ABSTRACT
The advent of automation has made diagnosis of Anemia and to some extent its underlying cause easy. The objective of our study is to correlate RBC indices and RBC Histogram findings with peripheral smear to provide a better approach in accurate diagnosis of Anemia and to analyze their limitations. All cases of Anemia as per WHO reference range of Hemoglobin levels were included in our study. Patients who have received medical treatment for Anemia in past three months, patients having recent history of blood transfusion, patients having Leukemia or Leukemoid reactions were excluded from the study. Venous blood samples collected from these patients were run in SYSMEX automated hematology analyzer and complete blood count, Red Blood Cell (RBC) indices ie, Mean Corpuscular Volume (MCV), Mean Corpuscular Hemoglobin (MCH), Mean Corpuscular Hemoglobin Concentration (MCHC), Red Cell Distribution Width (RDW) and RBC Histogram were obtained and peripheral smears were examined. Anemia typing was done based on RBC indices and position, shape and skewing of RBC histograms, followed by peripheral smear examination for morphological typing of Anemia. The diagnoses made by peripheral smear versus RBC histogram and indices were compared and analysed
ABSTRACT
Context: The International Consensus Group for Hematology Review (ICGHR) are essentially review criteria designed to reduce the number of manual smear reviews following analysis in automated hematology analyzers (AHAs). Although AHAs are an indispensable part of the present-day clinical laboratory, manual smear reviews still play an integral role in identifying morphological abnormalities and to confirm the results of the analyzers. Aims: The aim of this study is to evaluate the efficacy of the ICGHR criteria and our laboratory criteria using the Sysmex XN-1000 for manual peripheral smear review (MSR). Study Design: A prospective cross-sectional comparative study between the two sets of criteria for MSR was performed. Material and Methods: A total of 860 whole blood samples sent over a period of 19 months for complete blood count testing to our laboratory were collected using systematic random sampling. Truth tables were prepared for each set of criteria. Tests of proportion were used to compare performance specifications between both sets of criteria. Results: Using ICGHR criteria, sensitivity was 81.58%, specificity was 84.61%, 83.38% positive predictive value, and 82.92% negative predictive value. The microscopic smear review rate was 47.56% and efficiency was 83.14%. Using our laboratory criteria, sensitivity was 98.80%, specificity was 41.40%, positive predictive value of 61.46%, and negative predictive value of 97.34%. The microscopic smear review rate was 78.14% and efficiency 69.30%. Conclusions: There was a significant reduction in the microscopic smear review rates using the ICGHR criteria compared to our laboratory criteria. The ICGHR criteria can thus be adapted to daily laboratory practice provided they are first optimized and locally validated before use.
ABSTRACT
Objective To investigate the technical charactenstics ot SYSMEX XS1000i 5-part differential automated hematological analyzer and its clinical applications.Methods 209 samples were analyzed with the analyzer of XS1000i and compared to the results from Beckman-Coulter LH750 analyzer.The main parameters from XS1000i,such as precision within-run,day to day precision and carryover contamination rates etc,were recorded respectively in 509 samples to compare the difference between the instrumental and optical examination.Results All variation coefficients of precision from XSI000i were within the manufacturer.The carryover contamination rates of WBC,RBC,Hb,HCT and PLT were 0.19%,0.93%,0,-0.88%,-0.76%,respectively.The parameters of XS1000i were correlated with the results of LH750 except basophil granulocyte.The correlation coefficients of WBC,RBC, HGB and PLT were 0.994 5,0.996 8,0.997 0 and 0.974 6 ,respectively.The sensitivity of warning flags in immature leukocytes was 100% and the specificity was 69.7%,the sensitivity of warning flags in atypical lymphocyte was 100% and the specificity was 66.7%.Especially in 3 leukocytopenia that was induced by chemotherapy in patients with leukemia who had only few immature cells existed in the peripheral blood,the parameters of XS1000i were positive,and correlated with the results of detection of minimal residual disease with flow cytometry.Conclusions The warning system of XSIO00i provides more valuable information for manual microscopic examination.If it is combined with flow cytometry,the advantages in detection of residual leukemic cell will be fully displayed.