Sysmex XN-9000血液分析仪检测有核红细胞的临床应用评价

目的 评价Sysmex XN-9000血液分析仪检测外周血有核红细胞（NRBC）的临床应用价值。方法 收集16 273份外周血标本，分别应用Sysmex XN-9000血液分析仪和显微镜下人工检测两种方法检测NRBC，以显微镜下人工检测结果为金标准计算仪器检测的灵敏度、特异度、阳性预测值和阴性预测值。以两种方法检测均为阳性的248例标本作为研究对象，分析两种方法检测NRBC百分比的相关性。对277例显微镜下人工检测NRBC阳性患者的疾病谱进行分析。结果 Sysmex XN-9000血液分析仪检测NRBC的灵敏度为89.5%，特异度为99.6%，阳性预测值为80.5%，阴性预测值为99.8%。两种方法检测的NRBC百分比呈正相关（r_s=0.813，P<0.001）。分析277例显微镜下人工检测NRBC阳性患者的疾病谱，结果显示血液病患者173例，非血液病患者104例，经仪器检测的NRBC计数在两组之间差异有统计学意义（非血液病组中位数为0.38×10⁹/L，血液病组中位数为0.16×10⁹/L，P<0.05），而NRBC百分比差异无统计学意义（非血液病组中位数为2.95%，血液病组中位数为3.60%，P=0.835 1）。NRBC阳性血液病主要包括急性淋巴细胞白血病（31例）、急性粒细胞白血病（55例）、淋巴瘤（39例）、多发性骨髓瘤（18例），NRBC阳性非血液病主要包括实体肿瘤（24例）和肝硬化上消化道出血（36例）等。结论 Sysmex XN-9000血液分析仪检测NRBC准确度较高，具有较好的临床应用价值。

Sysmex XN-9000 hematology analyzer in examining peripheral blood nucleated red blood cells: an evaluation of clinical application

Objective To evaluate the clinical value of Sysmex XN-9000 hematology analyzer for detecting peripheral blood nucleated red blood cells (NRBC). Methods A total of 16 273 peripheral blood samples were collected and examined by Sysmex XN-9000 hematology analyzer and microscopic manual detection. The sensitivity, specificity and positive prediction value and negative predictive value of NRBC were measured by manual measurement under microscope. The 248 specimens positive by both methods were used as subjects, and the correlation between the two methods for detecting NRBC was analyzed. The disease types of 277 patients positive of NRBC were analyzed by microscopic examination. Results The sensitivity of NRBC detected by Sysmex XN-9000 hematology analyzer was 89.5%, specificity was 99.6%, positive predictive value was 80.5%, and negative predictive value was 99.8%. There was a positive correlation between the percentages of NRBC detected by the two methods (r_s=0.813, P<0.001). Among the 277 NRBC-positive patients, 173 had hematological diseases and 104 had no hematologic diseases, and there were significant differences in NRBC counts between the two groups (median:0.38×10⁹/L vs 0.16×10⁹/L, P<0.05), and the percentages of NRBC were not significantly different (median:2.95% vs 3.60%, P=0.835 1). Among patients with hematological diseases, NRBC was mainly present in patients with acute lymphoblastic leukemia (31 cases), acute myeloid leukemia (55 cases), malignant lymphoma (39 cases) and multiple myeloma (18 cases). Among patients without hematologic diseases, NRBC was mainly present in those with solid cancer (24 cases) and cirrhosis hemorrhage (36 cases). Conclusion The Sysmex XN-9000 hematology analyzer can detect NRBC with high accuracy, and it thus has a promising clinical application value.