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Objective:To provide consistent data basis for the application of reference intervals for children blood cell analysis in different testing systems.Methods:According to the requirements of American Institute for Clinical and Laboratory Standardization (CLSI) EP9-A3 document, 45 samples were collected and Sysmex XN20-A1 were used as reference system. Beckman DxH800, Siemens ADVIA 2120i, and Mindray BC5310 were comparison systems. Complete blood count and leukocyte classification were performed by four systems. The outliers of the detection results were tested by the generalized extreme student deviate (ESD) method. An optimal regression model was selected by scatter diagram, deviation diagram and frequency distribution diagram, which was used to fit the regression equation and calculate the deviation at the medical decision level and reference interval. The acceptable range for blood count deviation was cited from the Analytical Quality Specifications for Routine Tests in Clinical Hematology. The acceptable range for leukocyte classification was based on the EQA program of Royal College of Pathologists of Australasia (RCPA).Results:After the outliers were deleted, the scatter plot showed a linear relationship between the reference system and the three comparison systems. The deviation plot showed that the differences were variable. Deming regression or Passing-Bablok regression was selected according to the data distribution. The determination coefficient R2 of reference system and three comparison systems ranged from 0.95 to 0.99 in blood count and leukocyte classification. At the upper and lower limits of the reference interval, the deviations between XN-20A1 and ADVIA 2120 system were all acceptable, except for MONO# at 0.12×10 9/L. The deviations of all parameters at medical decision level were within acceptable ranges. The lower limit of PLT is partially unacceptable at the level of medical decision related to treatment and prognosis. Conclusions:The results of complete blood count and leukocyte classification in reference system and the comparison system had good consistency within the children′s reference interval. Our study provided a scientific basis for the feasibility of adopting a unified reference interval for different detection systems.
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ABSTRACT Background: The hematology analyzer, Sysmex XN-1000, generates white blood cell count with varying scattering intensities during a complete blood count (CBC) analysis. Objectives: The objectives of the study were to study the predictive role of median and coefficient of variation of neutrophil scattering items in blood samples for differentiation of leukemic subjects. Methods: We evaluated six neutrophil scattering parameters: neutrophil side scatter mean intensity, neutrophil side fluorescence light (SFL) mean intensity, neutrophil forward scatter mean intensity, neutrophil side scatter area distribution width (NE-WX), neutrophil SFL area distribution width (NE-WY), and neutrophil forward scatter area distribution width (NE-WZ), measured in white blood cell differential scattergram generated by the hematology analyzer (Sysmex XN-1000) at an academic medical center. Results: We collected 433 blood samples from acute myeloid leukemia (AML) and acute lymphoid leukemia (ALL) cases and normal controls. AML group showed highly significant differences in the mean values compared with the control group. Out of six neutrophil scattering items, NE-WX, NE-WY, and NE-WZ showed high efficiency, with area under the curve (AUC) values of 0.764, 0.748, and 0.757, respectively, to differentiate AML from ALL cases and control groups. When comparing combined acute leukemia cases (AML plus ALL) with the control group, NE-WX, NE-WY, and NE-WZ generated highly significant AUC values (0.840, 0.884, and 0.801, respectively). Conclusion: The neutrophil scattering parameters generated during CBC analysis provide a new tool for the prediction of acute leukemia and its lineage.
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Humans , Male , Female , Child , Adolescent , Adult , Middle Aged , Young Adult , Blood Cell Count/methods , Leukemia, Myeloid, Acute/blood , Precursor Cell Lymphoblastic Leukemia-Lymphoma/blood , Neutrophils/metabolism , Blood Cell Count/instrumentation , Case-Control StudiesABSTRACT
Background: Anaemia defined as reduction in the concentration in Haemoglobin is one of the key health indicators of health care system of the country. Accurate screening methods are required to estimate the levels of haemoglobin for diagnosing the cause of anaemia. Objectives of the study was to analyze and compare the results of haemoglobin concentrations estimated with automated haematology analyzer and point of care device HemoCue Hb301.Methods: It is a prospective cross-sectional study was conducted for one year after ethical approval. Non fasting capillary and venous blood samples were collected from the selected cases of children and Haemoglobin concentrations were estimated by automated analyzer and HemoCue Hb301 system and the values were noted. Quality control checks were performed for both. Statistical analysis was done using IBM SPSS Version 24.0.Results: Mean Hb% concentration was estimated in 108 children with 44 female and 64 males. The mean value of Automated hematology analyzer (11.965±1.012) was significantly higher when compared with the mean value of HemoCue Hb301 (11.697±1.312) (p=0.002). There was a significantly strong correlation between HemoCue Hb301and Automated hematology analyzer (r-value = 0.732, p <0.0001).Conclusions: The HemoCue is useful in many different settings and remains a widely used method in field settings as it has several advantages and is relatively inexpensive compared with automated haematology analysers. Further studies are needed to better understand potential sources of error in the Hb assessment by HemoCue with the aim to better train phlebotomists and implement appropriate standardised procedures.
