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Platelet Electron Microscopy: Utilizing LEAN Methodology to Optimize Laboratory Workflow.
Pediatric and Developmental Pathology ( IF 1.9 ) Pub Date : 2020-05-19 , DOI: 10.1177/1093526620915361
Lucas Asher 1 , Jessica Hata 1
Affiliation  

BACKGROUND Platelet electron microscopy (PEM) is the gold standard methodology for diagnosing storage pool disorder, defined as a paucity of delta granules, alpha granules, or both. PEM literature is limited with few published resources and without well-developed interlaboratory standardization for the preparation and examination of platelet samples. METHODS Whole mount (WM) dense body (DB) counts for 300 pediatric cases were reviewed to determine whether counting fewer platelets could yield the same results. For 6 cases, DB average was determined on the day of WM preparation and on 2 consecutive days. Both WM and thin section (TS) preparations were examined for all cases. RESULTS Employing LEAN methodology, an algorithm was developed to markedly decrease the number of platelets counted and still ensure accurate results. WMs decay with time; a statistically significant difference in DB counts was noted between day 0 and day 1 (p < .1). Twelve of 300 cases required both WM and TS preparations for a complete diagnosis. CONCLUSION It is possible to maintain accuracy and decrease 100 platelet DB counts by >75%. WMs must be counted on the day they are prepared to avoid false paucity of DB secondary to sample decay. An accurate evaluation of platelet morphology requires both the WM and TS techniques.

中文翻译:

血小板电子显微镜:利用精益方法优化实验室工作流程。

背景 血小板电子显微镜 (PEM) 是诊断储存池紊乱的金标准方法,储存池紊乱被定义为缺乏 delta 颗粒、α 颗粒或两者。PEM 文献有限,出版资源很少,并且没有完善的实验室间标准化来制备和检查血小板样本。方法 回顾了 300 个儿科病例的整体 (WM) 致密体 (DB) 计数,以确定计数较少的血小板是否可以产生相同的结果。对于 6 个案例,在 WM 制备当天和连续 2 天确定 DB 平均值。对所有病例都检查了 WM 和薄片 (TS) 制剂。结果 采用 LEAN 方法,开发了一种算法以显着减少计数的血小板数量,但仍确保结果准确。WMs 随时间衰减;在第 0 天和第 1 天之间注意到 DB 计数的统计学显着差异(p < .1)。300 例中有 12 例需要 WM 和 TS 准备才能进行完整诊断。结论 有可能保持准确性并将 100 个血小板 DB 计数减少 >75%。WMs 必须在他们准备好的那天进行计数,以避免由于样本衰减导致 DB 的错误缺乏。血小板形态的准确评估需要 WM 和 TS 技术。
更新日期:2020-05-19
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