Cornbleet P J, Myrick D, Judkins S, Levy R
Department of Pathology, Stanford University Medical Center, California 94305.
Am J Clin Pathol. 1992 Dec;98(6):603-14. doi: 10.1093/ajcp/98.6.603.
The CELL-DYN 3000 (Unipath Corp., Mountain View, CA) differential was evaluated in a tertiary care hospital using samples with a broad range of distributional and morphologic abnormalities. Particular attention was directed to the performance of the instrument-generated suspect flags that occur as an aid to identify samples with abnormal leukocytes, as well as the estimates of abnormal cells that are made by the instrument. The CELL-DYN 3000 showed excellent quantitative results for the white blood cell differential compared with a 400-cell manual differential, in which morphologic abnormalities were absent or occurred in low numbers (< or = 5%). Specificity of the BLAST, VARIANT LYMPH, NRBC, WBC, or DIFF suspect flags (with the requirement that the blast estimate and variant lymphocyte estimate by the instrument be > or = 1%) was 82.6%. Sensitivity of these flags to detection of more than 5% "abnormal" leukocytes (blasts, malignant lymphoid cells, grossly dysplastic neutrophils, nucleated red blood cells, or reactive lymphocytes) or significant platelet clumping was 81.6%. The primary deficiency was the inability of the CELL-DYN 3000 to flag samples with small numbers (< or = 5%) of nucleated erythrocytes, lymphoid blasts, or hairy cells, or more than 5% reactive lymphocytes. Specificity of the IG flag (with immature granulocyte estimate > or = 3%) for immature granulocytes (metamyelocytes, myelocytes, or promyelocytes) was 94.9%. Sensitivity of the immature granulocyte flag varied from 41.7% for identifying IG > or = 1% to 100% for the three samples with immature granulocytes > or = 3%. Calculation of sensitivity and specificity to varying percentages of bands showed poor flagging performance, with many false-positive and false-negative results at all levels.
使用具有广泛分布和形态异常的样本，在一家三级护理医院对CELL-DYN 3000（Unipath公司，加利福尼亚州山景城）血细胞分析仪进行了评估。特别关注仪器生成的可疑标记的性能，这些标记有助于识别白细胞异常的样本，以及仪器对异常细胞的估计。与400个细胞的手工分类计数相比，CELL-DYN 3000在白细胞分类计数方面显示出优异的定量结果，手工分类计数中形态异常不存在或数量较少（≤5%）。BLAST、异型淋巴细胞、有核红细胞、白细胞或分类计数可疑标记的特异性（要求仪器对原始细胞估计和异型淋巴细胞估计≥1%）为82.6%。这些标记对检测超过5%的“异常”白细胞（原始细胞、恶性淋巴细胞、严重发育异常的中性粒细胞、有核红细胞或反应性淋巴细胞）或明显血小板聚集的敏感性为81.6%。主要不足在于CELL-DYN 3000无法标记有少量（≤5%）有核红细胞、淋巴母细胞或毛细胞，或超过5%反应性淋巴细胞的样本。未成熟粒细胞标记（未成熟粒细胞估计≥3%）对未成熟粒细胞（晚幼粒细胞、中幼粒细胞或早幼粒细胞）的特异性为94.9%。未成熟粒细胞标记的敏感性从识别未成熟粒细胞≥1%时的41.7%到未成熟粒细胞≥3%的三个样本时的100%不等。对不同百分比的杆状核细胞计算敏感性和特异性显示标记性能较差，在所有水平上都有许多假阳性和假阴性结果。
