Reproductibility of the morphological identification of schisocytes and evaluation of non observer-dependent methods

被引:0
作者
Lesesve, JF [1 ]
Lecompte, T
Alla, F
Fenneteau, O
Cynober, T
Siest, JP
Troussard, X
Flandrin, G
机构
[1] CHU Nancy, Hematol Lab, Nancy, France
[2] CHU Nancy, Serv Epidemiol & Stat, Nancy, France
[3] Hop Robert Debre, APHP, Hematol Lab, F-75019 Paris, France
[4] Hop Bicetre, APHP, Hematol Lab, Paris, France
[5] Assoc Biol Prospect, Villers Les Nancy, France
[6] CHU Caen, Hematol Lab, F-14000 Caen, France
[7] Hop Necker Enfants Malad, APHP, Hematol Lab, Paris, France
关键词
schistocyte; morphological reproducibility; image analysis; automated analysis;
D O I
暂无
中图分类号
R446 [实验室诊断]; R-33 [实验医学、医学实验];
学科分类号
1001 ;
摘要
Schistocytes are red blood cell fragments observed on a blood smear. They are a mark of mechanical haemolytic anaemias whose group of the thrombotic micro-angiopathies requires an urgent treatment. The detection of the schistocytes and sometimes their quantification are thus of primary importance. To evaluate this search for schistocytes, several surveys of practice were carried out (1999-2003) including pictures of blood fields (identification of schistocytes among abnormal red blood cells) near biologists of variable level of specialization. The aim was to try to lead to a consensus, in particular for the morphological criterias of identification. Our results indicated that: 1) the biologists are badly sensitized with the importance of this research and the consequences of their response for the diagnosis; 2) the morphological identification of the schistocytes is difficult with an important variability of the criteria according to the observers. An investigation overviewed by the French Group of Cellular Hematology (Delphi method) allowed the development of a morphological consensus (fragments of triangular/crescent/helmet forms with rectilinear zone testifying to the zone of break). In order to cancel the observer-dependent identification of the schistocytes, a software of morphometric analysis (Q-WIN, Leica) was developed for sorting, starting from digitalized microscopic fields, the fragmented - among the normal - red blood cells. The results appeared encouraging, but not yet optimized. An automated analyzer (Bayer ADVIA 120) was also evaluated for the measurement of the schizocytes ("fragmented red blood cells" parameter). The moderate over-estimation of the real schizocytes (+ 0,4%) encouraged to observe the clinical value of the fragmented red blood cells detection in a group of patients that undergone a bone-marrow transplantation. The predictive value of the test (98%) was satisfactory.
引用
收藏
页码:279 / 289
页数:11
相关论文
共 34 条
[1]   THROMBOTIC THROMBOCYTOPENIC PURPURA - REPORT OF 16 CASES AND REVIEW OF LITERATURE [J].
AMOROSI, EL ;
ULTMANN, JE .
MEDICINE, 1966, 45 (02) :139-+
[2]   Automated detection of working area of peripheral blood smears using mathematical morphology [J].
Angulo, J ;
Flandrin, G .
ANALYTICAL CELLULAR PATHOLOGY, 2003, 25 (01) :37-49
[3]  
BESSIS M, 1972, NOUV REV FR HEMATOL, V12, P721
[4]  
BESSIS M, 1976, REINTERPREATION FROT
[5]   Morphologic diagnosis of thrombotic thrombocytopenic purpura [J].
Burns, ER ;
Lou, YM ;
Pathak, A .
AMERICAN JOURNAL OF HEMATOLOGY, 2004, 75 (01) :18-21
[6]  
DALKEY NC, 1969, RM5888PR SANT MON RA
[7]  
Dua A, 1996, J CLIN APHERESIS, V11, P176, DOI 10.1002/(SICI)1098-1101(1996)11:4<176::AID-JCA2>3.0.CO
[8]  
2-8
[9]  
GASSER C, 1955, Schweiz Med Wochenschr, V85, P905
[10]   How I treat patients with thrombotic thrombocytopenic purpura-hemolytic uremic syndrome [J].
George, JN .
BLOOD, 2000, 96 (04) :1223-1229