The Effect Of Thalassemia On C2FP HbAlc Detection System And The Application Of C2FP Two HbA2 Detection Systems To The Screening Of Thalassemia

Objective:To analyse the effect of thalassemia on the detection system of glycosylated hemoglobin(Hemoglobin Alc,HbA1c)by capillary electrophoresis(Capillarys Flex 2 Piercing,C2FP)dection;To explore the Hemoglobin A2(HbA2)dection results by Hemoglobin Alc system and Hemoglobin electrophoresis system of capillary electrophoresis method for analysing the application value on the screening of thalassemia,selecting suitable best cut-off value for our laboratory of these two kinds of detection system of HbA2 for screening of alpha and beta thalassaemia.Methods:Collecting the related clinical data and laboratory findings of the patients that routine gene testing for thalassemia(PCR+diversion hybridization)was performed at The second affiliated hospital of Kunming medical university from August 1,2019 to January 17,2020,78 patients with normal genetic test results were used as the control group,and 86 patients diagnosed with thalassemia were used as the geodystrophic group(including 50 patients with thalassemia and 36 patients with thalassemia).By comparing the determination results of Glycosylated hemoglobin on the C2FP HbAlc detection system between the control group and the thalassaemia patients group,the effect of thalassemia on the HbAlc detection system by capillary electrophoresis was analyzed.Compared control group with alpha thalassaemia patients group and beta thalassaemia patients group in C2FP HbAlc test system and C2FP HbA2 result of hemoglobin electrophoresis detection system by drawing ROC curve,in order to select two system suitable for the laboratory screening of alpha and beta thalassaemia HbA2 best cutoff value,analysing the HbA2 dection results of two test system of C2FP for the value of screening the thalassaemia.Results:(1)In 86 cases of the thalassaemia patients,27 cases of alpha thalassemia silent and 23 cases of alpha thalassaemia trait were statistically different from the control group in HbAlc dection results,and there was no significant difference in HbAlc dection results between the 35 patients with beta thalassaemia trait and the control group,so the detection results of HbAlc would increase by the effect of alpha thalassemia silent and trait,while beta thalassaemia trait will not interfere with the quantitative detection results of HbAlc in the C2FP HbAlc system.(2)In the C2FP HbAlc system,according to ROC curve analysis,the area under the curve was less than 0.5,which was only 0.387.Therefore,it was considered that the HbA2 results of this system were of little significance for the diagnosis of patients with alpha thalassemia silent and trait.HbA2 results as screening the remaining beta thalassemia trait diagnosis index,having high diagnosis accuracy,with 1.000 of the area under the curve,when HbA2>2.95%,the sensitivity and specificity were both 100.0%.and the Jordan index was the largest,the C2FP HbAlc test system can not only the quantitative detection of HbAlc,it can also provide HbA2 test results to screening beta thalassaemia trait.In the C2FP electrophoresis detection system,the alpha thalassemia silent and trait showed that the area under the curve was only 0.345 and less than 0.5,so it was considered that the HbA2 results of the system were of little significance for the diagnosis of the patients with the alpha thalassemia silent and trait.For beta thalassaemia,HbA2 results were used as the diagnostic index for screening beta thalassaemia.The diagnostic accuracy was relatively high,with the area under the curve being 0.988.When HbA2>was 3.15%,the sensitivity was 97.1%and the specificity was 100.0%,and the Jordan index was the largest.Conclusions:The C2FP HbAlc detection system was used for HbAlc detection,the alpha thalassemia silent and trait would increase the detection result of HbAlc,while the beta thalassemia trait had no effect on the result of HbAlc.The HbA2 detection results of the C2FP HbAlc system were used as the screening index of thalassemia.The area under the ROC curve for the alpha thalassemia silent and trait was only 0.387,less than 0.5,the diagnostic significance was not so good.The optimal cut-off value for screening of beta thalassemia trait was HbA2>2.95%,with high diagnostic value.HbA2 results of the C2FP HbA2 electrophoresis detection system were used to screen beta thalassemia trait.The area under the ROC analysis curve for thalassemia silent and trait was only 0.345,the diagnostic significance was not so good.The optimal cut-off value for beta thalassemia trait was of HbA2>3.15%,with high diagnostic value.