International Journal of Laboratory Hematology最新文献_第6页

Performance Evaluation of the Sysmex XN, XR, and DI-60 Body Fluid Applications for Leukocyte Differentiation Sysmex XN、XR和DI-60体液用于白细胞分化的性能评价

IF 2.3 4区医学 Q3 HEMATOLOGY

International Journal of Laboratory Hematology

Pub Date : 2025-07-08 DOI: 10.1111/ijlh.14530

Marth Briers, Nancy Boeckx, Lieselot Dedeene, Lien Gruwier, Christine Van Laer

Introduction

In response to the growing demand for automation in body fluid (BF) analysis, we evaluated the research four-part white blood cell (WBC) differentiation provided by the Sysmex XN and XR hematology analyzers (BF mode), as well as the Sysmex digital cell imaging analyzer DI-60 (CellaVision) BF application for microscopic analysis.

Methods

Cerebrospinal, pleural, peritoneal, and synovial fluid samples were analyzed. The four-part WBC differentiation (neutrophil, lymphocyte, monocyte, and eosinophil count (%)) provided by the XN- and XR-BF mode and the DI-60 BF application was compared to manual microscopic examination of May-Grünwald Giemsa stained cytocentrifuge slides. Additionally, the DI-60 BF application was assessed for its capability to detect malignancies.

Results

A total of 205 BF samples were included in the evaluation of the four-part WBC differentiation of the XN- and XR-BF mode. A very strong correlation coefficient (r_s) between the XN/XR analyzer and manual microscopic examination was observed for neutrophils (%): 0.851 (XN); 0.862 (XR) and lymphocytes (%): 0.833 (XN); 0.842 (XR). The XN and XR analyzers reported lower monocyte counts compared to manual microscopic examination (bias = −3.21% (XN); −1.16% (XR)). The eosinophil count (%) showed suboptimal correlation between the automated analyzers and manual microscopy (r_s = 0.428 (XN); 0.555 (XR)), probably due to low levels and outliers. Out of 161 cytospin slides, 39 could not be processed by the DI-60, resulting in 122 remaining samples. All WBC types showed strong correlation between the manual count and the DI-60 count (r_s values of 0.735–0.974).

Conclusions

The four-part WBC differentiation provided by the Sysmex XN- and XR-BF mode and the Sysmex DI-60 BF application are valuable tools for automating and standardizing BF analysis.

为了应对日益增长的对体液（BF）分析自动化的需求，我们评估了Sysmex XN和XR血液学分析仪（BF模式）提供的研究四部分白细胞（WBC）分化，以及Sysmex数字细胞成像分析仪DI-60 (CellaVision) BF应用于显微分析。方法：对脑脊液、胸膜液、腹膜液和滑液进行分析。XN-和XR-BF模式以及DI-60 BF应用提供的四部分WBC分化（中性粒细胞、淋巴细胞、单核细胞和嗜酸性粒细胞计数（%））与人工显微镜检查may - grind - gemsa染色的细胞离心玻片进行比较。此外，还评估了DI-60 BF应用于检测恶性肿瘤的能力。结果：共纳入205个BF样本，评估了XN-和XR-BF模式的四部分白细胞分化。XN/XR分析仪检测中性粒细胞与人工镜检有很强的相关系数（%）：0.851 (XN)；淋巴细胞（%）：0.833 (XN)；0.842 (XR)。与人工显微镜检查相比，XN和XR分析仪报告的单核细胞计数较低(偏差= -3.21% (XN)；-1.16% (XR))。嗜酸性粒细胞计数（%）与手工镜检呈次优相关性(rs = 0.428 (XN)；0.555 (XR))，可能是由于低水平和异常值。在161个细胞自旋玻片中，39个不能被DI-60处理，剩下122个样品。所有WBC类型人工计数与DI-60计数有较强的相关性（rs值为0.735 ~ 0.974）。结论：Sysmex XN-和XR-BF模式和Sysmex DI-60 BF应用程序提供的四部分白细胞分化是自动化和标准化BF分析的有价值的工具。

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引用次数: 0

Research Parameters in RBC Indices Shows Vital Importance in Screening α-Thalassemia 红细胞指标参数在α-地中海贫血筛查中具有重要意义。

IF 2.3 4区医学 Q3 HEMATOLOGY

International Journal of Laboratory Hematology

Pub Date : 2025-07-08 DOI: 10.1111/ijlh.14523

Liang Fu, Li Peng, Aiqun Li, Zhuowen Hu, Jingxian Liang, Shaoling Liu, Yimei Liu, Xiluan Yuan, Sijie He, Nan Yu

Background

The percentage of microcytic cells (%MICRO) and the percentage of hypochromic cells (%HYPO) were very useful in differentiating microcytic anemia, and hematological parameters had significant potential as predictive markers of the degree of α-gene deletions. This study aims to evaluate the value of these research parameters in screening for α-thalassemia compared to classical indices.

