Análise comparativa do hemograma entre a metodologia automatizada e a microscopia óptica

Abstract

The hemogram is the test that evaluates quantitatively and qualitatively the blood cellular elements and it is composed by three parts: red blood cells count, platelets count and white blood cells count. This latter one consisting of total and differential (relative and absolute) white blood cells count and leukocytes morphological analysis. This hematological evaluation is a major technique most requested in clinical laboratory tests, because it provides a large amount of information. Currently, this test may be performed by means of optical microscopy or through the automation. On the above, the purpose of this work is to make a comparison between the hemogram reports yielded by the automatic analyzer Abbott Cell Dyn 3700™ and those one performed by optical microscopy. Was used 120 blood distention glass slides belonging to the Laboratório de Hematologia da Universidade Federal do Ceará and performed differential white blood cell count (absolute and relative) and evaluated the red blood cell, leukocytes and platelets morphology of all these glass slides by the microscopy, using an optical Olympus microscope ® CX31. In possession with the results obtained by the microscopy and the reports issued by that equipment, the analysis was made with the results of both techniques. All data attained were engaged in a software Microsoft Office Excel 2010 ® spread sheets and analyzed using softwares SPSS® version 19 and Rgui 3.0.0. To assess the research results value reached using the two techniques, a Wilcoxon statistical test was done. Segmented neutrophils, eosynophils and lymphocytes obtained similar results on both relative and absolute differential white blood cell count techniques. The bands had a significantly higher counting in the microscopy, while the basophils were a significantly higher in the automation and the monocytes showed to be equivalent on both techniques considering the relative differential white blood cell count. Regarding the absolute differential white blood cell count, monocytes and bands showed higher scores on microscopy while basophils had top score in automation. Concerning about the red blood cells, leukocytes and platelets morphology, the microscopy was superior in comparison to the automation, which detect changes that were imperceptible to the automated equipment or that were numerically lower in the latter. Despite the proximity of the two techniques results in relation to the differential white blood cell count, the microscopy analisys still needful, especially in the detection of morphological abnormalities which may be overlooked by the automatic analyzers in order to ensure the quality of the results. We also concluded that all glass slides must be analyzed by the optical microscopy even though the results achieved using hematological equipment.