Comparative evaluation of schistocyte counting by an automated method and by microscopic determination
Comparative evaluation of schistocyte counting by an automated method and by microscopic determination
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DOI：
10.1309/my7077989kwdyp88
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发表时间：
2004-05-01
影响因子：
3.5
通讯作者：
Lecompte, T
中科院分区：
文献类型：
--
作者：
Lesesve, JF;Salignac, S;Lecompte, T
血细胞是循环中的红细胞碎片。裂细胞的形态学鉴定是困难的，因为它们所对应的形状仍在讨论中。自动血液学系统允许直接测量RBC碎片。我们将不同生物学家和技术人员进行的裂细胞计数与ADVIA 120（Bayer Health Care，Tarrytown，NY）的自动计数进行了比较。ADVIA 120和观察者平均值之间的一致性给出了0.7274的相关系数（95%置信区间，0.6285-0.8019）。ADVIA 120有高估计数的趋势（平均值，+0.445%）。无假阴性病例记录。在0.25%的阈值下确定分析仪的最大灵敏度（检测100%的裂细胞样本），但特异性较低（20%）。因此，血涂片检查仍然有必要确认裂细胞的存在。然而，临床特征尤其与阴性自动RBC碎片相关，RBC碎片的高阴性预测值排除了血栓形成事件（大血管病或微血管病）。
Schistocytes are circulating RBC fragments. The morphologic identification of schistocytes is difficult because the shapes to which they correspond are still under discussion. Automated hematology systems permit the possibility of direct measurement of RBC fragments. We compared schistocyte counts performed by different biologists and technicians with the automated counts by the ADVIA 120 (Bayer Health Care, Tarrytown, NY). The agreement between the ADVIA 120 and the average of the observers gives a correlation coefficient of 0.7274 (95% confidence interval, 0.6285-0.8019). The ADVIA 120 has a tendency to overestimate the count (average, +0.445%). No false-negative case was recorded. The maximum sensitivity (detection of 100% of samples with schistocytes) of the analyzer was determined at a threshold value of 0.25%, but the specificity was low (20%). Therefore, a blood smear examination remains necessary to confirm schistocyte presence. However, the clinical features correlated particularly with negative automated RBC fragments, and the high negative predictive value of RBC fragments ruled out thrombotic events (macroangiopathies or microangiopathies).