Methods

We analyzed the data of 402 subjects with α-thalassemia deletions and 553 normal subjects and evaluated the performance of each parameter with receiver operating characteristic (ROC) curves, sensitivity, and specificity. The correlation between red blood cell (RBC) indices and the number of α-genes deleted was also assessed.

Results

A close correlation was observed between the degree of α-gene deletions and cellular hemoglobin content (CH) (r = −0.835, p < 0.001), mean corpuscular hemoglobin (MCH) (r = −0.825, p < 0.001), and %MICRO+%HYPO (M + H) (r = 0.811, p < 0.001). The area under the curve (AUC) of CH consistently exceeded that of MCH (0.8988 vs. 0.8812, 0.987 vs. 0.984, 0.988 vs. 0.980, respectively). M + H exhibited better diagnostic performance than MCH in predicting two and three α-gene deletions (AUC 0.987 vs. 0.984, and 0.991 vs. 0.980, respectively). A CH < 23.35 pg. strongly suggests the presence of two α-gene deletions; when M + H > 89.40% or CH < 19.35 pg, a precise preliminary diagnosis of Hb H disease could be made.

Conclusions

The research parameters in RBC indices have vital importance in screening for α-thalassemia and can serve as an effective preliminary screening tool to predict the number of α-gene deletions.

背景：小细胞百分比（%MICRO）和低色细胞百分比（%HYPO）对鉴别小细胞性贫血非常有用，血液学参数作为α-基因缺失程度的预测指标具有重要的潜力。本研究旨在评价这些研究参数与经典指标在α-地中海贫血筛查中的价值。方法：对402例α-地中海贫血缺失患者和553例正常人的资料进行分析，用受试者工作特征曲线（receiver operating characteristic， ROC）、敏感性和特异性评价各参数的性能。红细胞（RBC）指数与α-基因缺失数的相关性也被评估。结果：α-基因缺失程度与细胞血红蛋白含量（CH）密切相关（r = -0.835, p 89.40%或CH）。结论：RBC指标中的研究参数对α-地中海贫血筛查具有重要意义，可作为预测α-基因缺失数量的有效初步筛选工具。

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引用次数: 0

Bone Marrow Basophil Evaluation in Myeloproliferative Neoplasms Using Flow Cytometry 流式细胞术评价骨髓增殖性肿瘤的骨髓嗜碱性粒细胞。

IF 2.3 4区医学 Q3 HEMATOLOGY

International Journal of Laboratory Hematology

Pub Date : 2025-07-04 DOI: 10.1111/ijlh.14520

Yuan Meng, Hongyan Liao, Yongmei Jin, Nenggang Jiang

Introduction

The aim of this study was to evaluate the characteristics of bone marrow (BM) basophils in myeloproliferative neoplasm (MPN) using flow cytometry (FCM). Basophils have been known to be elevated in chronic myeloid leukemia (CML) through blood analyzers or microscopes, but these methods are not reliable for identifying BM basophils, and the changes in BM basophils in non-CML MPN were unclear.

Methods

BM basophils of 101 MPN were evaluated by FCM, assessing indices related to basophil levels and CD63/CD203c expression. PB basophils were counted by blood analyzer. The basophil characteristics of MPN were compared to that of 95 individuals without hematopoietic disorders and 30 newly diagnosed myelodysplastic neoplasms (MDS).

Results

MPN patients showed increased levels of BM basophils and basophils with CD203c expression compared to normal or reactive group. Although weak correlation was observed, BM basophil levels were statistically different from those in PB. Comparing basophil characteristics between non-CML MPN and normal or reactive group, BM basophil indices demonstrated higher elevated counts than PB basophil indices in MPN. BM baso/lym ratio and basophil percentage were most effective in distinguishing non-CML MPN from non-hematopoietic disorders, while PB basophil indices demonstrated limited discriminative value. Most of the basophil indices of CML were different from those of normal group, reactive basophilia, non-CML MPN and MDS. CML could be discriminated from non-hematopoietic disorders by all basophil indices, with BM baso/lym ratio, PB basophil count and PB baso/lym ratio demonstrating superior capacity of discrimination.

