血涂片复审原始／幼稚血细胞的临床诊断性试验研究

目的建立仪器法血细胞分析后选择性显微镜筛检原始／幼稚血细胞的复审方案，解决临床关注热点。方法通过双盲法对1048份随机标本进行仪器分析和血涂片显微镜观察，建立复审原始／幼稚血细胞的方案，进行临床诊断性试验评价，并与国际41条复审规则进行比较研究。结果①国际41条复审规则真阳性率（7．44％）最高而假阴性率（0．19％）最低，但复检率高达46．95％，与本方案复检率（22．90％）比较，差异有统计学意义（P〈0．01）；②本复审方案特异性、准确度、Youden指数、阳性似然比和阳性预测值优于国际规则；，⑧两种血涂片复审方案漏检率均〈1％。④验证试验硅示除阳性预测值外，其余各项临床诊断性评价指标与建模数据差异均无统计学意义（P均〉0．05）。结论所建立血涂片复审原始／幼稚血细胞的方案具有很好的实效性。

The study on the clinic diagnostic test for blood smear review of blast/immature cells

Objective To establish a review program for selective microscopic sereening of blast/immature cells following instrumental analysis of blood cells and resolve the clinical focus. Methods 1048 cases random samples were tested by the instrument and microscopic observation with a double-blind method. The program for blast/immature cells review was established and valued with tbe clinic diagnostic test. The program was also compared with the international 41 review rules. Results ①The international 41 review rules had the highest true positive rate （7.44%） and the lowest false negative rate （0.19%）, but with a high review rate （46.95%） and the difference with the review program （22.90%） had statistical significanee （P〈 0.01）; ②The specificity, accuracy, diagnosis index, positive likelihood ratio and positive predictive value of the review program were all better than international 41.③The false negative rates of the two review programs were both less than 1%; ④There were no statistical significance existed in the clinic diagnostic evaluation indicators except positive predictive value between the validation test data and the model-building data（Pall〉 0.05）. Conclusion The new established program for blast/immature cells review has good practicability.