Application of Erythrocyte Indices for Screening Thalassemia Trait in Jiujiang prefecture

Abstract Background: The screening efficiency of Erythrocyte indices varies in different regions. This study aimed to analyze the application efficiency of 11 Erythrocyte indices in Jiujiang prefecture. Methods: A total of 2379 patients with suspected thalassanemia were enrolled in Jiujiang Maternal and Child Health Hospital. Thalassanemia genes were detected by reverse dot blot hybridization. In addition, receiver operating characteristic curve (ROC) was used to analyze and calculate the sensitivity, specificity, Youden's Index(YI), positive likelihood ratio(+LR) , negative likelihood ratio(-LR) and area under curve (AUC) of the Erythrocyte indices. Results: 1)Thalassanemia carriers in Jiujiang prefecture mainly involved α- thalassanemia and β-thalassanemia, with the detection rate of 11.60%%. Thereinto, --SEA/αα(50.35%%) and -α3.7/αα(39.86%%) predominated in α-Thalassanemia, while the commonest gene mutation types of β-Thalassanemia were βIVS-II-654/βN, βCD41-42/βN, and βCD17/βN, accounting for 64.29%,15.87% and 9.542%, respectively. 2) Of 11 erythrocyte indices, Green and King (G&K) exhibited the highest diagnostic efficiency, with the AUC above 90%, a high sensitivity and a good specificity, which followed by England and Fraser (E&F), Sirdah(SI), Jayabose (RDW index) and Ricerca(RI). while Bessman), Ehsani(EI), Srivastava(Sriv), Shine and Lal (S&L), MentzIer(MI) and RBC count(in million) possessed a lower application value for thalassanemia screening. Conclusion: 1)Analysis of thalassanemia genotypes can provide a theoretical basis for thalassanemia screening, prenatal diagnosis and genetic counseling. 2)Compared with other erythrocyte indices, Green and King (G&K) showed higher application value for thalassanemia screening, with the largest AUC above 90%. which is considered feasible for thalassanemia screening in Jiujiang prefecture, Jiangxi province.