Conclusions

BM basophil indices, particularly the baso/lym ratio, enhance MPN identification and outperform PB basophil indices in discriminating non-CML MPN from non-hematopoietic disorders. These findings indicate BM basophil analysis by FCM could serve as a potential tool for MPN screening.

前言：本研究的目的是利用流式细胞术（FCM）评估骨髓增生性肿瘤（MPN）中骨髓（BM）嗜碱性粒细胞的特征。嗜碱性粒细胞在慢性髓性白血病（CML）中通过血液分析仪或显微镜被发现升高，但这些方法在鉴别骨髓性粒细胞方面并不可靠，而且在非CML MPN中骨髓性粒细胞的变化尚不清楚。方法：采用流式细胞仪检测101个MPN的BM嗜碱性粒细胞，评估嗜碱性粒细胞水平及CD63/CD203c表达相关指标。血液分析仪检测PB嗜碱性粒细胞。将MPN的嗜碱性细胞特征与95例无造血功能障碍患者和30例新诊断的骨髓增生异常肿瘤（MDS）患者进行比较。结果：与正常或反应组相比，MPN患者BM嗜碱性粒细胞和CD203c表达的嗜碱性粒细胞水平升高。虽然观察到弱相关性，但BM的嗜碱性粒细胞水平与PB有统计学差异。比较非cml MPN与正常或反应组的嗜碱性粒细胞特征，MPN中BM嗜碱性粒细胞指数高于PB嗜碱性粒细胞指数。基底淋巴比和嗜碱性粒细胞百分比是区分非cml型MPN和非造血疾病最有效的指标，而嗜碱性粒细胞指数的区分价值有限。CML的大部分嗜碱性指标与正常组、反应性嗜碱性、非CML MPN和MDS均有差异。CML可通过所有的嗜碱性指标与非造血疾病区分，其中BM碱性/淋巴比、PB嗜碱性计数和PB碱性/淋巴比具有较强的区分能力。结论：BM嗜碱性粒细胞指数，特别是基底/淋巴比值，增强了MPN的识别，并且在区分非cml MPN和非造血疾病方面优于PB嗜碱性粒细胞指数。这些结果表明，FCM分析骨髓嗜碱性粒细胞可作为MPN筛选的潜在工具。

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引用次数: 0

Clinical Study on the Assessment of Infection-Induced Disseminated Intravascular Coagulation (DIC) and Its Prognosis in Neonates by Tissue-Type Plasminogen Activator-Plasminogen Activator Inhibitor-1 Complex 组织型纤溶酶原激活物-纤溶酶原激活物抑制剂-1复合物评价新生儿感染诱导的弥散性血管内凝血（DIC）及其预后的临床研究

IF 2.3 4区医学 Q3 HEMATOLOGY

International Journal of Laboratory Hematology

Pub Date : 2025-07-04 DOI: 10.1111/ijlh.14516

Xu Wei, Jinlin Wu, Ge Zhang, Chuyang Lin, Lei Ye

Background

Disseminated intravascular coagulation (DIC) is a critical complication in neonatal infections, necessitating early detection to reduce mortality. This study investigates the clinical utility of the tissue-type plasminogen activator-plasminogen activator inhibitor-1 complex (t-PAIC) in assessing infection-induced neonatal DIC.

Methods

A retrospective analysis of 61 neonates with infections (July 2021–February 2023) at West China Second University Hospital categorized patients into DIC (n = 23) and non-DIC (n = 38) groups using the Chinese DIC scoring system (CDSS). Univariate, multivariate, ROC, and Kaplan–Meier analyses evaluated t-PAIC levels, and a nomogram model was developed. A prospective study (March 2023–January 2024) with 53 neonates validated the t-PAIC threshold for DIC prediction.

