Kneifati-Hayek Jerard, Fleischman William, Bernstein Larry H, Riccioli Anthony, Bellevue Rita
Department of Pathology, New York Methodist Hospital, Brooklyn, NY, USA Hunter College, New York, NY 11215, USA.
Lab Hematol. 2007;13(4):119-23. doi: 10.1532/LH96.07003.
beta-thalassemia screening is primarily limited to pregnant women. The ratio of the mean corpuscular volume (MCV) and red blood cell count (RBC) can be automatically calculated with any of the newer hematology analyzers.
The results of 398 patient screens were collected. Data from the set were divided into training and validation subsets. The Mentzer ratio was determined through a receiver operating characteristic (ROC) curve on the first subset, and screened for thalassemia using the second subset. HgbA2 levels were used to confirm beta-thalassemia.
We determined the correct decision point of the Mentzer index to be a ratio of 20. Physicians can screen patients using this index before further evaluation for beta-thalassemia (P < .05).
The proposed method can be implemented by hospitals and laboratories to flag positive matches for further definitive evaluation, and will enable beta-thalassemia screening of a much larger population at little to no additional cost.
β地中海贫血筛查主要局限于孕妇。平均红细胞体积(MCV)与红细胞计数(RBC)的比值可通过任何一种新型血液分析仪自动计算得出。
收集了398例患者的筛查结果。将该数据集的数据分为训练子集和验证子集。通过第一个子集的受试者工作特征(ROC)曲线确定门策尔比值,并使用第二个子集筛查地中海贫血。血红蛋白A2水平用于确诊β地中海贫血。
我们确定门策尔指数的正确判定点为比值20。医生可在对β地中海贫血进行进一步评估之前,使用该指数对患者进行筛查(P < 0.05)。
所提出的方法可由医院和实验室实施,以标记出阳性匹配结果以便进行进一步的确定性评估,并且能够以很少甚至无需额外成本对更多人群进行β地中海贫血筛查。