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Clinical Chemistry and Laboratory Medicine (CCLM)

Published in Association with the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM)

Editor-in-Chief: Plebani, Mario

Ed. by Gillery, Philippe / Greaves, Ronda / Lackner, Karl J. / Lippi, Giuseppe / Melichar, Bohuslav / Payne, Deborah A. / Schlattmann, Peter

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Volume 52, Issue 5


Quantitative detection of target cells using unghosted cells (UGCs) of DxH 800 (Beckman Coulter)

Wonbae Lee / Jung-Ho Kim / In Kyung Sung / Sung Kyun Park
  • Department of Surgery, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Seong Taek Oh
  • Department of Surgery, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Hun-Hee Park / Yeon-Joon Park / Yonggoo Kim / Eun-Jee Oh / Myungshin Kim / Hae-Il Park / Kyungja Han
Published Online: 2013-12-05 | DOI: https://doi.org/10.1515/cclm-2013-0676


Background: In the Retic channel of DxH 800 (Beckman Coulter), the red blood cells (RBCs) resistant to hemoglobin clearing are counted as unghosted cells (UGCs). The aim of this study was to evaluate that the UGC is a surrogate marker for both the detection and counting of target cells.

Methods: In total, 1181 samples including 22 from iron deficiency anemia (IDA) patients, 95 from jaundice, 2 from sickle cell anemia, 3 from thalassemia, 1 cord blood, and 269 from normal controls were analyzed. Slides were prepared from all samples except normal controls and target cells were counted for correlation analysis of target cell counts to UGCs.

Results: The normal control samples showed 0.01% (0%–0.01%) UGCs, and the reference range was set at ≤0.02%. The IDA samples showed 0.015% (0.01%–0.03%) UGC count and 0.05% (0%–0.2%) target cell count. The jaundice samples showed 0.98% (0.1%–5.36%) UGC count, and 1.4% (0.1%–7.0%) target cell count. The two sickle cell anemia samples showed 0.41% and 3.74% UGC counts and 0.4% and 11.5% target cell counts. A cord blood sample showed 0.01% UGCs and 0% target cells. The three thalassemia samples showed 0.01%, 1.99%, and 7.82% UGC counts and 0%, 1.4%, and 15.5% target cell counts. The samples showing poikilocytosis other than target cells showed normal UGC count (≤0.02%). The positive predictive value of UGCs was 58.2% (124/213) and the negative predictive value was 96.8% (674/696). The UGC counts were well correlated to the manual target cell counts (r=0.944, p=0.000).

Conclusions: This study demonstrates for the first time in the literature that a hematological parameter obtained automatically every time a reticulocyte counting is performed can be used to both screen for the presence of target cells and reliably quantify them.

Keywords: automated hematology analyzer; poikilocyte; target cell; unghosted cells (UGCs)


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About the article

Corresponding author: Kyungja Han, MD, Department of Laboratory Medicine, The Catholic University of Korea, Seoul St. Mary’s Hospital, 505 Banpo-dong, Seocho-gu, Seoul 137-701, Republic of Korea, Phone: +82-2-2258-1644, Fax: +82-2-2258-1719, E-mail:

Received: 2013-08-21

Accepted: 2013-11-06

Published Online: 2013-12-05

Published in Print: 2014-05-01

Citation Information: Clinical Chemistry and Laboratory Medicine, Volume 52, Issue 5, Pages 693–699, ISSN (Online) 1437-4331, ISSN (Print) 1434-6621, DOI: https://doi.org/10.1515/cclm-2013-0676.

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