Results

t-PAIC (OR = 1.332, p = 0.045), thrombin time (TT) (OR = 2.317, p = 0.014), and aspartate aminotransferase (AST) (OR = 1.008, p = 0.014) were independent DIC risk factors. t-PAIC predicted DIC with an AUC of 0.783 (p = 0.000), sensitivity of 0.652, and specificity of 0.816. A t-PAIC threshold ≥ 8.85 ng/mL increased DIC risk and mortality (HR = 3.434, p = 0.01). The nomogram combining t-PAIC, TT, and AST showed superior predictive performance (AUC = 0.896, sensitivity = 0.826, specificity = 0.842). The prospective study confirmed t-PAIC ≥ 8.85 ng/mL as a predictive marker for DIC (p < 0.05).

Conclusion

t-PAIC is an independent DIC risk factor in neonates with infections. A t-PAIC level ≥ 8.85 ng/mL significantly increases DIC risk and mortality, highlighting its clinical utility in assessing infection-induced neonatal DIC.

背景：弥散性血管内凝血（DIC）是新生儿感染的重要并发症，需要早期发现以降低死亡率。本研究探讨了组织型纤溶酶原激活剂-纤溶酶原激活剂抑制剂-1复合物（t-PAIC）在评估感染诱导的新生儿DIC中的临床应用。方法：回顾性分析华西第二大学医院61例感染新生儿（2021年7月- 2023年2月），采用中国DIC评分系统（CDSS）将患者分为DIC组（n = 23）和非DIC组（n = 38）。单因素分析、多因素分析、ROC分析和Kaplan-Meier分析评估了t- pac水平，并建立了nomogram模型。一项涉及53名新生儿的前瞻性研究（2023年3月至2024年1月）验证了t- pac阈值用于DIC预测。结果：t- pac （OR = 1.332, p = 0.045）、凝血酶时间（OR = 2.317, p = 0.014）、天冬氨酸转氨酶（OR = 1.008, p = 0.014）是独立的DIC危险因素。t- pac预测DIC的AUC为0.783 (p = 0.000)，敏感性为0.652，特异性为0.816。t- pac阈值≥8.85 ng/mL会增加DIC风险和死亡率（HR = 3.434, p = 0.01）。t- pac、TT和AST联合的nomogram预测效果较好（AUC = 0.896，灵敏度= 0.826，特异性= 0.842）。该前瞻性研究证实t-PAIC≥8.85 ng/mL可作为DIC的预测指标(p)。结论：t-PAIC是感染新生儿DIC的独立危险因素。t- pac水平≥8.85 ng/mL显著增加DIC风险和死亡率，突出其在评估感染诱导的新生儿DIC中的临床应用。

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引用次数: 0

Assessing the Persistence and Relevance of Small T-LGL Clones via TRBC1 in a Flowcytometric Lymphoid Screening Tube 在流式细胞术淋巴细胞筛管中通过TRBC1评估小T-LGL克隆的持久性和相关性

IF 2.3 4区医学 Q3 HEMATOLOGY

International Journal of Laboratory Hematology

Pub Date : 2025-07-01 DOI: 10.1111/ijlh.14525

Nathan Debunne, Barbara Cauwelier, Helena Devos, Sylvia Snauwaert, Jan Emmerechts

Introduction

Recently, monoclonal antibodies targeting one of the two mutually exclusive constant regions of the TCR β receptor chain (TRBC1 and TRBC2) have been proposed as a surrogate tool for assessing T-cell clonality by flowcytometry. The detection of T-cell clones is typically interpreted in the context of malignancy. However, small T-cell clones of uncertain significance (T-CUS) are frequently identified, posing diagnostic and clinical challenges. Since 2022, TRBC1 was incorporated as a marker for T-cell clonality in our flowcytometric lymphoid screening tube (LST), a tube designed to detect both B- and T-cell aberrancies in the blood of patients with clinical suspicion of hematological malignancy. The objective of the current study was to systematically evaluate the frequency and size of T-cell clones identified at initial diagnosis and to evaluate clonal evolution in follow-up samples.

Methods

In this single-centre retrospective study (2022–2024), peripheral blood samples of 3495 unique patients were tested for T-cell clonality using TRBC1. The monotypic T-cell clones of > 50/μL were stratified into three groups: T-CUS1 (50–500 monotypic cells/μL), T-CUS2 (500–2000 monotypic cells/μL), and T-LGL (> 2000 monotypic cells/μL). Follow-up samples were obtained at least 6 months after initial testing (range: 6–30 months) and potential indicators of progression to T-CUS2 or T-LGL were evaluated.

