在临床实践中使用 Mindray BC-6800plus 血液分析仪上的 Micro-RBC#、Macro-RBC%、"PLT 结块?"标志和 "PLT 异常直方图 "标志构建血小板计数-光学方法反射测试规则。

IF 3.8 2区 医学 Q1 MEDICAL LABORATORY TECHNOLOGY Clinical chemistry and laboratory medicine Pub Date : 2024-09-02 DOI:10.1515/cclm-2024-0739
Yang Fei, Zhi-Gang Xiong, Liang Huang, Chi Zhang
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引用次数: 0

摘要

目的:利用 RBC 或 PLT 相关参数建立 PLT-O 反射检验规则,可帮助实验室快速识别需要进行 PLT-O 复检的 PLT-I 受干扰标本:对6857份EDTA抗凝全血样本进行前瞻性PLT-I和PLT-O测试,按2:3的比例随机分为训练组和验证组。根据 PLT-I 和 PLT-O 结果的差异区分反射组和非反射组。通过比较训练集中的 RBC 和 PLT 参数差异和标志,我们找出了与 PLT-O 反射测试相关的因素。利用 Lasso 回归,然后通过单变量和多变量逻辑回归进行细化,选出了候选参数。根据这些参数构建了预测提名图,随后使用验证集进行了验证。同时还绘制了 ROC 曲线:结果:反射组和非反射组在 19 个参数上存在显著差异,包括 RBC、MCV、MCH、MCHC、RDW-CV、RDW-SD、Micro-RBC#、Micro-RBC%、Macro-RBC#、Macro-RBC%、MPV、PCT、P-LCC、P-LCR、PLR、"PLT 结块?"标志、"PLT 异常直方图 "标志、"IDA 贫血?"标志和 "RBC 异常直方图 "标志。经过进一步分析,微小红细胞(Micro-RBC)#、巨红细胞(Macro-RBC)%、"PLT 结块?"和 "PLT 异常直方图 "标志被确定为建立提名图的候选参数,其 AUC 为 0.636(95 %CI:0.622-0.650),灵敏度为 42.9 %(95 %CI:37.8-48.1 %),特异性为 90.5 %(95 %C1:89.6-91.3 %):作为对 ICSH41 指南的补充,所制定的规则可帮助实验室提高血小板计数测定的效率和准确性。
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Construction of platelet count-optical method reflex test rules using Micro-RBC#, Macro-RBC%, "PLT clumps?" flag, and "PLT abnormal histogram" flag on the Mindray BC-6800plus hematology analyzer in clinical practice.

Objectives: Utilizing RBC or PLT-related parameters to establish rules for the PLT-O reflex test can assist laboratories in quickly identifying specimens with interfered PLT-I that require PLT-O retesting.

Methods: Prospective PLT-I and PLT-O testing was performed on 6857 EDTA-anticoagulated whole blood samples, split randomly into training and validation cohorts at a 2:3 ratio. Reflex and non-reflex groups were distinguished based on the differences between PLT-I and PLT-O results. By comparing RBC and PLT parameter differences and flags in the training set, we pinpointed factors linked to PLT-O reflex testing. Utilizing Lasso regression, then refining through univariate and multivariate logistic regression, candidate parameters were selected. A predictive nomogram was constructed from these parameters and subsequently validated using the validation set. ROC curves were also plotted.

Results: Significant differences were observed between the reflex and non-reflex groups for 19 parameters including RBC, MCV, MCH, MCHC, RDW-CV, RDW-SD, Micro-RBC#, Micro-RBC%, Macro-RBC#, Macro-RBC%, MPV, PCT, P-LCC, P-LCR, PLR,"PLT clumps?" flag, "PLT abnormal histogram" flag, "IDA Anemia?" flag, and "RBC abnormal histogram" flag. After further analysis, Micro-RBC#, Macro-RBC%,"PLT clumps?", and "PLT abnormal histogram" flag were identified as candidate parameters to develop a nomogram with an AUC of 0.636 (95 %CI: 0.622-0.650), sensitivity of 42.9 % (95 %CI: 37.8-48.1 %), and specificity of 90.5 % (95 %C1: 89.6-91.3 %).

Conclusions: The established rules may help laboratories improve efficiency and increase accuracy in determining platelet counts as a supplement to ICSH41 guidelines.

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来源期刊
Clinical chemistry and laboratory medicine
Clinical chemistry and laboratory medicine 医学-医学实验技术
CiteScore
11.30
自引率
16.20%
发文量
306
审稿时长
3 months
期刊介绍: Clinical Chemistry and Laboratory Medicine (CCLM) publishes articles on novel teaching and training methods applicable to laboratory medicine. CCLM welcomes contributions on the progress in fundamental and applied research and cutting-edge clinical laboratory medicine. It is one of the leading journals in the field, with an impact factor over 3. CCLM is issued monthly, and it is published in print and electronically. CCLM is the official journal of the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) and publishes regularly EFLM recommendations and news. CCLM is the official journal of the National Societies from Austria (ÖGLMKC); Belgium (RBSLM); Germany (DGKL); Hungary (MLDT); Ireland (ACBI); Italy (SIBioC); Portugal (SPML); and Slovenia (SZKK); and it is affiliated to AACB (Australia) and SFBC (France). Topics: - clinical biochemistry - clinical genomics and molecular biology - clinical haematology and coagulation - clinical immunology and autoimmunity - clinical microbiology - drug monitoring and analysis - evaluation of diagnostic biomarkers - disease-oriented topics (cardiovascular disease, cancer diagnostics, diabetes) - new reagents, instrumentation and technologies - new methodologies - reference materials and methods - reference values and decision limits - quality and safety in laboratory medicine - translational laboratory medicine - clinical metrology Follow @cclm_degruyter on Twitter!
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