COMPARISON OF SCREENING INDICATORS FOR DIFFERENT TYPES OF THALASSEMIA CARRIERS IN HUNAN PROVINCE.

Background: Carrier screening is the most effective method to block the occurrence of thalassemia. However, due to differences in race and genotype, MCV, MCH, HbA2 and other indicators are far from each other. The purpose of this study is to evaluate the common screening indicators of a, P and aP-compound thalassemia carriers in Hunan Province, and try to use the relevant formulas in the existing literature to predict and distinguish different types of thalassemia carriers. Methods: Receiver operating characteristic curve (ROC curve) combined with Youden index was utilized to analyze results of blood routine examination, hemoglobin electrophoresis, and literature-related formulas for 1111 a-thalassemia carriers, 464 P-thalassemia carriers and 24 aP-thalassemia carriers. Results: For a-thalassemia carriers, no matter which screening index or formula, the screening efficiency was not ideal. For P-thalassemia minor carriers, RBC, RDW-CV, HBA2, HbF and formula 5-7 could be used, and for compound thalassemia, RBC, RDW-CV, HbA2 and formula 5-6 are suitable. HbA2 has high efficiency in the screening of P-thalassemia minor and aP-thalassemia. For the screening of P-thalassemia minor, if the cut-off value of HbA2 is set to 3%, the detection rate of 93.32% can be obtained at the positive rate of 9.6%, and if it is set to 3.15%, the detection rate can also reach 81.68% at the positive rate of 2.89%. For aP-thalassemia, if the cut-off value of HbA2 is set to 3%, the detection rate of 95.83% can be obtained under the positive rate of 8.08%. Conclusion: Different screening indicators and formulas have different efficiencies for different thalassemia carriers, a-thalassemia carriers are easily missed by screening indicators or corresponding formulas. HbA2 is a better screening indicator for both p-thalassemia minor carriers and otJB- thalassemia carriers, and formulas 5, 6, and 7 are suitable for p-thalassemia minor carriers, and formulas 5 and 6 are better for ap-thalassemia carriers. To fully and objectively understand each screening index, data support has been provided for clinical and laboratory tests. [ABSTRACT FROM AUTHOR]

Uvod: Skri ning nosioca je najefikasniji metod za blokiranje pojave talasemije. Međutim, zbog razlika u rasi i genotipu, MCV, MCH, HBA2 i drugi indikatori su daleko jedni od drugih. Svrha ove studije je da proceni uobičajene indikatore skrininga za nosioce talasemije a, P i aP-jedinjenja u provinciji Hunan, i pokuša da koristi relevantne formule u postojećoj literaturi za predviđanje i razlikovanje različitih tipova nosilaca talasemije. Metode: Kriva operativne karakteristike prijemnika (ROC kriva) u kombinaciji sa Youden-ovim indeksom koriščena je za analizu rezultata rutinskog pregleda krvi, elektroforeze hemoglobina i formula u vezi sa literaturom za 1111 nosioca a-talasemije, 464 nosioca P-talasemije i 24 nosioca thalasemije ap. Rezultati: Za nosioce a-talasemije, bez obzira na indeks skrininga ili formulu, efikasnost skrininga nije bila idealna. Za male nosioce P-talasemije mogu se koristiti RBC, RDW-CV, HbA2, HbF i formula 5-7, a za jedinjenja talasemije su pogodni RBC, RDW-CV, HbA2 i formula 5-6. HbA2 ima visoku efikasnost u skriningu P-talasemije minor i aP-talasemije. Za skrining male P-talasemije, ako je granična vrednost HbA2 podešena na 3%, stopa detekcije od 93,32% može se dobiti pri pozitivnoj stopi od 9,6%, a ako je podešena na 3,1 5%, stopa detekcije ta kode može dostići 81,68% uz pozitivnu stopu od 2,89%. Za aP-talasemiju, ako je granična vrednost HbA2 postavljena na 3%, stopa detekcije od 95,83% može se dobiti pod pozitivnom stopom od 8,08%. Zaključak: Različiti indikatori i formule skrininga imaju različitu efikasnost za različite nosioce talasemije. Nosioci a-talasemije se lako mogu propustiti indikatorima skrininga ili odgovarajućim formulama. HbA2 je bolji indikator za skrining i za nosioce p-talasemije i za nosioce ap-talasemije, a formule 5, 6 i 7 su pogodne za p-talasemije manje nosioce, a formule 5 i 6 su bolje za nosioce o.p-tala se mi je. Za potpuno i objektivno razumevanje svakog indeksa skrininga, obezbeđena je podrška podacima za klinička i laboratorijska ispitivanja. [ABSTRACT FROM AUTHOR]