Pseudothrombocytopenia caused by platelet clumping (PC) can lead to unnecessary platelet transfusions or underdiagnosis of hematologic neoplasms. To overcome these limitations, we assessed the capacity of the Sysmex DI-60 digital morphology analyzer (Sysmex, Kobe, Japan) for detecting PC and determining an accurate platelet count in the presence of PC. For this purpose, 135 samples with or without PC (groups Y and N, respectively) were processed by an examiner (a hematologic specialist) using both the Sysmex XN-9000 and DI-60 analyzers. Although the platelet aggregate (PA) and giant platelet (GP) counts reported by the DI-60 and the examiner exhibited strong correlations, they proved inadequate as effective indicators for screening samples containing PC. Between the PA and GP counts and four platelet indices (the platelet distribution width [PDW], mean platelet volume [MPV], platelet large cell ratio [P_LCR], and plateletcrit [PCT]) reported by the XN-9000, we observed statistically significant correlations (both overall and with group Y), but they were relatively weak. The platelet counts determined using the DI-60 and light microscopy in group Y showed substantial variations. Although the performance of the DI-60 was reliable for detecting PA and GP in smear images, such fixed areas are not representative of whole samples. Further, in the presence of PC, the resulting platelet counts determined using the DI-60 were not sufficiently accurate to be accepted as the final count.

中文翻译：

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DI-60 数字图像分析仪检测血小板聚集并获得准确血小板计数的可靠性。

血小板凝集 (PC) 引起的假性血小板减少症可导致不必要的血小板输注或血液肿瘤的漏诊。为了克服这些限制，我们评估了 Sysmex DI-60 数字形态分析仪（Sysmex，神户，日本）检测 PC 并在 PC 存在的情况下确定准确的血小板计数的能力。为此，检查员（血液学专家）使用 Sysmex XN-9000 和 DI-60 分析仪处理了 135 个带有或不带有 PC 的样本（分别为 Y 组和 N 组）。尽管 DI-60 和检查者报告的血小板聚集体 (PA) 和巨血小板 (GP) 计数表现出很强的相关性，但事实证明它们不足以作为筛查含有 PC 的样本的有效指标。在 XN-9000 报告的 PA 和 GP 计数以及四个血小板指数（血小板分布宽度 [PDW]、平均血小板体积 [MPV]、血小板大细胞比率 [P_LCR] 和血小板压积 [PCT]）之间，我们进行了统计观察显着相关性（总体相关性和与 Y 组的相关性），但相对较弱。使用 DI-60 和光学显微镜测定的 Y 组血小板计数显示出显着差异。尽管 DI-60 的性能对于检测涂片图像中的 PA 和 GP 来说是可靠的，但这种固定区域并不能代表整个样本。此外，在 PC 存在的情况下，使用 DI-60 测定的血小板计数不够准确，无法被接受为最终计数。