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Background: Reticulocytes are young or immature red blood cells released from bone marrow and that contain remanants of ribonucleic acid (RNA) and ribosomes. Reticulocyte count (RC) is the index of erythropoietic activity within bone marrow. The reticulocyte counting methods at clinical laboratories are currently divided into manual and automated.Methods: A total of 500 samples of study cases were processed by manual method using New Methylene Blue (NMB) and automated method based on flowcytometry by PENTRA XLR HORIBA hematology analyzer. All quality control parameters were evaluated and values obtained by both methods were compared using various statistical methods.Results: Automated hematology analyzer provides excellent precision and linearity with no significant carryover. On comparing manual and automated RC method good method correlation was found (correlation coefficient r-0.865), however individual case wise percent deviation between manual and automated RC and CRC varied significantly. In addition within run precision calculated for automated RC differed significantly from manual count. The mean of difference between duplicate readings (150 samples) of manual and automated RC (<5%) were 0.3 and 0.01 respectively while 6.3 and 0.15 respectively for >5% RC. Thus, automated method was found to be more precise than the manual RC.Conclusions: The manual count method for RC associated with significant imprecision compared to flowcytometric method mostly based on interobserver variation and the smaller number of cell being counted. In contrast, the automated method is rapid, easy to operate, count higher number of cells with precise measurement.
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Background: Thrombocyte is important and very essential component of blood and have significant role in maintenance of hemostasis. Thrombocyte count is an important investigation done in various acquired and congenital coagulable states which include conditions like pregnancy. Thrombocyte count is routinely done by automated hematology analyzer method. The automated hematology analyzer counters are not usually available at all centres especially in peripheral and rural side though thrombocytes can also be assessed from the peripheral blood smears, which can be easily and precisely done at any set up. Aim and objective of this study was to compare the thrombocyte estimation by peripheral blood smear method and automated hematology analyzer in pregnant women.Methods: Thrombocyte estimation was done from samples taken from 120 normal pregnant women between December 2018 to March 2019, where samples were Ethylene Diamine Tetra Acetic acid (EDTA) anticoagulated. Thrombocyte was counted manually using PBS (Leishman stain) and hematology analyzer (Sysmex XN1000 series). Thrombocyte counts were expressed in Mean and standard Deviation. Statistical analysis was done by student’s t test using MS excel and SPSS version 17.Results: Thrombocyte count by PBS have mean value of 2.04 lacs/mm3 with standard deviation of 0.56 lacs/mm3 and by automated method have mean value of 1.89 lacs/mm3 and standard deviation of 0.71 lacs/mm3 with p value 0.010. Thus, there was no statistically significant difference found between two methods.Conclusions: Estimation of thrombocyte count on the basis of manual thrombocyte count is a reliable technique and can be used to validate automated thrombocyte counts. It can also be used in under resourced laboratories, where there are no automated counters of good precision available. In fact, all the tests showing abnormal thrombocyte counts must be reported only after cross examining on PBS.
