Mechanistic investigation and data-driven correction of lipemic interference in hematological parameters on the Mindray BC-6800 hematology analyzer.

OBJECTIVES: This study aimed to systematically investigate the interference of lipemia on the Mindray BC-6800 hematology analyzer, elucidate the underlying mechanisms via optical signal analysis, and develop data-driven strategies for its recognition and correction. METHODS: In vitro models of moderate and severe lipemia were established using 30 healthy specimens. Complete blood count (CBC) parameters, leukocyte differentials, and optical signals were measured and compared against controls. A random forest model was constructed for interference identification, and a multiple linear regression model was developed from 600 normal samples to predict hemoglobin (HGB). RESULTS: Lipemia significantly increased Hb, MCH, and MCHC (P < 0.05), with severe lipemia further affecting HCT, LYMPH%, and MONO%. Optical analysis revealed increased X-axis (side scatter) and decreased Y-/Z-axis (fluorescence) signals (P < 0.001). The random forest model achieved an AUC of 0.952, and a simplified rule ("MCH >36 pg & MCHC >410 g/L″) attained 81.1% accuracy. The HGB prediction model (HGB = 6.67 + 3.14 × HCT) performed robustly across lipemia levels (R2 > 0.96). CONCLUSIONS: Lipemia interferes with multiple parameters on the Mindray BC-6800 through alterations in cellular optical signals. The developed recognition and correction models demonstrate high clinical applicability for improving result accuracy.