ABSTRACT
Objective:To assess the role of Delta-RBC parameters in the automated hematocrit analyzer RET channel for the recognition of cold agglutinins (CA) and to explore the value of RET channel optical method parameters in correcting interference with CA.Methods:This is a retrospective study. The Cas group included 68 samples with Cas interference and the control group included 45 samples without CA interference. All specimens were collected from Zhongshan Hospital Fudan University Outpatient Department from January 2022 to January 2023. Specimens in both the CA and Control group were examined using the CBC+RET channel at room temperature. Recorded and calculated the Impedance method test parameters RBC-I, HGB, HCT-I, MCH-I, MCV-I, MCHC-I and the Optical method test parameters RBC-O, HCT-O, MCH-O, R-MFV, MCHC-O, Delta-RBC. Examined the specimens in the CA group using the CBC channel after prewarmed at 37 ℃ for 2 h, and Impedance method parameters RBC-I 37 ℃ 2 h, HGB 37 ℃ 2 h, HCT-I 37 ℃ 2 h, MCH-I 37 ℃ 2 h, MCV-I 37 ℃ 2 h, MCHC-I 37 ℃ 2 h were recorded. The ROC curves were used to analyze the discrimination efficacy of Delta-RBC in identifying CA interference, and the Bland-Altman method was used to analyze the consistency between the results of the optical method RBC parameters at room temperature and the results of the impedance method after prewarming. The correlation analysis was performed using Pearson and Spearman correlation analysis to analyze the results of the RBC parameters before and after prewarming in the CA group. Result:If Delta-RBC was used as diagnostic indicators for the identification of CA interference, the best cut-off value was 1.065, with AUCs of 0.998. In the CA group, the correlation coefficients between RBC-O, HCT-O, R-MFV, MCH-O, MCHC-O, and RBC-I 37 ℃ 2 h, HCT-I 37 ℃ 2 h, MCV-I 37 ℃ 2 h, MCH-I 37 ℃ 2 h, MCHC-I 37 ℃ 2 h were 0.985, 0.981, 0.729, 0.870, and 0.649, respectively. The percentages within the limits of agreement of the percentage differences between the results of the two methods were 95.6%, 92.6%, 95.6%, 94.1%, and 95.6%, respectively. Conclusions:The RBC parameter Delta-RBC from RET channel optical method can be used as an indicator to effectively assist in the clinical determination of the presence of CA. Reporting results using the optical method RBC parameters of the RET channel can correct the interference of CA without specimen pre-treatment and obtain more correct results of complete blood counts.