Clinical blood test interpretation. Part 1. Neutrophil granulocytes

INRODUCTION. Recent decades are characterized by a rapid introduction of modern automated analytical systems in clinical laboratory diagnostics such as hematology analyzers, which provide a high accuracy of results as well as additional (compared to routine tests) and often more valuable information. Automated blood test has made urgent the problem of interpreting both new tests and “routine” parameters that is relevant to any section of clinical medicine. Therefore, this lecture is aimed at doctors of different specialties.

OBJECTIVE. Interpret a clinical blood test.

DISCUSSION. It is hard to review all aspects of hematological analysis within the scope of one lecture, thus part 1 will investigate one of leukocyte populations – neutrophil granulocytes, which include stab and segmented neutrophils. The lecture presents well-known data about neutrophilic leukocytosis and neutropenia. The emphasis is placed on new parameters of automated blood test – IG (immature granulocytes), Neut-RI (reactivity index), Neut-GI (granularity index), MNV (the average volume of neutrophil), structurally dispersed characteristics (NE-WX, NE-SFL, NE-WZ) and some others. Along with modern parameters it was noted the importance of the traditional cytological examination of blood smear, enabling to detect anomalies of neutrophil (degenerative-dystrophic changes of cytoplasm, apoptosis, nucleus pathology).

Overall, recent years have shown a significant improvement in laboratory diagnostic capabilities of reactive changes (with inflammation, injury, etc.) and blood diseases (anemia, myelodysplastic syndromes, hemoblastosis, etc.), based on accumulated knowledge in the field of laboratory hematology, including clinical significance in evaluating neutrophils.

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