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Background: There are several methods of platelet count used in hematology laboratory. These methods are manual counting, automated hematology analyzer counting, platelet count estimation by peripheral blood smear (PBS) method etc. Many diseases such as dengue, malaria, pregnancy induced hypertension etc. may leads to severe thrombocytopenia. Timely and precise diagnosis of platelet count plays very crucial role in critical care management of thrombocytopenia cases. The present study was undertaken to estimate platelet counts by PBS method and correlate them with results from automated hematology analyzer method.Methods: Study included one hundred randomly collected blood samples in EDTA anticoagulant vacutainer tubes. Each blood sample was processed for platelet count estimation with automated hematology analyzer and Leishman’s stained PBS examination. The statistical analysis was done by using Pearson's correlation test to access the agreement between both the methods.Results: The Pearson's correlation test showed significant positive correlation for platelet count estimation between both the methods. (r =0.9789).Conclusions: Platelet count estimation by PBS method is reliable and statistically significant when compared to hematology analyzer method. PBS platelet estimation method can be taken as early and rapid procedure for platelet assessment in critical severe thrombocytopenia cases. This method is simple, cheaper and can be done in rural hospital setup where automation is not available.
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[Abstract] 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 (rs＝0.813, P0.001). 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, P0.05), 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.
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[Abstract] Objective To investigate the significance of lymphocyte structure parameters of Sysmex XN-9000 hematology analyzer in screening peripheral blood atypical lymphocytes when positive alarm of atypical lymphocytes occurs. Methods From Dec. 2017 to Dec. 2018, 370 blood samples with positive alarm of atypical lymphocytes, which were detected by XN-9000 hematology analyzer in outpatient and emergency department of Changhai Hospital, Naval Medical University (Second Military Medical University), were collected in this study. Six lymphocyte structure parameters were recorded, including lymphocyte complexity (L-X), lymphocyte fluorescence intensity (L-Y), lymphocyte size (L-Z), dispersion width of lymphocyte complexity (L-WX), dispersion width of lymphocyte fluorescence intensity (L-WY) and dispersion width of lymphocyte size (L-WZ). According to the atypical lymphocyte proportion detected manually under microscope, the 370 samples were divided into 2 groups: atypical lymphocyte positive group (100 samples with an atypical lymphocyte proportion5%) and atypical lymphocyte negative group (270 samples with an atypical lymphocyte proportion≤5%), and the significance of each lymphocyte structure parameter was evaluated by receiver operating characteristic (ROC) curve. Then the parameters with high accuracy for screening atypical lymphocytes were analyzed by logistic regression model to study the significance of their combination. Results The lymphocyte structure parameters L-WY, L-X and L-Z had high accuracies in screening atypical lymphocytes, with the ROC area under curve (AUC) being 0.927, 0.939 and 0.931, respectively. The combined predictor was generated using L-WY, L-X and L-Z by logistic regression analysis model, and the ROC AUC of combined predictor was 0.979. When 0.058 1 was selected as the cut-off value, the sensitivity was 100.0% and the specificity was 77.8%. Conclusion Lymphocyte structure parameters L-WY, L-X and L-Z detected by Sysmex XN-9000 hematology analyzer can effectively screen peripheral blood atypical lymphocytes when positive alarm of atypical lymphocytes occurs.
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Objective@#To establish the review criteria for children′s blood cell analysis, ensure the accuracy of blood cell analysis results, and ensure that pathological cells are not missed.@*Methods@#A total of 1 420 samples of blood cell analysis were collected from outpatients and inpatients in Shanxi Children′s Hospital from May to June 2018, which were detected by SYSMEXXN-350 and XN-A1 automated blood cell analyzer. Blood smears weredouble-blindly examinedunder microscope. Among them, 463 were used for the establishment of review criteria, 586 were used for the verification and evaluation of review criteria, and 371 were used for the application effect study of review criteria. According tothe 41 rules recommended by ISLH, combining the characteristics of children′s physiology, pathology, disease and abnormal alarming information of hematology analyzer, the review criteria suitable for children′s blood cells were established.@*Results@#Through the evaluation and optimization of 41 rules recommended by ISLH, 23 rules for reexamination of children′s blood cell analysis were formulated, with a reexamination rate of 25.09%, and a false positive rate was 14.16%. A total of 371 samples of patients with hematological diseases were selected for the application of the review criteria. The false negative rate was 2.96%, and no pathological cells were missed.@*Conclusion@#The children′s blood cell review criteria established in this study has been verified and evaluated, which not only ensures the quality of the report, but also improves the work efficiency, and provides an important basis for the diagnosis and differential diagnosis of childhood leukemia, infectious mononucleosis and other hematological diseases.
