Shen Yimin, Liu Dongmei, Wang Yong, Cao Jun, Zhang Shuaishuai, Wen Hui, Dong Qiuqiu, Zheng Dong, Qiu Jun
Center of Clinical Laboratory, the First Affiliated Hospital of Soochow University, Suzhou, China.
Ann Transl Med. 2022 Jun;10(12):692. doi: 10.21037/atm-22-1501.
The accuracy of low-value platelet (PLT) testing is a key reference for clinical decision-making regarding PLT transfusion or surgery. This study aimed to evaluate the capability to detect low-value PLT of the 8 times optical platelet counting (PLT-8X) mode of the BC-6800Plus auto hematology analyzer.
Totally 40 fresh anticoagulated venous whole blood samples with PLT ≤50×10/L were collected from the clinical laboratory at the First Affiliated Hospital of Soochow University to evaluate the precision of low-value PLT in PLT-8X mode. Moreover, 67 samples with PLT <100×10/L were collected, and a methodological comparison was conducted between the results of PLT-8X and those obtained by the reference method [red blood cell (RBC)/PLT ratio method] recommended by the International Committee for Standardization of Hematology (ICSH). In addition, fresh whole blood and PLT-free plasma were used to prepare samples at a series of concentrations within the low-value ranges to evaluate the linearity of PLT and finally investigate the limit of blank (LoB) and limit of detection (LoD) for low-value PLT in PLT-8X mode.
The precision low-value PLT in PLT-8X mode was significantly superior to that in PLT-I (P<0.0001); and the correlation coefficient of PLT-8X mode compared with the reference method of flow cytometer was 0.992. The expected bias at the low-value medical decision levels (5×10/L, 10×10/L and 20×10/L) of PLT fell within the range of ±1.0×10/L, and that at 50×10/L fell within the range of ±1.5×10/L. In addition, the correlation coefficient of PLT-8X in the low-value ranges (0 to 30×10/L and 0 to 100×10/L) of PLT was greater than 0.99, and its nonlinear coefficients were not significantly different from 0 (P>0.05). Finally, the LoB and LoD of PLT-8X mode were 0.33×10/L and 0.89×10/L, respectively.
The PLT-8X mode of the BC-6800Plus auto hematology analyzer has extremely low detection sensitivity for low-value PLTs in anticoagulated venous whole blood samples. With good linearity, its precision and accuracy can sufficiently meet the needs for hematology laboratory use, and it can effectively help clinicians to accurately diagnose and treat patients with thrombopenia-related diseases.
低值血小板(PLT)检测的准确性是临床关于PLT输血或手术决策的关键参考依据。本研究旨在评估BC-6800Plus全自动血液分析仪的8倍光学血小板计数(PLT-8X)模式检测低值PLT的能力。
从苏州大学附属第一医院临床实验室收集40例PLT≤50×10⁹/L的新鲜抗凝静脉全血样本,以评估PLT-8X模式下低值PLT的精密度。此外,收集67例PLT<100×10⁹/L的样本,对PLT-8X的结果与国际血液学标准化委员会(ICSH)推荐的参考方法[红细胞(RBC)/PLT比值法]的结果进行方法学比较。另外,使用新鲜全血和无PLT血浆制备一系列低值范围内浓度的样本,以评估PLT的线性度,并最终研究PLT-8X模式下低值PLT的空白限(LoB)和检测限(LoD)。
PLT-8X模式下低值PLT的精密度显著优于PLT-I模式(P<0.0001);PLT-8X模式与流式细胞仪参考方法相比的相关系数为0.992。PLT在低值医学决策水平(5×10⁹/L、10×10⁹/L和20×10⁹/L)时的预期偏差在±1.0×10⁹/L范围内,在50×10⁹/L时的预期偏差在±1.5×10⁹/L范围内。此外,PLT在低值范围(0至30×10⁹/L和0至100×10⁹/L)内PLT-8X的相关系数大于0.99,其非线性系数与0无显著差异(P>0.05)。最后,PLT-8X模式的LoB和LoD分别为0.33×10⁹/L和0.89×10⁹/L。
BC-6800Plus全自动血液分析仪的PLT-8X模式对抗凝静脉全血样本中的低值PLT具有极低的检测灵敏度。其线性良好,精密度和准确性能够充分满足血液学实验室使用需求,可有效帮助临床医生准确诊断和治疗血小板减少相关疾病的患者。