Sysmex XE-2100自动血细胞分析和白细胞分类的复检规则探讨

目的 采用Sysmex XE-2100血细胞分析仪评估国际血液学复检专家组推荐的血细胞复检规则,通过对实验数据进行分析,提出适合于中国人群使用的血细胞复检规则.方法 3家医院均采用日本希森美康公司生产的XE-2100五分群(类)全自动血细胞分析仪,随机检测患者标本共3 594份,同时涂片做显微镜检查,包括细胞形态观察和人工白细胞分类.按照国际血细胞复检规则、自行拟定的筛选方案和涂片镜检阳性标准进行评估,计算出真阳性、假阳性、真阴性、假阴性和涂片复检的比率,并筛选出最佳方案.结果 根据国际血液学复检专家组推荐的41条复检规则和涂片镜检阳性规则对检测结果进行统计学分析,真阳性率为14.02%(504/3 594),假阳性率为32.67%(1 174/3 594),真阴性率为51.47%(1 850/3 594),假阴性率为1.84%(66/3 594).由于中国人群血细胞参考范围不同于西方人群,我们采用修改后的复检规则(方案8)和镜检规则对3 594份标本的数据进行分析,结果显示,真阳性率为12.33%(443/3 594),假阳性率为21.01%(755/3 594),真阴性率为63.44%(2 280/3 594),假阴性率为3.23%(116/3 594).在此基础上,参考"国际血液学41条复检规则"、XE-2100的性能特点和我国的常规工作情况,提出了中国人群应用XE-2100的血细胞计数和白细胞分类的涂片复检规则,验证试验结果显示,血液病细胞无漏检情况.结论 制定合理适用的血细胞计数和白细胞分类的涂片复检规则非常重要,既可保证检测结果质量,又可提高工作效率.血细胞复检规则应该在工作中不断地改进完善.

Review criteria for automated complete blood count and WBC differential analysis by Sysmex XE-2100 hematology analyzer

Objective To find out the suitable hematology review criteria for Chinese population via the analysis of experimental data from Sysmex XE-2100 hematology analyzer. Methods The total 3 594 patient samples were randomly detected in three hospitals respectively with automated hematology analyzer XE-2100 and blood smear was reviewed including observation of cell morphology and manual WBC differential analysis. Base on hematology review criteria suggested by international consensus group, we evaluated the true positive ratio(TP), the false positive ratio (FP), the true negative ratio (TN) and the false negative ratio (FN) as well as the prevalence for smear review, we finalized the optimal program. Results According to "the 41 items of International Consensus Review Rules and Slide Review Rule" proposed by international hematology expert group, TP, FP, TN and the FN were 14.02% (504/ 3 594), 32.67% ( 1 174/3 594), 51.47% ( 1 850/3 594) and 1.84% (66/3 594), respectively. Because the reference range of Chinese peripheral blood was different from the Western people and the 3 594 specimen data were analyzed by using the revised review criteria ( Chapter Ⅷ ) and the microscopic smear review. The TP, FP, TN and FN were 12.33% (443/3 594), 21.01% (755/3 594), 63.44% (2 280/ 3 594) and 3.23% (116/3 594) accordingly. On the basis of above "41 items of International Consensus Review Rules", the performance, characteristic of XE-2100 and Chinese laboratory situation, we put forward the criteria for slide review following automated CBC and WBC differential analysis in XE-2100 hematology analyzer, which was more suitable for population in China. The validation result demonstrated that no blast cell and immature cell was missed. Conclusions It's very important in establishing the applied criteria for slide review following automated CBC and WBC differential analysis to assure quality of hematology results. It can enhance work efficiency and reduce unnecessary labor consuming. The criteria should be improved in laboratory practice.