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Modification of the Algorithm Used by Automated Hematology Analyzer XN-3000 Improves Specificity in the Detection of Schistocytes by Motoki Hisasue, Tomohiko Ai, Konobu Kimura, Akihiko Matsuzaki, Kumiko Nishibe, Yoko Tabe, Akimichi Ohsaka

Background: This study investigated the feasibility and accuracy of an automated hematology analyzer in the detection of schistocytes.
Methods: In total, 1,026 peripheral blood samples were collected. Schistocytes were morphologically diagnosed by manual examination of digital microscopic red blood cell images captured by a Sysmex DI-60. Automated diagnoses were performed using a Sysmex XN-3000.
Result: The accuracy of automated diagnosis using the XN-3000 with the default algorithm "fragments?" was determined through comparison with the findings of morphological examination. The comparison showed a sensitivity of 100% and a specificity of 41.6% for automated diagnosis. To improve the low specificity, a two-step analysis was performed. Use of the algorithm “fragments?” in XN-3000 followed by an off-line analysis using the cell parameter %FRC (percent fragmented red blood cells) yielded a sensitivity of 86.5% and a specificity of 70.3%.
Conclusions: Our study indicated that combined use of the %FRC parameter with the default algorithm of the Sysmex XN-3000 automated hematology analyzer can improve the low specificity of the default algorithm in rapid screening for schistocytes.

DOI: 10.7754/Clin.Lab.2020.200227