Results

The majority of T-CUS clones (22/36, 61%) were not detected (< 50 monotypic cells/μL) at follow-up, thereby demonstrating the importance of evaluation of the persistance of small T-cell clones. Fifteen percent of patients with a T-CUS1 progressed to T-CUS2, but none to T-LGL (95% CI: 0%–15%). 22% (95% CI: 3%–60%) of T-CUS2 patients evolved to T-LGL, all of which showed aberrant expression of CD57. In the patient group who showed evolution to T-CUS2 or T-LGL, significantly lower hemoglobin levels and neutrophil counts were observed at the time of T-CUS detection. Additionally, in this group, comparable increases in monotypic T-cell clones were observed over time, with a main increment of 90 monotypic cells/μL per month (95% CI: 34%–145%).

Conclusions

The low number of persistence observed in T-CUS at follow-up highlights the need for cautious interpretation of small T-cell clones (T-CUS1). Low hemoglobin and neutrophil counts at diagnosis might indicate higher risk for progression and need for closer follow-up.

最近，针对TCR β受体链上两个相互排斥的恒定区域（TRBC1和TRBC2）之一的单克隆抗体被提出作为流式细胞术评估t细胞克隆性的替代工具。t细胞克隆的检测通常在恶性肿瘤的背景下解释。然而，不确定意义的小t细胞克隆（T-CUS）经常被发现，给诊断和临床带来挑战。自2022年以来，TRBC1被纳入我们的流式细胞淋巴筛管（LST）中作为t细胞克隆的标记物，LST是一种用于检测临床怀疑血液恶性肿瘤患者血液中B细胞和t细胞异常的试管。本研究的目的是系统地评估在初始诊断时鉴定的t细胞克隆的频率和大小，并评估后续样本中的克隆进化。方法：在这项单中心回顾性研究（2022-2024）中，使用TRBC1检测3495例特殊患者的外周血样本的t细胞克隆性。将> 50/μL的单型t细胞克隆分为T-CUS1（50-500个单型细胞/μL）、T-CUS2（500-2000个单型细胞/μL）和T-LGL(> 2000个单型细胞/μL) 3组。随访样本在初始检测后至少6个月（范围：6-30个月）获得，并评估进展为T-CUS2或T-LGL的潜在指标。结果：大多数T-CUS克隆（22/36,61%）未被检测到(结论：随访时观察到的T-CUS的持久性较低，表明需要谨慎解释小t细胞克隆（T-CUS1）。诊断时血红蛋白和中性粒细胞计数低可能表明进展的风险较高，需要更密切的随访。

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引用次数: 0

Concurrent Cryptococcus neoformans and Hematoidin in a HIV-Negative Male Patient on Peripheral Blood Smears 一名hiv阴性男性患者外周血涂片并发新型隐球菌和类血素。

IF 2.3 4区医学 Q3 HEMATOLOGY

International Journal of Laboratory Hematology

Pub Date : 2025-07-01 DOI: 10.1111/ijlh.14528

Hong Li, Ningning Zhao, Ting Li, Ying Bu, Hui Wang

引用次数: 0

Machine Learning for Discriminating Microcytic Hypochromic Anemia Based on Erythrocyte Parameters 基于红细胞参数的机器学习识别小细胞性低色素贫血。

IF 2.3 4区医学 Q3 HEMATOLOGY

International Journal of Laboratory Hematology

Pub Date : 2025-07-01 DOI: 10.1111/ijlh.14524

Jing Lv, Jinmi Li, Xiaodong Ren, Qing Huang, Shaoli Deng

Introduction

Thalassemia trait (TT) and iron deficiency anemia (IDA) are two common types of microcytic hypochromic anemia (MHA), but current diagnostic methods have limitations. This research sought to employ machine learning (ML) algorithms to identify MHA using erythrocyte parameters to distinguish between TT and IDA.

Methods

One hundred and ninety-three subjects with MHA (98 TT and 95 IDA) were retrospectively analyzed. The cohort was randomized to training set (60%), validation set (20%) and test set (20%). Erythrocyte parameters were collected on an automated hematology analyzer (DxH800, Beckman Coulter), and five ML algorithms were selected to build discriminant models, including Random Forest, XGBoost, logistic regression, AdaBoost and LightGBM. In the assessment of discriminant performance of different models, indicators including sensitivity, specificity, accuracy, AUC, NPV, PPV, cutoff, F1 score and Kappa coefficients were utilized.

