M. Velizarova, T. Yacheva and K. Tzatchev Department of Clinical Laboratory and Clinical Immunology, MU Sofia

Transcription

1 50, 48, 2012, 3, ADVIA 2120.,.., ANALYSIS OF DIAGNOSTIC RED CELL CYTOGRAMS, GENERATED BY THE ADVIA 2120 HEMATOLOGY ANALYZER M. Velizarova, T. Yacheva and K. Tzatchev Department of Clinical Laboratory and Clinical Immunology, MUSofia : : : Summary: Key words: Address for correspondence:, -, -., (RBC) -., 946 ( ) ADVIA 2120 (Siemens Healthcare Diagnostics Inc). (V) (HC),, -,, -. -., Advia 2120,, RBC -,,,... 1, 1431, , mvelizarova@abv.bg The laboratory staff is familiar with the basic interpretation of numerical results, obtained by the automated hematology analyzers, but seemingly complex cytograms and histograms are often ignored. The purpose of this study was to identify characteristic red cell (RBC) cytogram patterns in various hematological conditions. Numerical and graphical results of the RBC data in 946 (342 healthy individuals and 620 patients with hematological diseases/conditions) were analyzed by the automated hematology analyzer ADVIA 2120 (Siemens Healthcare Diagnostics Inc). The graphical pattern of red cell distribution according to RBC volume/hemoglobin concentration (V/HC) was evaluated in iron deficiency anemia, heterozygous and homozygous thalassemia, megaloblastic and nonmegaloblastic macrocytosis, dual deficiency anemia, and post-transfusion findings. Red cell cytograms and other automated results were correlated with the clinical profiles and biochemical data. automated hematology analyzers, Advia 2120, cytogram, RBC Milena Velizarova, M. D., Department of Clinical Laboratory and Clinical Immunology, MU, 1, Sv. G. Sofiyski Str., 1431 Sofia, tel mvelizarova@abv.bg

2 ., : CBC Complete blood count EDTA Ethylediaminetetra-acetic acid WBC White blood cells RBC Red blood cells Hb Hemoglobin Hct Hematocrit fl femto litre MCV Mean corpuscular volume MCH Mean corpuscular hemoglobin MCHC Mean corpuscular hemoglobin concentration pg pico grams RDW Red cell distribution width NRBC Nucleated red blood cells V/HC Volume/Hemoglobin Concentration (RBC) (- ) -. - (CBC) - -. RBC - -, ,. - - CBC [14, 15, 18], RBC - [2, 9, 12]. RBC, [4, 9, 11, 12, 16].,,, -,,, [7, 8, 12]., - (), - RBC [2, 5, 9, 12, 13]. -? -, - - RBC ( WBC - ), ,,. 962 ( ) ADVIA 2120 (Siemens Healthcare Diagnostics Inc). 2, - 2- ù (Cooley) Siemens Healthcare Diagnostics.

3 52, 48, 2012, 3 ( - ) - (2-3º) (5-15º) [1, 12]. - RBC, (V) (HC),.. V/HC RBC (. 1). V/HC, 28 g/dl 41 g/dl. HC 28 g/dl -, 41 g/dl. y, - 60 fl 120 fl fl, 120 fl. V/HC. (. 2) 2. : Hb82 g/l, RBC4,93 x /l, Hct0.32, MCV65,4 fl, MCH16,6 pg, MCHC254 g/l, CH15,8 pg, RDW18,6%. -. -, -. MCV MCH -, RDW.. 1. V/HC ( N. Kakkar M. Makkar, 2009). - (CH) - 28 g/dl (x) y (41 g/dl). y - (V) - 60 fl () 120 fl (b) V/HC (. 2) 1. : Hb 157 g/l, RBC5,36 x /l, Hct0.45, MCV84,0 fl, MCH29,3 pg, MCHC349 g/l, CH28,4 pg, RDW12,2%. - (, ) - V/HC V/HC (. 2) 3. : Hb117 g/l, RBC6,12 x /l, Hct0,39, MCV 63,8 fl, MCH19,1 pg, MCHC300 g/l, CH 19,0 pg, RDW14,5%. - ( - ), -. -, -,. RDW, -,.

