Reliability of Different RBC Indices and Formulas in Discriminating between β-Thalassemia Minor and other Microcytic Hypochromic Cases

不同红细胞指标和公式在鉴别β-地中海贫血轻型与其他小细胞低色素性贫血病例中的可靠性

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Abstract

OBJECTIVE: Different indices and formulas of CBC parameters have been suggested as indicators of early stage screenings to detect couples with β-thalassemia minor (BTMi). In this study, we evaluated the accuracy of five previous published formulas and compared them to our new formula (│80-MCV│×│27-MCH│) in screening of β-thalassemia. METHODS: All couples in the premarital β-thalassemia screening program of Roodbar, Iran, for whom molecular analysis had been done, were selected during two years. The red blood cell parameters were applied to each formula, and a ROC curve was plotted for each one to check its discriminative effectiveness in β-thalassemia detection. RESULT: None of the studied indices and formulas demonstrated 100% precision. However, we found that the Shine-Lal formula and our formula had the highest sensitivity in identifying BTMi individuals. The highest specificity belonged to our formula and Sirdah formula. CONCLUSION: Previous studies reported different sensitivities and specificities for the formulas. This can be attributed to different kinds of HBB gene mutations in various populations. Undoubtedly, physicians in different areas should evaluate the accuracy of published formulas for their own populations in the discrimination of BTMi from other causes of microcytic hypochromic anemia.

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