Discriminant value of %microcytic cells/%hypochromic cells ratio in the differential diagnosis of microcytic anemia

Abstract

The Mindray 6800 Plus analyzer reports red cells (RBC) extended parameters, which represent the subsets of erythrocytes. We aimed to evaluate the reliability of RBC extended parameters in the differential diagnosis of microcytic anemia. The learning set comprised samples from 250 patients with microcytic anemia mean cell volume <80 fL. MH ratio (%microcytic cells/%hypochromic cells) and other discriminant functions were calculated. Optimal cut offs were established using receiver operator curves. This value was used in the validation set of 135 patients 50 carriers and 85 with mild iron deficiency anemia (IDA). Area under the curve 0.945 (95% confidence interval 0.890 to 0.977), cut off >10 rendered the best Youden index (0.798), sensitivity 93.2%, specificity 86.2%. In the validation set using MH ratio >10, 45 in 50 patients were correctly classified as carriers. All of 40 beta carriers were correctly classified, while the 5 false negatives resulted to be alpha carriers. In the IDA group 5 patients had MH ratio >10 and thus considered carriers, but all of them had Hyper <3%. The combination of MH ratio >10 and %Hyper <3% correctly classified 100% of IDA patients. An algorithm derived from RBC extended parameters provided by the Mindray 6800 Plus analyzer could be a useful tool in the differential diagnosis of microcytic anemia.

 

Mindray 6800+分析仪可报告红细胞(RBC)扩展参数,代表红细胞的子集。我们旨在评估RBC扩展参数在小细胞性贫血鉴别诊断中的可靠性。 学习集包括250名小细胞性贫血患者的样本,平均细胞体积<80 fL。计算了MH比值(%微红细胞/%低色素细胞)和其他判别函数。使用接收者操作曲线建立最佳的切分值。该值用于135名患者50名携带者和85名轻度缺铁性贫血(IDA)的验证集。 曲线下面积0.945(95%置信区间0.890~0.977),截止点>10呈现最佳的Youden指数(0.798),灵敏度93.2%,特异性86.2%。 在使用MH比值>10的验证集中,50名患者中有45名被正确分类为携带者。40名β携带者全部被正确分类,而5名假阴性结果为α携带者。 在IDA组中,有5名患者的MH比值大于10,因此被认为是携带者,但他们的Hyper都小于3%。MH比值>10和%Hyper<3%的组合对IDA患者进行了100%的正确分类。 由Mindray 6800+分析仪提供的RBC扩展参数推导出的算法可以成为小细胞性贫血鉴别诊断的有用工具。

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Published
2020-03-04
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Original Articles
Keywords:
Anemia, discriminant formulae, iron deficiency, thalassemia.
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  • Abstract views: 676

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How to Cite
Urrechaga, E. (2020). Discriminant value of %microcytic cells/%hypochromic cells ratio in the differential diagnosis of microcytic anemia. Thalassemia Reports, 10(1). https://doi.org/10.4081/thal.2020.8388