Results

Among the five ML algorithms aforementioned, the Random Forest and logistic regression models presented excellent discriminant performance, outperforming other models in the testing set, with the AUC value, sensitivity, specificity, and ACC of 0.977, 0.928, 0.953, and 0.940 for Random Forest, and 0.978, 0.879, 0.979, 0.928 for logistic regression. Eight vital peripheral erythrocyte parameters were finally selected, including RBC, RDW, MCV, MCHC, RDWSD, HGB, MAF, and LHD.

Conclusion

We successfully developed a discriminant model using ML algorithms based on erythrocyte parameters to identify MHA rapidly from TT or IDA, which may assist patients in taking preventive measures.

地中海贫血（Thalassemia trait， TT）和缺铁性贫血（iron deficiency anemia， IDA）是两种常见的小细胞性低色素贫血（microcytic hypochromic anemia， MHA），但目前的诊断方法存在局限性。本研究试图采用机器学习（ML）算法来识别MHA，使用红细胞参数来区分TT和IDA。方法：对193例MHA患者（TT 98例，IDA 95例）进行回顾性分析。队列随机分为训练集（60%）、验证集（20%）和测试集（20%）。在自动血液学分析仪（DxH800, Beckman Coulter）上采集红细胞参数，选择5种ML算法建立判别模型，包括Random Forest、XGBoost、logistic回归、AdaBoost和LightGBM。在评价不同模型的判别性能时，采用敏感性、特异性、准确性、AUC、NPV、PPV、截止值、F1评分和Kappa系数等指标。结果：在上述5种ML算法中，Random Forest和logistic回归模型的判别性能优异，在测试集中优于其他模型，Random Forest的AUC值、灵敏度、特异度和ACC分别为0.977、0.928、0.953和0.940，logistic回归的AUC值分别为0.978、0.879、0.979和0.928。最终选取8个重要外周血红细胞参数，包括RBC、RDW、MCV、MCHC、RDWSD、HGB、MAF和LHD。结论：我们成功建立了基于红细胞参数的ML算法判别模型，可快速从TT或IDA中识别MHA，有助于患者采取预防措施。

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引用次数: 0

Diagnostically Challenging but Infrequent Aberrant Immunophenotypic Patterns in B-Lymphoblastic Leukemia/Lymphoma (B-ALL) b淋巴母细胞白血病/淋巴瘤（B-ALL）诊断上具有挑战性但罕见的异常免疫表型模式。

IF 2.3 4区医学 Q3 HEMATOLOGY

International Journal of Laboratory Hematology

Pub Date : 2025-06-29 DOI: 10.1111/ijlh.14522

Kritika Krishnamurthy, Joseph Sweeney, Qing Wang, Yanan Fang, Yang Shi, Yanhua Wang

引用次数: 0

Evaluating Unghosted Cells (UGC): An Automated Blood Cell Counter-Derived Novel Red Cell Research Parameter for Its Clinical Utility and Diagnostic Implications Across a Spectrum of Pathological Conditions 评估无宿主细胞（UGC）：一种自动血细胞反衍生的新型红细胞研究参数，用于临床应用和诊断各种病理条件。

IF 2.3 4区医学 Q3 HEMATOLOGY

International Journal of Laboratory Hematology

Pub Date : 2025-06-29 DOI: 10.1111/ijlh.14521

Anita Giri, Praveen Sharma, Dikshat Gopal Gupta, Minakshi Gupta, Pulkit Rastogi, Srinivasan Peyam, Aashima Arora, Alka Rani Khadwal, Elena Sukacheva, Prashant Sharma, Reena Das

Introduction

Automated estimation of poikilocytes by automated hematology analyzers remains challenging. The unghosted cells (UGC) parameter in Beckman Coulter UniCel DxH 800 analyzers has been reported to correlate with target cells and other conditions with increased erythrocytic osmotic resistance like microcytosis/hypochromia, sickle cells, and post splenectomy. We assessed UGCs' reference range and potential clinical utility in a specialist hematology laboratory.

Materials and Methods

We prospectively enrolled 520 participants, encompassing healthy individuals (n = 45), β-thalassemia trait (n = 196), hemoglobinopathies (n = 104), iron deficiency anemia (n = 88), liver disease (n = 46), spherocytosis (n = 18), and neonatal cord blood samples (n = 23). Peripheral blood EDTA samples were analyzed. UGC data were correlated with peripheral smear findings. In addition, red cell parameters including UGC were compared to differentiate β-thalassemia trait (βTT) from iron deficiency.

