Modification of the Algorithm Used by Automated Hematology Analyzer XN-3000 Improves Specificity in the Detection of Schistocytes.

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.