Joutovsky Alla, Nardi Michael
Department of Pathology, New York University School of Medicine and Bellevue Hospital Center, New York, NY 10016, USA.
Arch Pathol Lab Med. 2004 Apr;128(4):435-9. doi: 10.5858/2004-128-435-HCAHOV.
Current standards for laboratory accreditation from the College of American Pathologists state that when high-performance liquid chromatography (HPLC) is used as a screening test, all non-A, non-S abnormal hemoglobin (Hb) variants must be confirmed by an alternative method, including alkaline and acid electrophoresis.
To determine whether confirmation of Hb C and Hb O-Arab variants by an alternative method is required when using the Bio-Rad Variant II HPLC system.
We reviewed 48 478 consecutive hemoglobin identification test results performed on the Bio-Rad Variant II HPLC system during the period November 15, 2000 to January 15, 2003.
Special Hematology Laboratory, Department of Pathology, Bellevue Hospital Center, New York, NY.
The chromatogram patterns and retention times (RTs) for specimens containing Hb C and Hb O-Arab were analyzed. We compared the results by the HPLC method with those by the confirmatory tests (alkaline and acid electrophoresis) for both variants.
We identified 3668 cases of abnormal hemoglobin variants, including 660 cases of Hb C trait (17%), 5 cases of Hb O-Arab trait (0.1%), and 1 case of Hb SO-Arab (0.03%). A unique pattern of separation on the chromatogram for Hb O-Arab was revealed, presenting as 2 distinct peaks in 2 different manufacturer-defined RT windows, namely, D and C. The chromatogram for Hb C did not show the D window in any of the reviewed cases. The RT in the C window (C-RT) revealed a statistically significant difference for Hb C and Hb O-Arab (5.18 +/- 0.01 minutes and 4.91 +/- 0.01 minutes, respectively; P <.001).
According to our review, the identification of Hb C and Hb O-Arab is accurate using HPLC methodology, as performed by the Bio-Rad Variant II HPLC system. This method can be both confirmatory and diagnostic at the same time.
美国病理学家学会当前的实验室认可标准指出，当使用高效液相色谱法（HPLC）作为筛查试验时，所有非A、非S异常血红蛋白（Hb）变异体必须通过替代方法进行确认，包括碱性和酸性电泳。
确定使用伯乐Variant II HPLC系统时，是否需要通过替代方法对Hb C和Hb O-Arab变异体进行确认。
我们回顾了2000年11月15日至2003年1月15日期间在伯乐Variant II HPLC系统上进行的48478例连续血红蛋白鉴定试验结果。
纽约市贝尔维尤医院中心病理科特殊血液学实验室。
分析含有Hb C和Hb O-Arab标本的色谱图模式和保留时间（RTs）。我们将HPLC方法的结果与两种变异体的确认试验（碱性和酸性电泳）结果进行了比较。
我们鉴定出3668例异常血红蛋白变异体，包括660例Hb C性状（17%）、5例Hb O-Arab性状（0.1%）和1例Hb SO-Arab（0.03%）。揭示了Hb O-Arab在色谱图上独特的分离模式，在两个不同的厂家定义的RT窗口（即D和C）中呈现为2个不同的峰。在任何回顾的病例中，Hb C的色谱图均未显示D窗口。C窗口中的RT（C-RT）显示Hb C和Hb O-Arab之间存在统计学显著差异（分别为5.18±0.01分钟和4.91±0.01分钟；P<.001）。
根据我们的回顾，使用伯乐Variant II HPLC系统进行的HPLC方法能够准确鉴定Hb C和Hb O-Arab。该方法可同时进行确认和诊断。
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