Results

UGCs were undetectable or present in very low numbers in healthy individuals (range 0%–0.01%). They demonstrated a significant positive correlation with manual target cell counts on peripheral smear (correlation coefficient, r = 0.64, p < 0.001). The highest UGC levels were observed in those with liver disease, with a median value of 0.395% (range: 0%–8.23%). All non-control subgroups, except for spherocytosis, showed significantly increased UGC% (p < 0.0001) vis-à-vis healthy individuals. A novel formula at a cut-off of 0.77 demonstrated 86.22% sensitivity and 93.10% specificity in differentiating βTT and IDA.

Conclusions

UGC% represents an innovative, automated hematological red cell research parameter capable of screening target cells and quantifying them. UGC shows significant potential for clinical diagnostic applications across a wide range of disorders characterized by target cells, facilitating differential diagnoses in clinical practice.

导言：自动化血液学分析仪对潜在细胞的自动估计仍然具有挑战性。据报道，Beckman Coulter UniCel DxH 800分析仪中的无宿主细胞（UGC）参数与靶细胞和其他红细胞渗透阻力增加的情况相关，如小细胞增多/低色素血症、镰状细胞和脾切除术后。我们在一个专业血液学实验室评估了UGCs的参考范围和潜在的临床应用。材料和方法：我们前瞻性地招募了520名参与者，包括健康个体（n = 45）、β-地中海贫血特征（n = 196）、血红蛋白病（n = 104）、缺铁性贫血（n = 88）、肝脏疾病（n = 46）、球形红细胞增生（n = 18）和新生儿脐带血样本（n = 23）。分析外周血EDTA样本。UGC数据与外周涂片结果相关。此外，我们还比较了包括UGC在内的红细胞参数，以区分β-地中海贫血性状（βTT）与缺铁。结果：UGCs在健康个体中检测不到或存在极低数量（范围为0%-0.01%）。它们与外周涂片上的人工靶细胞计数呈显著正相关（相关系数，r = 0.64, p）。结论：UGC%代表了一种创新的、自动化的血液学红细胞研究参数，能够筛选靶细胞并对其进行量化。UGC在以靶细胞为特征的各种疾病的临床诊断应用中显示出巨大的潜力，促进了临床实践中的鉴别诊断。

{"title":"Evaluating Unghosted Cells (UGC): An Automated Blood Cell Counter-Derived Novel Red Cell Research Parameter for Its Clinical Utility and Diagnostic Implications Across a Spectrum of Pathological Conditions","authors":"Anita Giri, Praveen Sharma, Dikshat Gopal Gupta, Minakshi Gupta, Pulkit Rastogi, Srinivasan Peyam, Aashima Arora, Alka Rani Khadwal, Elena Sukacheva, Prashant Sharma, Reena Das","doi":"10.1111/ijlh.14521","DOIUrl":"10.1111/ijlh.14521","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Automated estimation of poikilocytes by automated hematology analyzers remains challenging. The unghosted cells (UGC) parameter in Beckman Coulter UniCel DxH 800 analyzers has been reported to correlate with target cells and other conditions with increased erythrocytic osmotic resistance like microcytosis/hypochromia, sickle cells, and post splenectomy. We assessed UGCs' reference range and potential clinical utility in a specialist hematology laboratory.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>We prospectively enrolled 520 participants, encompassing healthy individuals (<i>n</i> = 45), β-thalassemia trait (<i>n</i> = 196), hemoglobinopathies (<i>n</i> = 104), iron deficiency anemia (<i>n</i> = 88), liver disease (<i>n</i> = 46), spherocytosis (<i>n</i> = 18), and neonatal cord blood samples (<i>n</i> = 23). Peripheral blood EDTA samples were analyzed. UGC data were correlated with peripheral smear findings. In addition, red cell parameters including UGC were compared to differentiate β-thalassemia trait (βTT) from iron deficiency.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>UGCs were undetectable or present in very low numbers in healthy individuals (range 0%–0.01%). They demonstrated a significant positive correlation with manual target cell counts on peripheral smear (correlation coefficient, <i>r</i> = 0.64, <i>p</i> < 0.001). The highest UGC levels were observed in those with liver disease, with a median value of 0.395% (range: 0%–8.23%). All non-control subgroups, except for spherocytosis, showed significantly increased UGC% (<i>p</i> < 0.0001) vis-à-vis healthy individuals. A novel formula at a cut-off of 0.77 demonstrated 86.22% sensitivity and 93.10% specificity in differentiating βTT and IDA.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>UGC% represents an innovative, automated hematological red cell research parameter capable of screening target cells and quantifying them. UGC shows significant potential for clinical diagnostic applications across a wide range of disorders characterized by target cells, facilitating differential diagnoses in clinical practice.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14120,"journal":{"name":"International Journal of Laboratory Hematology","volume":"47 6","pages":"1018-1024"},"PeriodicalIF":2.3,"publicationDate":"2025-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531976","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Uncovering Hidden Traces of K2EDTA Contamination in Citrated Blood Samples: A Novel Approach Using Fibrinogen Clot Waveform Graphs 在柠檬酸血液样本中发现隐藏的K2EDTA污染痕迹：一种使用纤维蛋白原凝块波形图的新方法。

