{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T06:46:04Z","timestamp":1792133164704,"version":"4.4.0"},"reference-count":25,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T00:00:00Z","timestamp":1792022400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T00:00:00Z","timestamp":1792022400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100012226","name":"Fundamental Research Funds for the Central Universities","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100012226","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Laboratory Analysis"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>To determine whether flow cytometric lymphocyte subset enumeration could reproduce conventional absolute lymphocyte count (ALC)\u2010based lymphopenia grading and add information for discriminating C\u2010reactive protein (CRP)\u2010defined inflammation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We 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\u2010defined inflammation was defined as high\u2010sensitivity CRP \u2265\u200910\u2009mg\/L. The 974 patients with measured CRP constituted the prespecified primary discrimination cohort. Spearman correlations, receiver operating characteristic analyses with Youden\u2010derived cutoffs, quadratic\u2010weighted kappa, five\u2010fold internal validation, and multivariable logistic regression were used.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>T\u2010cell absolute count correlated most strongly with ALC (rho\u2009=\u20090.886), largely reflecting its dominant contribution to the total lymphocyte pool. Internally optimized T\u2010cell cutoffs of 700, 573, and 356 cells\/\u03bcL showed substantial agreement with conventional grading (weighted kappa\u2009=\u20090.792). For CRP\u2010defined inflammation (20.9%), conventional and T\u2010cell grades showed only modest discrimination (areas under the curve, 0.611\u20130.622). B\u2010cell count had the numerically highest single\u2010marker area under the curve (0.667), although all single\u2010marker values remained below clinically actionable thresholds. Parsimonious multivariable models incorporating B\u2010cell count yielded modest cross\u2010validated areas under the curve (0.628\u20130.642), whereas a full five\u2010subset model exhibited severe collinearity and unstable coefficients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>T\u2010cell count serves as an internally optimized surrogate for conventional lymphopenia grading rather than an independent classifier. For CRP\u2010defined inflammation, lymphocyte subset models offer limited cross\u2010sectional discrimination, with B\u2010cell count providing the most reproducible incremental signal.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jcla.70375","type":"journal-article","created":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T06:01:47Z","timestamp":1792130507000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Flow Cytometric Lymphocyte Subset Enumeration for Lymphopenia Grading and C\u2010Reactive Protein\u2010Defined Inflammation Discrimination"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5893-8822","authenticated-orcid":false,"given":"Shicheng","family":"Li","sequence":"first","affiliation":[{"name":"School of Computing Science and Artificial Intelligence Suzhou City University  Suzhou China"},{"name":"Suzhou Key Lab of Multi\u2010Modal Data Fusion and Intelligent Healthcare Suzhou City University  Suzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tingting","family":"Fu","sequence":"additional","affiliation":[{"name":"Department of Radiology The Fourth Affiliated Hospital of Soochow University, Suzhou Dushu Lake Hospital  Suzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yang","family":"Yang","sequence":"additional","affiliation":[{"name":"School of Computing Science and Artificial Intelligence Suzhou City University  Suzhou China"},{"name":"Suzhou Key Lab of Multi\u2010Modal Data Fusion and Intelligent Healthcare Suzhou City University  Suzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuwei","family":"Pu","sequence":"additional","affiliation":[{"name":"Department of General Surgery The Second Affiliated Hospital of Soochow University  Suzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5016-575X","authenticated-orcid":false,"given":"Wenying","family":"Yan","sequence":"additional","affiliation":[{"name":"School of Computing Science and Artificial Intelligence Suzhou City University  Suzhou China"},{"name":"Suzhou Key Lab of Multi\u2010Modal Data Fusion and Intelligent Healthcare Suzhou City University  Suzhou China"},{"name":"Key Laboratory of Symbolic Computation and Knowledge Engineering of Ministry of Education Jilin University  Changchun China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junjun","family":"Zhang","sequence":"additional","affiliation":[{"name":"PRaG Center, Center for Cancer Diagnosis and Treatment The Second Affiliated Hospital of Soochow University  Suzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,15]]},"reference":[{"key":"e_1_2_14_2_1","unstructured":"National Cancer Institute \u201cCommon Terminology Criteria for Adverse Events (CTCAE) Version 5.0 [Online] \u201d(2017)."},{"key":"e_1_2_14_3_1","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pmed.1002685","article-title":"Lymphopenia and Risk of Infection and Infection\u2010Related Death in 98,344 Individuals From a Prospective Danish Population\u2010Based Study","volume":"15","author":"Warny M.","year":"2018","journal-title":"PLoS Medicine"},{"key":"e_1_2_14_4_1","doi-asserted-by":"crossref","DOI":"10.1186\/s12879-023-08845-1","article-title":"Pooled Prevalence of Lymphopenia in All\u2010Cause Hospitalisations and Association With Infection: A Systematic Review and Meta\u2010Analysis","volume":"23","author":"Elcioglu Z. 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