ArticleJournal of clinical laboratory analysis2026
Flow Cytometric Lymphocyte Subset Enumeration for Lymphopenia Grading and C-Reactive Protein-Defined Inflammation Discrimination.
Article in Journal of clinical laboratory analysis, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundTo determine whether flow cytometric lymphocyte subset enumeration could reproduce conventional absolute lymphocyte count (ALC)-based lymphopenia grading and add information for discriminating C-reactive protein (CRP)-defined inflammation.
methodsWe retrospectively analyzed 2896 hospitalized adults with concurrent complete blood count and flow cytometric lymphocyte subset analysis (T, CD4+ T, CD8+ T, B, and natural killer cells). CRP-defined inflammation was defined as high-sensitivity CRP ≥ 10 mg/L. The 974 patients with measured CRP constituted the prespecified primary discrimination cohort. Spearman correlations, receiver operating characteristic analyses with Youden-derived cutoffs, quadratic-weighted kappa, five-fold internal validation, and multivariable logistic regression were used.
resultsT-cell absolute count correlated most strongly with ALC (rho = 0.886), largely reflecting its dominant contribution to the total lymphocyte pool. Internally optimized T-cell cutoffs of 700, 573, and 356 cells/μL showed substantial agreement with conventional grading (weighted kappa = 0.792). For CRP-defined inflammation (20.9%), conventional and T-cell grades showed only modest discrimination (areas under the curve, 0.611-0.622). B-cell count had the numerically highest single-marker area under the curve (0.667), although all single-marker values remained below clinically actionable thresholds. Parsimonious multivariable models incorporating B-cell count yielded modest cross-validated areas under the curve (0.628-0.642), whereas a full five-subset model exhibited severe collinearity and unstable coefficients.
conclusionT-cell count serves as an internally optimized surrogate for conventional lymphopenia grading rather than an independent classifier. For CRP-defined inflammation, lymphocyte subset models offer limited cross-sectional discrimination, with B-cell count providing the most reproducible incremental signal.
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