Relationship of VCS parameters for the detection of band form neutrophil and atypical lymphocyte in blood smear

Abstract

The increasing number of immature white blood cells in blood smear are helpful in the diagnosis of inflammation or infection.   Immature cells tend to be larger and have lower nuclear complexity than mature cells.   Thus, the changing of mean volume and mean complexity of cells indicate the presence of immature cells in blood circulation.   The Coulter LH 750 hematology analyzer uses the volume (V), conductivity (C), and scatter (S) technology for differential white blood cell count. We evaluated the neutrophil and lymphocyte VCS parameters of blood samples collected from 80 hematologically normal and 211 abnormal subjects with mean age of 53 ± 25 years. The results showed that there were significant higher mean neutrophil volume (MNV) (153.3 ± 15.2, P < 0.001) and standard deviation of neutrophil volume (SD-MNV) (26.6 ± 4.6, P < 0.001) in the samples with increased band form neutrophil (mean, 11.7 ± 10.2 %) when compared to healthy subjects (MNV = 147.5 ± 8.9, and SD-MNV = 21.1 ± 2.0).   There were correlations between MNV and SD-MNV and manual band form neutrophil count (r = 0.477, P < 0.001 and r = 0.194, P = 0.005, respectively).   In the blood samples with high atypical lymphocytes (mean, 6.6 ± 8.0 %), the standard deviation of lymphocyte volume (SD-MLV) (18.0 ± 3.2, P < 0.001) was increased when compared with healthy subjects (14.6 ± 1.4) and also moderate correlation (r = 0.407, P = 0.001) was found between both groups. This suggests that the abnormal MNV, SD-MNV and SD-MLV may be used as indicator for manual blood smear differential white blood cells count.  However, further study on known cases with neutrophilia or high atypical lymphocyte is needed.