4 ., (. 2) 4. : Hb90 g/l, RBC3,34 x /l, Hct0,28, MCV81,9 fl, MCH26,4 pg, MCHC322 g/l, CH26,7 pg, RDW21,9%, NRBC301,6%. -,. -, , RDW -, 20%. (NRBC) - ù. (. 3) 5. : Hb 132 g/l, RBC 3,68 x /l, Hct 0,39, MCV 108,4 fl, MCH 35,9 pg, MCHC 331 g/l, CH 35,4 pg, RDW 13,8%. - (MCV 100 fl), - (RDW ). -. -,. (. 3) 6. : Hb 105 g/l, RBC 2.92 x /l, Hct 0.32, MCV fl, MCH 36.1 pg, MCHC 327 g/l, CH 35.5 pg, RDW 21.2%., RDW -. (. 3) 7. : Hb52 g/l, RBC1,46 x /l, Hct0,20, MCV109,0 fl, MCH35,4 pg, MCHC324 g/l, CH34 pg, RDW22.0%. () (RDW 20-25%) ().. (. 3) 8. : Hb82 g/l, RBC3.90 x /l, Hct0.28, MCV71.2 fl, MCH21.0 pg, MCHC295 g/l, CH21.1 pg, RDW22.9% V/HC, -. -, RDW.,, - ù. [6, 7, 9], - -

5 54, 48, 2012, 3 [3, 9, 13, 17]., - [5, 8, 12]. - RBC V/HC / - -. (),, RDW, - ( ),, RDW,,, RDW, RBC MCV, RDW, RBC, MCV, RDW, RBC, RDW, RBC, RDW ( > 25%), : 1) - - ; 2) - - ; 3) ,.,... ADVIA 2120: COULTER LH 750.., 48, 2012, 2, A d v i a 120 Hematology System Technology and cytogram interpretation. Bayer Diagnostics, Tarrytown, NY, A l e x a n d e r, H. D. et al. Cell sizing in chronic lymphoproliferative disorders: an aid to differential diagnosis. J. Clin. Pathol., 45, 1992, 10, A s l i n i a, F., J. J. Mazza et S. H. Yale. Megaloblastic anemia and other causes of macrocytosis. Clin. Med. Res., 4, 2006, 3, B o u r n e r, G., J. Dhaliwal et J. Sumner. Performance evaluation of the latest fully automated hematology analyzers in a large, commercial laboratory setting: a 4-way, sideby-side study. Lab. Hematol., 11, 2005, 4, B u t t a r e l l o, M. Quality specification in haematology: the automated blood cell count. Clin. Chim. Acta, 346, 2004, 1, B u t t a r e l l o, M. et M. Plebani. Automated blood cell counts state of the art. Am. J. Clin. Pathol, 130, 2008, 1, C o n s t a n t i n o, B. T. The red cell histogram and the dimorphic red cell population. Lab. Med., 42, 2011, 5, D e N i c o l a, D. B. Advances in hematology analyzers. Top Companion Anim. Med., 26, 2011, 2, J u n g, S. et al. Differential blast counts obtained by automated blood cell analyzers.korean J. Lab. Med., 30, 2010, 6, K a f e r l e, J. et C. E. Strzoda. Evaluation of macrocytosis. Am. Fam. Physician, 79, 2009, 3, K a k k a r, N. et M. Makkar. Red cell cytograms generated by an ADVIA 120 automated hematology analyzer: characteristic patterns in common hematological conditions. Lab. Med., 40, 2009, 9, L e e r s, M. P. et al. Performance evaluation of the Abbott CELL-DYN Ruby and the Sysmex XT-2000i haematology analysers. Int. J. Lab. Hematol., 33, 2011,.1, M a c o n i, M. et al. Erythrocyte and reticulocyte indices in iron deficiency in chronic kidney disease: comparison of two methods. Scand. J. Clin. Lab. Invest., 69, 2009, 3, N a d a r a j a n, V., P. Sthaneshwar et G. I. Eow. Use of red blood cell indices for the identification of iron deficiency among blood donors. Transfus. Med., 18, 2008, 3, S e p p ä, K., P. Sillanaukee et M. Saarni. Blood count and hematologic morphology in nonanemic macrocytosis: differences between alcohol abuse and pernicious anemia.alcohol, 10, 1993, 5, Sullivan, E. Hematology analyzer: From workhorse to thoroughbred. Lab. Med., 37, 2006, 5, U r r e c h a g a, E. Clinical utility of the new Beckman-Coulter parameter red blood cell size factor in the study of erithropoiesis. Int. J. Lab. Hematol., 31, 2009, 6,