytes are suspected to be present. In this case, in this example, cases where blast cells or uny1 white blast cells are present are roughly classified into five types. That is, in the first case, there are lymphoid immature cells (Figure 6).
The second type is granulocytic cells (eosinophilic 17k, basophilic cells,
There are young neutrophils (especially neutrophils), but their ratio to one cell is relatively small, so there are mountains corresponding to small particles SC, medium particles MC, and large particles LC. This is the case when the AVF particle size distribution curve is formed (FIG. 7). Thirdly, there is a case where the number of young cells increases more than in the second case, and the peak of the particle size distribution of the white blood cell sample exists in the distribution area of medium-sized particles MC (Fig. 8). The particle size distribution also has three peaks. Furthermore, fourthly, the number of juvenile cells of the F system further increases, making it impossible to establish the boundary T2 between the medium-sized particles MC and the large particles LC, and therefore the small particles SC
In the fifth case, the particle size distribution curve becomes bimodal with peaks formed only in response to MC and medium-sized particles MC (Figure 9), and in the fifth case, the particle size distribution curve becomes peaked due to the presence of blast cells. case (10th
Figure).

(a) First case (Figure 6) Lymphocytes are small particles SC, but young lymphoid cells are distributed slightly closer to the large particles LC than lymph f and y. As a result, the particle size distribution of a leukocyte sample obtained from blood containing immature lymphoid cells is as shown in FIG. 6. In other words, the valley between the distribution of small particles SC and the distribution of medium particles MC is set to be shifted toward the large particle LC side compared to the normal case shown in FIG. Therefore, the boundary T
The particle size XT in , becomes larger than usual. As a result, the width SCB between the boundaries WL and T becomes larger than in the normal case (42 (around fj)). This means that the particle size XW at the boundary WL,
Using L and a constant, XT, -XWL>a (f
l) −(1).

Furthermore, when lymphoid immature cells are present, the number of small particles SC may be larger than normal, or a peak (A flash point) in the distribution area of small particles 7-3C may occur.
It is set to the large grain -7-IC side than in the case of P cut1m (') (after 54 (fffi)+in).

This reduces the particle size at peak SCP to
CP, 1), and c as a constant, respectively, SCC>
b (XIO”/μ2) ... (2) XSCP>
It can be expressed as c (f l) - (3). Therefore, the above formula (1) holds true, and
If the above formula (2) or formula (3) holds true, the presence of lymphoid immature cells is suspected.

It has been confirmed that highly accurate determination is possible by setting the constants a, b, and c as follows.

a...54-59 b...25-30 C...66-71 (b) Second case (Figure 7) Neutrophil blasts are medium-sized particles It is widely distributed on the head of MC, and its young cells become large particles as they mature. Therefore, when young neutrophil cells appear, as shown in FIG. 7, the number MCC of medium-sized particles increases and the boundary 'r.

The width MCB between T2 is larger than in the normal case shown in FIG. Furthermore, since cells at the unsuccessful stage are mixed, particles with a size intermediate between medium particles MC and large particles LC slightly increase. As a result, the boundary Tt is set closer to the large particle LC side than usual.

Therefore, d.

e, (with constant, MCC>d (X l O”/μl) ... (4
) and xTt>e(rl) ... (5
) and XT, -XT,>r (If (1) - (6) holds true, the presence of neutrophil-based immature cells is suspected.

It is preferable that the ten constants d, e, and r are set as follows, and by such settings, highly accurate I
It has been confirmed that 11 constants are possible.

d...7~15 e...-=・126~1:, (lf...
- 48-53 The best results were obtained when the constant d was IO.

(c) Case 3 (Figure 8) When the proportion of immature neutrophils is relatively high and the proportion of mature cells is relatively small, the particle size distribution of the white blood cell sample is as shown in Figure 8. As shown in the figure, the peak WCP is in the distribution region of medium-sized particles MC. In this case, the medium-sized particles −〇 will also increase, so the boundary ′” will be smaller than the normal case shown in FIG.
The boundary T is set by moving toward the C side, and the boundary T is set by moving toward the C side with larger particles t than usual. Therefore, with g and h as constants, XT, <g CEPri ... (7) and XTz >h (f l) ... (8
)KaX T + < X W CP < X T z
... If (9) holds true, the presence of immature neutrophil cells is suspected. However, xwcp is the particle size at the peak WCP of the particle size distribution, and is written as (
Equation 9) is a condition for the peak WCP to exist in the distribution region of medium-sized particles MC. It has been confirmed that highly accurate determination is possible by setting the constants g, h, and constants g and h within the following ranges, respectively.

g...73-78 h...126-131 If the number of neutrophil-based immature cells is increasing, the white blood cell count WBC is also increasing, so the above item (7) 2nd to 9th (9th)
With the formula, WBC> i (X l O"/μP)...
00), it can also be determined that the number of young cells is increasing. However, i is a constant, and preferably has a value of about 10, for example.

(d) Case 4 (Figure 9) If there are fewer mature neutrophils and more immature cells than in case (c) above, the particle size distribution of the white blood cell sample will be as shown in Figure 9. As shown, the particle size distribution is 2M, with two peaks corresponding to the small particles SC and medium particles MC.

In this case, it is not possible to set the boundary ``2'' (
Boundary T,,T.

