{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,15]],"date-time":"2025-11-15T04:07:33Z","timestamp":1763179653633,"version":"3.45.0"},"reference-count":15,"publisher":"Wiley","issue":"21","license":[{"start":{"date-parts":[[2025,10,25]],"date-time":"2025-10-25T00:00:00Z","timestamp":1761350400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Laboratory Analysis"],"published-print":{"date-parts":[[2025,11]]},"abstract":"ABSTRACT<\/jats:title>\n \n Background<\/jats:title>\n This study investigated the accuracy of the \u201cPLT Clumps?\u201d flag triggered by different channels on the Sysmex XN haematology analyser in identifying two sample states and to optimize the platelet review strategy for cancer patients.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n 570 samples flagged \u201cPLT Clumps?\u201d in CBC\u2009+\u2009DIFF mode were analysed. After excluding clots, retesting was conducted in CBC\u2009+\u2009DIFF\u2009+\u2009PLT\u2010F mode. The accuracy of the \u201cPLT Clumps?\u201d flag and its correlation with PLT aggregation (PA) or fibrin precipitation (FP) were evaluated. Low\u2010platelet count samples were collected for a second blood draw to confirm whether pseudothrombocytopenia (PTCP) was present. The incidence and positive predictive value (PPV) of the \u201cPLT Clumps?\u201d flag across different tumours were also analysed.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Among 85 verified cases (PA\u2009=\u200917, FP\u2009=\u200963), the overall PPV of the \u201cPLT Clumps?\u201d flag was 14.9% (85\/570) in CBC\u2009+\u2009DIFF mode, 3.5% in WNR channel only, 73.9% in WDF channel only, and 94.4% in dual\u2010channel. In CBC\u2009+\u2009DIFF\u2009+\u2009PLT\u2010F mode, the overall PPV and NPV were 98.5% (65\/66) and 97.0% (484\/499), respectively. PA and FP accounted for 73.9% (17\/23) and 26.1% (6\/23) of the PLT\u2010F\u2010only flagged samples, respectively, and all WDF\u2010only and dual\u2010flagged cases were triggered by FP. The incidence of PTCP in samples flagged for \u201cPLT Clumps?\u201d in CBC\u2009+\u2009DIFF\u2009+\u2009PLT\u2010F mode was 80%. Samples from patients with hepatobiliary tumours showed highest flagging rate (20.4%) but a lower PPV.<\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n The correlation between \u201cPLT Clumps?\u201d flags originating from different channels and two common preanalytical factors interfering in PLT counting was analysed, and the platelet review strategy for cancer patients was optimized.<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/jcla.70111","type":"journal-article","created":{"date-parts":[[2025,10,25]],"date-time":"2025-10-25T07:40:41Z","timestamp":1761378041000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Evaluating the \u201c\n PLT<\/scp>\n Clumps?\u201d Flag Originating From Different Channels of the Sysmex\n XN<\/scp>\n Haematology Analyser: A Method for Rapidly Distinguishing Between Two Preanalytical Factors Affecting\n PLT<\/scp>\n Counting for Cancer Patients"],"prefix":"10.1002","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9279-6883","authenticated-orcid":false,"given":"Danfei","family":"Xu","sequence":"first","affiliation":[{"name":"National Cancer Center\/National Clinical Research Center for Cancer\/Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Na","family":"Zhao","sequence":"additional","affiliation":[{"name":"National Cancer Center\/National Clinical Research Center for Cancer\/Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wenqi","family":"Tai","sequence":"additional","affiliation":[{"name":"National Cancer Center\/National Clinical Research Center for Cancer\/Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jing","family":"Yang","sequence":"additional","affiliation":[{"name":"National Cancer Center\/National Clinical Research Center for Cancer\/Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Li","family":"Wang","sequence":"additional","affiliation":[{"name":"National Cancer Center\/National Clinical Research Center for Cancer\/Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,10,25]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.15537\/smj.2023.44.11.20220946"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.29271\/jcpsp.2023.01.10"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.3390\/cancers16071293"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm9030808"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/ijlh.12487"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1532\/LH96.05019"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.3390\/diagnostics12010068"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.3760\/cma.j.cn114452\u201020200331\u201000343"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/ijlh.13920"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.3343\/alm.2023.43.5.418"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1080\/10408363.2020.1800585"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12288\u2010022\u201001582\u20106"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.7754\/Clin.Lab.2023.231129"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.3390\/cancers11101568"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12885\u2010023\u201011621\u20108"}],"container-title":["Journal of Clinical Laboratory 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