Tao Yi-feng, Deng Zeng-fu, Liao Lin, Qiu Yu-ling, Chen Wen-qiang, Lin Fa-quan
Affiliated Tumor Hospital of Guangxi Medical University, Nanning, Guangxi, China.
Ann Hematol. 2015 May;94(5):747-51. doi: 10.1007/s00277-014-2270-2. Epub 2014 Dec 12.
The objective of this study is to compare and evaluate the diagnostic value of hereditary spherocytosis (HS) by three screening tests, comparing mean spherical corpuscular volume (MSCV) to mean corpuscular volume (MCV), mean corpuscular hemoglobin concentration (MCHC), and flow cytometric osmotic fragility test. Peripheral blood was collected from 237 participators diagnosed at the First Affiliated Hospital of Guangxi Medical University, including 56 hereditary spherocytosis patients, 86 thalassemia patients, and 95 healthy people. The samples were examined by three tests, and the three screening tests were evaluated by the sensitivity and specificity of tests. The sensitivity was only 41.07%, and specificity was 94.47% when using MCHC >355 g/L as diagnostic criteria. The sensitivity was 89.28%, and specificity was 96.14% when using MSCV < MCV as the optimum cutoff point. When using the residual red cell percentage <23.6% as the diagnostic threshold in flow cytometric osmotic fragility test, the sensitivity was 85.71% and the specificity was 97.24%. Flow cytometry osmotic fragility test or comparing MSCV to MCV combined with smear examination of peripheral red blood cells morphology can be a simple, practical, and accurate hereditary spherocytosis (HS) laboratory screening method.
本研究的目的是比较和评估三种筛查试验对遗传性球形红细胞增多症（HS）的诊断价值，将平均球形红细胞体积（MSCV）与平均红细胞体积（MCV）、平均红细胞血红蛋白浓度（MCHC）以及流式细胞术渗透脆性试验进行比较。从广西医科大学第一附属医院确诊的237名参与者中采集外周血，其中包括56例遗传性球形红细胞增多症患者、86例地中海贫血患者和95名健康人。对样本进行三项试验检测，并通过试验的敏感性和特异性对这三项筛查试验进行评估。以MCHC>355 g/L作为诊断标准时，敏感性仅为41.07%，特异性为94.47%。以MSCV＜MCV作为最佳截断点时，敏感性为89.28%，特异性为96.14%。在流式细胞术渗透脆性试验中，以残余红细胞百分比<23.6%作为诊断阈值时，敏感性为85.71%，特异性为97.24%。流式细胞术渗透脆性试验或将MSCV与MCV进行比较并结合外周红细胞形态涂片检查，可成为一种简单、实用且准确的遗传性球形红细胞增多症（HS）实验室筛查方法。