6), so first XT, -XT, =0 ・-・Cl11
holds true. Furthermore, in order for the distribution of small particles SC to form a mountain, the boundary WL and the boundary T1 must not be defeated, so that XT, -XWL>O... 0. Furthermore, although an increase in medium-sized particles MC is observed, it is not possible to calculate the number of medium-sized particles MC when the particle size distribution becomes bimodal. It can be set as a constant that WBC-3CC>j(XIO"/μN) (13) holds true.Then, the large particle LC side of the boundary T1 (i.e., the distribution area of medium and large particles ) is considered to exist in the distribution region of medium-sized particles MC, so if the particle size at the peak LCP is XLCP and k is a constant, XLCP<k (f12) -011) holds true. In this way, if all of the above-mentioned generations 01) 2 to 04 are established, the existence of neutrophil-type immature cells is suspected.The above constant j is set as follows. , highly accurate judgment is possible.

J...10-25 k...138-144 Regarding the constant j, it has been shown that a value around 20 is particularly good (1'&?2).

(e) Case 5 (Figure 10) In the case of chronic myeloid leukemia (CML) or leukomyeloid reaction, blast cells appear, and in this case, the particle size distribution of the leukocyte sample is as shown in Figure 10. This results in a unimodal particle size distribution as shown in . In this case, the white blood cell count WBC becomes abnormally high. Therefore, the appearance of blast cells can be detected using the following determination conditions, where m is a constant.

WBC>m (X 102/lt l) -θ and XT, -χW l = O... 0ω The above formula 00 is a condition for the boundary WL, T to lose once, and this condition is satisfied. In this case, the particle size distribution can be said to be unimodal. In addition, fixed 1! By selecting a value of Im between 500 and 800, highly accurate determination is possible.

Each determination according to (a), (b), (c), (d), and (e) above is performed in the data analysis device 2, and depending on any of the determinations, the presence of bud or immature hemorrhage f,) is determined by the data analysis device 2. If you suspect that
'Bfa s L s/1mm.

The suspect message “Ce1ls” is output.At this time, the action message “Re
v, Srn r, (Review Smear
)” is output, prompting the examiner to check the specimen.

As described above, according to this embodiment, it is determined based on certain determination conditions whether or not the presence of blast cells or immature white surface ■, j is suspected, and this determination is performed by the data analysis device 2,
The results are displayed and output on a display device IO or the like. Therefore, such a determination can be made accurately without depending on the experience of the inspector, and there are no individual differences among the people viewing the particle size distribution. In addition, since the above-mentioned judgment is performed automatically, it is possible to first screen a large number of samples and then test samples suspected of having an abnormality. Inspection work efficiency will be significantly improved.

〔Effect of the invention〕

As described above, according to the blood data analysis method of the present invention, it is determined whether or not the presence of blast cells or immature leukocytes is suspected based on certain determination conditions, so this determination is at the discretion of the examiner. The process can be performed accurately and efficiently without relying on experience. That is, when testing blood, first sieve out abnormal samples according to the present invention, and then perform a more detailed test on samples suspected of being abnormal.
It becomes possible to perform blood tests with good workability and accuracy.

[Brief explanation of drawings]

Fig. 1 is a block diagram showing the overall configuration for carrying out an embodiment of the present invention, and Fig. 2 is a diagram showing the standard distribution of neko in a blank sample after hemolysis treatment. , Figure 3 is a particle size distribution diagram corresponding to the distribution state of particles shown in Figure 2, and Figure 4 is a particle size distribution diagram corresponding to the distribution state of particles shown in Figure 2.
The figure is a particle size distribution diagram to explain changes in the particle size distribution curve due to changes in particle size distribution, Figure 5 is a particle size distribution diagram showing the standard particle size distribution of Shirogumi fM test sample 1, and Figures 6- Figure 1 shows the presence of blasts or immature leukocytes (0 blood tH).
FIG. 3 is a particle size distribution diagram of a test sample.

Claims (1)

[Claims] Blood is diluted and hemolyzed to reduce red blood cells and platelets, lymphocytes into small particles, monocytes, eosinophils, basophils and blasts into medium-sized particles, and neutrophils into medium-sized particles. A white blood cell sample made into large particles is prepared, and a white blood cell particle size distribution is determined from this white blood cell sample. Set the boundary with medium-sized particles and the boundary between medium-sized particles and large particles, and set the particle sizes of each boundary to XWL, XT_1, and XT, respectively.
_2, the size of the particle that takes the peak value in the white blood cell particle size distribution is XWCP, and the size of the particle that takes the peak value in the distribution area of small particles, medium-sized particles, and large particles of the white blood cell particle size distribution, respectively. Let XSCP and XLCP be the number of small particles and the number of medium particles, respectively, SCC and MCC, and let the total number of white blood cells be WBC, and let a, b, c, d, e, f, g, h, j, k, and m be constants, When at least one of the following conditions (a), (b), (c), (d), or (e) is met, it is determined that there is a suspicion that blast cells or immature leukocytes are present. A blood data analysis method characterized by: (b) XT_1-XWL>a and SCC>b or XSCP>c (b) MCC>d and XT_2>e and XT_2-XT_1>f (c) XT_1<g and XT_2>h and XT_1<XWCP<XT_2 ) WBC-SCC>j and XLCP<k and XT_1-XWL>0 and XT_2-XT_1=0 (e) WBC>m and XT_1-XWL=0