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BACKGROUND: Here we investigated the clinical utilities of blast suspect, large unstained cell (LUC), delta neutrophil index ll (DN ll), and delta neutrophil index l (DN l), analyzed in peripheral blood samples with automated hematology analyzers to predict the relapse of acute leukemia. METHODS: We retrospectively reviewed the medical records of 112 patients, including 56 patients with acute leukemia relapse and 56 controls. Blast suspect, LUC, DN ll, and DN l were compared between the control and leukemia relapse groups. RESULTS: Significant differences in blast suspect (P<0.001), LUC (P<0.001), DN ll (P<0.001), and DN l (P=0.002) were observed between the leukemia relapse and control groups. The areas under the curve (AUC) value was 0.927 for blast suspect (95% confidence interval [CI]: 0.8750.978, P<0.001), 0.868 for LUC (95% CI: 0.794–0.941, P<0.001), and 0.900 for DN ll (95% CI: 0.841–0.960, P<0.001). Logistic regression analysis for the prediction of leukemia relapse revealed odds ratio values of 1.52 (95% CI: 1.26–1.96, P=0.0002) for blast suspect, 1.66 (95% CI: 1.27–2.42, P=0.0019) for LUC, 1.16 (95% CI: 1.08–1.29, P=0.0014) for DN ll, and 1.05 (95% CI: 1.01–1.13, P=0.0845) for DN l. CONCLUSIONS: Multiple parameters provided by automated blood cell analyzers may serve as powerful ancillary tools for the prediction and diagnosis of leukemia relapse.
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Humans , Blood Cells , Diagnosis , Hematology , Leukemia , Logistic Models , Medical Records , Neutrophils , Odds Ratio , Recurrence , Retrospective StudiesABSTRACT
Incidentally, hemoglobin (Hb) variants can be detected using HbA1c tests in clinical laboratories. We found 38 patients with Hb variants after reviewing a total of 29,398 HbA1c test results from January 2017 to December 2017. While reviewing the complete blood count results of the patients (N=36) using the Sysmex XN-9000 analyzer (Sysmex, Japan), 35 patients were flagged as unremarkable with respect to differential white blood cell (WBC) counts. However, 1 patient with a normal WBC count did not obtain a differential WBC count while being flagged for an abnormal WBC scattergram in the white blood cell differential (WDF) channel. The WBC histogram showed an abnormally low fluorescent signal in the WDF channel; however, the differential WBC count was normal upon microscopic examination. After testing the patient's buffy coat suspended in normal saline and removing red blood cells (RBCs), the WBC scattergram and differential WBC count returned to normal. This finding suggests that the presence of a patient's RBCs may affect WBC scattergrams and Hb variants may interfere with the fluorescent dye in the differential WBC count. Therefore, when an abnormal WBC scattergram with an abnormally low fluorescent signal is encountered on the Sysmex XN-9000 analyzer, the presence of an Hb variant can be suspected.
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Humans , Blood Cell Count , Erythrocytes , Hematology , LeukocytesABSTRACT
Object To verify and evaluate the performances of Sysmex XN-9000 hematology analyzer under body fluid mode when used for peritoneal and pleural fluids detection.Methods According to the guidance of ICSH, Sysmex XN-9000 hematology analyzer under body fluid mode had its performances verified on background counting, carryover, precision, linear range and etc of RBC-BF and TC-BF, and then was compared with microscopy on RBC-BF, TC-BF, PMN％, MN％, N％, L％, M％and E％.Results The RBC-BF and TC-BF had the background counting being 0.00, carryover being 0.00％and 0.07％ respectively, coefficients of variation (CV) of within-run precision being from 0.96％to 17.89％as well as from 2.19％to 10.33％respectively, CV of between-run precision being from 3.34％to 4.73％as well as from 8.33％to 10.75％resptctively, and the linear ranges being (0～5) ×1012/L and (0～20) ×109/L respectively. There was a high correlation between Sysmex XN-9000 hematology analyzer and microscopy when detecting RBC-BF, TC-BF, PMN％, MN％, N％, L％, M％and E％. The Spearman rank correlation coefficients (rs) were 0.977, 0.995, 0.863, 0.929, 0.926, 0.949, 0.965 and 0.816 (P<0.05), and there were statistical significances between the correlations. Bland-Altman bias analysis on the analyzer and microscopy showed that RBC-BF had the bias (4.6％) lower than that (5.6％) of TC-BF;MN％had the bias (-2.0％) lower than that (4.2％) of PMN％;L％, N％, M％and E％had the bias being-0.5％, 4.4％,-5.9％and-1.6％respectively, which were all met the requirements of the manufacturer.Conclusion Sysmex XN-9000 hematology analyzer under body fluid mode proves its performances for routine detection of peritoneal and pleural fluids.
