Related Experiment Video
Updated: Aug 6, 2026
10:28
Probe-based Real-time PCR Approaches for Quantitative Measurement of microRNAs
Published on: April 14, 2015
Local reference intervals for MacroR, MicroR, IG% and IG# on Sysmex XN-1000: A retrospective indirect LIS-based study
Özben Özden Işiklar1, Evin Kocatürk
1Department of Medical Biochemistry, Faculty of Medicine, Eskişehir Osmangazi University, Eskişehir, Türkiye.
Medicine
|July 18, 2026
Summary
This study establishes local reference intervals for extended complete blood count parameters on the Sysmex XN-1000 analyzer. These validated intervals aid in the accurate interpretation of microcytic and macrocytic red blood cell fractions and immature granulocyte indices.
Area of Science:
- Clinical Hematology
- Laboratory Medicine
- Diagnostic Technology
Background:
- Extended complete blood count (CBC) parameters, including microcytic red blood cell fraction (MicroR), macrocytic red blood cell fraction (MacroR), and immature granulocyte (IG) indices, are increasingly utilized in clinical practice.
- Limited availability of locally validated reference intervals (RIs) for these advanced CBC parameters poses challenges for accurate interpretation.
- Sysmex XN analyzers are widely used, necessitating specific RIs for their extended parameters.
Purpose of the Study:
- To derive and validate local reference intervals (RIs) for MicroR, MacroR, immature granulocyte percentage (IG%), and immature granulocyte count (IG#) using the Sysmex XN-1000 analyzer.
- To implement an indirect approach utilizing laboratory information system (LIS) data for RI derivation.
- To provide practical local benchmarks for the routine interpretation of extended CBC parameters.
Main Methods:
- An indirect method using routine LIS data from a tertiary-care university hospital was employed.
- A reference-candidate dataset was constructed via a CBC-based selection workflow, followed by outlier exclusion using Tukey's method and visual review.
- Nonparametric percentile methods (2.5th-97.5th) were used for RI estimation, with bootstrap resampling for confidence intervals. Sex-specific analysis for MacroR was performed.
Main Results:
- Pooled RIs were established for MicroR (0.50%–6.10%) and IG indices (IG#: 0.01–0.04 × 10^9/L; IG%: 0.10%–0.60%).
- Sex-specific RIs were determined for MacroR: 3.60%–5.20% in males and 3.30%–4.60% in females.
- Derived RIs align with expected Sysmex XN platform patterns, highlighting potential discrepancies with manufacturer-provided limits.
Conclusions:
- Local RIs for MicroR, MacroR, IG%, and IG# on the Sysmex XN-1000 were successfully established using an indirect LIS-based workflow.
- These validated RIs offer essential local benchmarks for interpreting extended CBC parameters in routine diagnostics.
- The indirect LIS-based design necessitates careful interpretation without individual clinical verification.
