血细胞分析仪白细胞分类结果提示异常的准确性评价

目的:研究SYSMEX SF-3000血细胞分析仪白细胞(WBC)分类结果提示异常的准确性。方法:血细胞分析仪WBC分类结果提示Blast／A-Ly(原始／异型淋巴细胞)?,Imm Gran(未成熟粒细胞)?的标本505例,按WBC计数结果分五组,<4.00×109／L;<4.00×109／L-10.00×109／L;10.01×109／L-20.00×109／L;20.01×109／L-30.00×109／L;>30.00×109／L。这些标本中另外还有MONO ↑(单核细胞增高)、EO ↑(嗜酸性粒细胞增高)、BASO ↑(嗜硷性粒细胞增高)等。同时推血片、染色、镜检分类。结果:505例仪器分类全部提示异常的标本,镜检分类结果21.98％(111／505)含有幼稚粒细胞,其中原始粒细胞21.32％(29／136例次);中、晚幼稚粒细胞78.68％(107／136例次);7.92％(40／505)的标本有异型淋巴细胞;21.58％(109／505)的标本中性粒细胞中含有中毒颗粒。并且WBC计数4×109／L-10×109／L组异常细胞和中毒颗粒检出率较高67.86％(57／84)。WBC计数>30×109／L组原始粒细胞检出率达100％(24／24)。仪器分类提示单核细胞增高的155例与镜检分类有显著性差异(P<0.05)。提示嗜酸性粒细胞和嗜碱性粒细胞增高的55例和40例与镜检分类无显著性差异(P>0.05)。结论:SF-3000血细胞分析仪WBC分类结果提示异常的标本,需要镜检分类,避免漏诊。

Evaluation of the accuracy of the abnormal WBC differential count by SYSMEX SF-3000 Analyzer

Background: To evaluate the accuracy of the abnormal WBC differential count by SYSMEX SF-3000 analyzer. Methods: 505 blood samples displayed Blast/A-Ly?and Imm Gran?in Sysmex SF-3000 analyzer, which Contained abnormal WBC were investigated. Samples were classified into 5 groups according to the result of WBC count by the analyzer. The five groups were 4.00×l09/L; 4.00×l09/L-10.00×109/L; 10.01×l09/L- 20.00×l09/L: 20.01×l09/L-30.00×l09/L; 30.00xl09/L. the samples also contained MONO ↑ EO ↑ and BASO ↑. at same time, smeared and wright stained the same samples before examing them under a microscope. Results: Among the 505 abnormal samples classified by the analyzer, microscope found 21.98% of the total(111/505) contained immature celis, of which myeloblast was 21.32%(29/136 times), and myelocyte, together with metamyelocyte was 78.68%(107/136times). 7.92% of the total(40/505) contained atypical lymphocyte, and 21.58%(109/505) contained toxic granule. In addition, the detective rate of abnormal was 67.86%(57/84) when WBC was 4.00×l09/L-10.00×l09/L, and the positive rate of myeloblast was 100%(24/24) when WBC was>30.00×109/L. It was significently different for the 155 cases of monocytosis(M ↑) by the SYSMEX SF-3000 analyzer, when they were examined under a microscope (P<0.05). However for the 55 cases of eosinophilia(EO ↑) and 40 cases of basophilism(BASO ↑), it was not significently different when they was examined by analyzer or under a microscope (P<0.05). Condusion: The samples, of which the differential count is abnormal, should be examined under the microscope to exclude the false negative.