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Objective To evaluate the creditability of warning message of white differential count (WDF) and white precursor cell (WPC) channels in Sysmex XN-3000 hematology analyzer,and verify its optimal threshold and adjust the alarm threshold.Methods A total of 61 EDTA-K2 anticoagulated blood samples without abnormal warning and 521 EDTA-K2 anticoagulated blood samples with abnormal warning were simultaneously detected in WDF and WPC channels.After the smear specimens of blood sample were automatically prepared by the instrument,microscopic examinations were performed manually.The results of microscopic examination were considered as the gold standard to determine the reliability of the warning message from the instrument and verify the reasonability of initial warning threshold value provided by the manufacture.Consequently,the threshold values were adjusted based on the requirements in practical work.Results The warning messages of atypical lymphocytes and blasts/abnormal lymphocytes in WDF channel were higher sensitive (95.8％ and 100％ respectively),but lower specific (34.7％ and 23.5％ respectively) compared with microscopic examination.The warning messages of atypical lymphocyte,blasts and abnormal lymphocytes in WPC channel were lower sensitive (81.3％,66.7％,and 76.5％ respectively) but higher specific (61.9％,55.5％ and 88.3 ％ respectively) compared with microscopic examination.According to the ROC curve analysis,the prognostic values of warning message of microscopic examination were of medium level,except the warning message for abnormal lymphocytes was poor compared with WPC channel.Combining the practical retest rules,the optimal critical threshold values of atypical lymphocytes and blasts/Abn lymph in WDF channel were adjusted as 120,and they were adjusted as 140 in WPC channel.Conclusion The high sensitive WDF channel should first be used for screening,and the detectable warning message could be retested by using high specific WPC channel to shorten the turnaround time of the test results and improve the working efficiency.The initial critical warning threshold provided by the manufacture should be verified and adjusted to the optimum critical threshold in order to ensure the accuracy of test results.
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Objective To evaluate Sysmex XS-800i,XS-1000i and XE-2100D hematology analyzers when used to detect RBC count,hemoglobin (HGB),hematocrit (HCT),mean corpuscular volume (MCV),mean corpuscular hemoglobin (MCH) and mean corpuscular hemoglobin concentration (MCHC).Methods XE-2100D hematology analyzer was calibrated after performance evaluation,and the three analyzers had the intra-day precisions measured with three levels of whole-blood quality control materials.Totally 50 whole-blood specimens were detected with the three analyzers respectively,and statistical analyses and clinically acceptable performance evaluation were carried out on RBC count and the obtained results.Results XE-2100D hematology analyzer met the clinical requirements,and the three analyzers all gained high precisions when used to measure the parameters of the whole-blood quality control materials.The correlation coefficients (r2) respectively between the three analyzers were all higher than 0.95 when used to test the 50 specimens.At all medical decision levels XS-800i and XS-1000i hematology analyzers both gained acceptable detection results except XS-800i hematology analyzer in case of 5.9×1012/L RBC count as well as 35％ or 50％ HCT.Conclusion Sysmex XS-800i,XS-1000i and XE-2100D hematology analyzers have high precisions and correlations when used to detect RBC count,HGB,HCT and MCV,and contrast test is suggested to be executed periodically to ensure the comparability of tbe result.