IF 2.3 4区医学 Q3 HEMATOLOGY

International Journal of Laboratory Hematology

Pub Date : 2025-06-29 DOI: 10.1111/ijlh.14519

Ozben Ozden Isiklar, Evin Kocaturk, Kevser Setenay Oner, Ibrahim Ozkan Alatas

Background

Preanalytical mistakes in coagulation assays to a great extent affect diagnostic results. K₂EDTA contamination is one of the preanalytical mistakes that significantly interferes with assays of prothrombin time (PT), activated partial thromboplastin time (aPTT), fibrinogen, and thrombin time (TT).

Objective

To assess how different levels of K₂EDTA contamination influence coagulation test results and to evaluate the effectiveness of clot waveform analysis in identifying such contamination in citrated blood samples.

Methods

Contamination was introduced at varying concentrations (5%, 13%, 17%, 29%, 33%, 43%, and 100%) in citrated whole blood samples from 36 healthy volunteers. Coagulation assays for aPTT, PT, fibrinogen, and TT were performed using the Sysmex CN 6000 analyzer. Clot waveform analysis was used to detect contamination.

Results

The results revealed significant differences from the reference ranges for aPTT at contamination above 17% K₂EDTA and at 29% in PT and fibrinogen. As far as TT is concerned, significant changes were found from a contamination of 33%. Notably, fibrinogen second-derivative graphs showed min2 values above 0.31, with a sensitivity of 80.3%, specificity of 99.3%, and an area under the curve (AUC) of 0.94. These changes indicated a high likelihood of K₂EDTA contamination.

Conclusions

K₂EDTA contamination above 17% can significantly alter coagulation test results, potentially leading to diagnostic inaccuracies. Clot waveform analysis, particularly fibrinogen second-derivative graphs, can detect contamination, and proper sample collection guidelines are crucial for accuracy.

背景：凝血分析前错误在很大程度上影响诊断结果。K2EDTA污染是分析前错误之一，显著干扰凝血酶原时间（PT）、活化部分凝血活酶时间（aPTT）、纤维蛋白原和凝血酶时间（TT）的测定。目的：评价不同水平的K2EDTA污染对凝血试验结果的影响，评价血凝块波形分析在鉴别柠檬酸血样本中K2EDTA污染的有效性。方法：在36名健康志愿者的柠檬酸全血样本中引入不同浓度的污染（5%、13%、17%、29%、33%、43%和100%）。使用Sysmex CN 6000分析仪进行凝血检测aPTT、PT、纤维蛋白原和TT。血块波形分析用于检测污染。结果：结果显示，当K2EDTA污染超过17%，PT和纤维蛋白原污染超过29%时，aPTT与参考范围存在显著差异。就TT而言，33%的污染发现了显著的变化。值得注意的是，纤维蛋白原二阶导数图显示min2值大于0.31，灵敏度为80.3%，特异性为99.3%，曲线下面积（AUC）为0.94。这些变化表明K2EDTA污染的可能性很高。结论：K2EDTA污染超过17%可显著改变凝血试验结果，可能导致诊断不准确。凝块波形分析，特别是纤维蛋白原二阶导数图，可以检测污染，适当的样品收集指南是至关重要的准确性。

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引用次数: 0