Plateau Technique de Biologie, Service d'Hématologie Biologique, CHU de Dijon, Dijon, France.
Int J Lab Hematol. 2010 Oct;32(5):519-23. doi: 10.1111/j.1751-553X.2009.01216.x. Epub 2010 Feb 2.
Hereditary spherocytosis (HS) is a common red blood cell disorder. It has been shown that the mean sphered corpuscular volume (MSCV), an artificial volume, is always lower than the MCV in HS and also in some autoimmune haemolytic anaemia (AIHA). Our purpose was to assess the reliability of MSCV in routine practise, and its relevance in screening for HS. Comparison of MSCV and MCV was undertaken in a prospective study of 366 patients with anaemia. In addition, included were patients previously diagnosed to have HS (n = 33) or AIHA (n = 16). When MSCV was lower than MCV, a flow cytometric (FC) test for HS was performed. Delta (MCV-MSCV) values >9.6 fl were obtained for all HS patients. A wider spread of delta (MCV-MSCV) values was obtained for AIHA patients whose red cells gave FC test results negative for HS. In the ROC curve analysis, the determination of delta (MCV-MSCV) value has a 90.57% specificity and 100% sensitivity for HS. MSCV is a reliable automated parameter indicating possible HS. When a delta (MCV-MSCV) value is >9.6 fl, the FC test and the Coombs test are required in the differential diagnosis of HS and some AIHA.
遗传性球形红细胞增多症（HS）是一种常见的红细胞疾病。已经表明，平均球形红细胞体积（MSCV）是一种人为的体积，总是低于 HS 以及一些自身免疫性溶血性贫血（AIHA）中的 MCV。我们的目的是评估 MSCV 在常规实践中的可靠性，以及其在筛查 HS 中的相关性。我们对 366 名贫血患者进行了前瞻性研究，比较了 MSCV 和 MCV。此外，还包括以前诊断为 HS（n=33）或 AIHA（n=16）的患者。当 MSCV 低于 MCV 时，对 HS 进行流式细胞术（FC）检测。所有 HS 患者的 MCV-MSCV 差值（Delta）均>9.6 fl。AIHA 患者的 Delta（MCV-MSCV）值分布更广泛，其 FC 检测结果为 HS 阴性。在 ROC 曲线分析中，Delta（MCV-MSCV）值的测定对 HS 具有 90.57%的特异性和 100%的敏感性。MSCV 是一种可靠的自动参数，提示可能存在 HS。当 Delta（MCV-MSCV）值>9.6 fl 时，需要进行 FC 检测和抗球蛋白检测，以对 HS 和某些 AIHA 进行鉴别诊断。