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Objective To build anautoverification system for hematology analysis system and validate the system based on commercialized labXpert software.Methods Preliminary validation rules was established base on 41 Items of International Consensus Review Rules and instructions for Mindray CAL8000 auto hematology analyzer,and input the rules into labX pert sample validation system.999 clinical samples were collected from Beijing Hospital Ministry of Health to test the preliminary rules and parameters including false positive rate,false negative rate and autoverification pass rate were calculated,based on which to adjust and customize the original protocol.Then 15 934 samples were tested,respectively,for autoverification by calculating the autoverification pass rate,proportion of manual verification and microscopic verification.Autoverification were compared as well as the turnover time (TAT,timefrom receipt of sample to report of result) before and after application of autoverification system.Results Preliminary verification results showed that false negative rates in both hospitals were less than 2％,and the false negative mainly caused by low promyelocytic cells value (blasts and promyelocytes less than 3 ％),abnormal erythrocyte morphology,and abnormal platelet morphology.No sample with excess blasts or percentage of blasts and promyelocytes higher 3％ with tested with false negative result,indicating relatively low clinical risks.Both hospitals reported with relatively high false positive rates,up to nearly 18％,using preliminary programs,which may affect the autoverification rate of the system.Based on the analyzing result of false positive results,the program was adjusted to significantly reduce the false positive rate while remaining the false negative rate low,therefore resulted with 4 remarkable increase of autoverification pass rate.Over 10,000 samples were tested with improved program,and the autoverification pass rates for hospital was 78.4 ％,respectively.Primary reason causing failure of autoverification included increased IMG％,flag for immature cells and WBC exceeding set limit.Application of system reduced the TAT by 5 min (P＜0.05).Conclusion Autoverificationsystem using Mindray CAL8000 auto hematology analyzer andlabXpert has been confirmed effective in reducing TAT and enhancing working efficiency while remaining low false negative rate.The autoverification pass rate tested 75％,which suggested that laboratory workers can spare more time on reexamination of abnormal samples for better blood routine report.
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Objective To evaluate the performance alarms and parameters generated by hematology analyzer during detection of circulating sezary cells of peripheral blood smears.Methods Blood samples from patients with Sezary syndrome (n=21) were studied with Sysmex XN-9000 analyzer,and compared to patients with benign or tumoral skin lesions (n=48) and patients with chronic lymphoproliferative B-cell diseases (n=55) and normal person (n=45) used as control.Results In present series,the value of structural lymphoid parameters (ly-x and ly-z) and the alarm Blast/Abn Lympho were statistically higher in Sezary cases than in control cases (U=37,40,44,55,38,41,all P＜0.05).Screening Sezary cells critical values of ly-x and ly-z determined by ROC curve were greater than or equal to 86 and was more than or equal to 68.The combination of above three indexes up (i.e.alarm Blast/Abn Lympho＞ 100,ly-x=86 and ly-z＞68) sensitivity and specificity respectively for 100 ％ and 92.1 ％,in order to get the best screening Sezary cells diagnostic efficiency.In addition,the value of ly-x was associated to the count of circulating Sezary cells and value of ly-z to the presence of large Sezary cells,both parameters described as prognostic factors.Conclusion The combination of alarm Blast/Abn Lympho and structural parameters (ly-x/ ly-z/ly-y) may allow to define rule of blood slide review to screen circulating Sezary cells.
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Objective To explore the method of comparing different hematology analyzer in Sports Biochemistry Laboratories with the median concentration.Methods In accordance with the American Society of Clinical and Laboratory Standards Institute EP9-A2 document requirements,ADVIA120(120) was chosen as a standard comparative instrument,ADVIA2120i(2120) as a test instrument,six different batches of normal and non-normal 2 quality control were monitored continuously for one year,combined with 42 cases of fresh sample which were selected randomly,the author analyzed the precision,accuracy and comparability of the two instruments,and white blood cell(WBC),red blood cell (RBC),hemoglobin(HGB),hematocrit (HCT),mean corpuscular volume(MCV),mean corpuscular hemoglobin(MCH),mean corpuscular hemoglobin concentration(MCHC) and platelet(PLT) were chosen as the test indicators.Results The precision(CV％ values within a range of 0.9-5.0) of the two instruments were all within the CLIA'88 1/4 tolerance accepted range;All indicators' percentage difference between the two instruments are fit with the International Blood Standardization Committee(ICSH) Standard.The test results of 42 blood samples detected by different hematological analyzers were analyzed by regression analysis,which showed that the correlative coefficient (r) was over 0.97.Conclusion The method of continuously monitored the normal and non-normal 2 quality control for one year,combined with 42 cases of fresh sample which were selected randomly can well be used in the study of tests results comparability and consistency of two different hematological analyzers in Sports Biochemistry Laboratories.
