Clinical Pathology Laboratory, Hospital Alessandro Manzoni, Lecco, Italy.
Clinical Pathology and Clinical Biochemistry, University of Milan, Milan, Italy.
Blood Transfus. 2020 Sep 22;18(5):406-412. doi: 10.2450/2020.0070-20. Epub 2020 Jul 22.
Although the clinical assessment of iron status is usually based on iron stores, a rapid and accurate diagnosis of iron deficiency is challenging since ferritin is often unavailable as an urgent test and its value is frequently increased in acute phase conditions. This study was therefore aimed at evaluating the diagnostic performance of the new Sysmex XN "Iron Deficiency?" (Iron-Def) parameter for identifying patients with iron deficiency.
The study population consisted of 688 consecutive patients (median age: 71 years; 341 women and 347 men), referred for routine diagnostics to the Laboratory of Clinical Pathology of Lecco Hospital, Italy. A complete clinical chemistry profile and haematological testing were performed for identifying iron deficiency anaemia.
A significant negative correlation was found between Sysmex XN Iron-Def and ferritin, serum iron, mean cell haemoglobin concentration, mean cell haemoglobin, mean corpuscular volume and age, while a positive correlation was noted with transferrin, percentage of microcytic red cell, red blood cell count and red blood cell distribution width. The diagnostic accuracy of Iron-Def for identifying patients with a percentage of saturation of transferrin <15% (n=104) was 84%, with a sensitivity of 0.952 and specificity of 0.538. A sub-analysis of 71 patients with ferritin <20 ng/dL yielded an even better diagnostic performance (86%, with a sensitivity of 0.935 and specificity of 0.620).
Although additional confirmatory investigations would be needed, the preliminary findings of our study attest that Iron-Def may be an easy, inexpensive, rapid and reliable parameter for screening iron deficiency anaemia.
尽管临床铁状态评估通常基于铁储存量，但由于铁蛋白通常无法作为紧急检测，并且其值在急性相条件下经常升高，因此快速准确地诊断缺铁具有挑战性。因此，本研究旨在评估新的希森美康 XN“缺铁？”（Iron-Def）参数识别缺铁患者的诊断性能。
研究人群由 688 例连续患者（中位数年龄：71 岁；341 名女性和 347 名男性）组成，这些患者因常规诊断而被转介至意大利莱科医院的临床病理学实验室。进行全面的临床化学分析和血液学检测以确定缺铁性贫血。
XN Iron-Def 与铁蛋白、血清铁、平均细胞血红蛋白浓度、平均细胞血红蛋白、平均红细胞体积和年龄呈显著负相关，而与转铁蛋白、小细胞比例、红细胞计数和红细胞分布宽度呈正相关。Iron-Def 识别转铁蛋白饱和度<15%（n=104）患者的诊断准确性为 84%，灵敏度为 0.952，特异性为 0.538。对 71 例铁蛋白<20ng/dL 的患者进行的亚分析得出了更好的诊断性能（86%，灵敏度为 0.935，特异性为 0.620）。
尽管需要进行额外的确认性研究，但本研究的初步结果证明，Iron-Def 可能是一种简单、经济、快速和可靠的缺铁性贫血筛查参数。