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Objective To explore the method of comparing different hematology analyzer in Sports Biochemistry Laboratories with the median concentration.Methods In accordance with the American Society of Clinical and Laboratory Standards Institute EP9-A2 document requirements,ADVIA120(120) was chosen as a standard comparative instrument,ADVIA2120i(2120) as a test instrument,six different batches of normal and non-normal 2 quality control were monitored continuously for one year,combined with 42 cases of fresh sample which were selected randomly,the author analyzed the precision,accuracy and comparability of the two instruments,and white blood cell(WBC),red blood cell (RBC),hemoglobin(HGB),hematocrit (HCT),mean corpuscular volume(MCV),mean corpuscular hemoglobin(MCH),mean corpuscular hemoglobin concentration(MCHC) and platelet(PLT) were chosen as the test indicators.Results The precision(CV％ values within a range of 0.9-5.0) of the two instruments were all within the CLIA'88 1/4 tolerance accepted range;All indicators' percentage difference between the two instruments are fit with the International Blood Standardization Committee(ICSH) Standard.The test results of 42 blood samples detected by different hematological analyzers were analyzed by regression analysis,which showed that the correlative coefficient (r) was over 0.97.Conclusion The method of continuously monitored the normal and non-normal 2 quality control for one year,combined with 42 cases of fresh sample which were selected randomly can well be used in the study of tests results comparability and consistency of two different hematological analyzers in Sports Biochemistry Laboratories.
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Objective To evaluate the reliability of the white precursor cell (WPC) channel on the Sysmex XN-9000 hematology analyzer (XN-9000) in giving the abnormal white blood cell (WBC) alarm.Methods A total of 520 blood samples with abnormal WBC alarm from the Sysmex XE-2100 (XE-2100) and XN-9000 were performed the manual peripheral blood smear review,and their results were analyzed.Results The specificity of the XN-9000 WPC channel in the blast alarm was significantly higher than that of XE-2100 (x2 =6.98,P＜0.05),while the false positive rate of the XN-9000 (36％) significantly lower than that of XE-2100 (64％,x2 =6.18,P ＜ 0.05).The overall efficiency of the XN-9000 WPC channel in identifying blasts and abnormal lymphocytes (90.4％ and 94.4％) was significantly higher than that of the XE-2100 (72.2％ and 80.1％,x2 =5.6 and 6.33,P ＜ 0.05).Under the automatic reflex analysis mode of WPC channel,the specificity and overall efficiency of the WPC channel in identifying blasts and abnormal lymphoeytes of all the detected samples were significantly higher than those of the WDF channel (x2 =6.15,4.14,6.02 and 4.88,P ＜0.05).The total review rate of the XN-9000 (WDF/WPC) was significantly lower than that of the XE-2100 (x2 =4.33,P ＜ 0.05).Similarly,the review rate of the XN-9000 for the blast/abnormal lymphocyte alarm (84/260,32％) was significantly lower than that of the XE-2100 (107/260,41％) (x2 =4.38,P＜0.05).Conclusion Compared with the XE-2100,the XN-9000 WPC channel can improve the overall efficiency of the blast/abnormal lymphocyte alarm,reduce the false positive rate and the review rate,and then improve the efficiency of clinical laboratories.
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Objective To explore the value of Sysmex XE 5000 blood cell analyzer in alarm of atypical lymphocytes and basophil.Methods 198 samples of Sysmex XE 5000 blood cell analyzer and suggested that atypical lymphocytes and basophils, 915 copies of the instrument tip shaped specimens.Single lymphocyte increased blood smear microscopy for examination under a microscope to detect atypical lymphocytes as the gold standard and to verify the alarm not exactly.Results The microscopic examination results as the gold standard, and suggested that atypical lymphocytes and basophilia specimens after reinspection, eosinophilic granulocyte alkaline or positive value of 1.8%,in the normal range, the positive rate of atypical lymphocytes (129/198) was 65.2%,but the instrument alone atypical lymphocytes alarm specimens the positive rate of atypical lymphocytes after review of 72.4% microscope (663/915),the former was lower than the latter with significant difference (x2=4.521,P<0.05).Conclusion Sysmex XE 5000 blood cell analyzer at the same time of atypical lymphocyte and basophil alarm, two detection levels of interference, combined with microscope examination can improve detection accuracy, reduce the misdiagnosis rate, and provide reliable data for clinical treatment.