[Laboratory evaluation of the Sysmex NE-7000 flagging system; a tool for the recognition of abnormal cells in white cell differentials].

Sysmex NE-7000 flagging system was evaluated for the recognition of abnormal cells in white cell differentials. Six flags that could mark blasts, immature granulocytes, left shift, nucleated red blood cells, atypical lymphocytes, and platelet clumps were selected for evaluation. 182 morphologic abnormal samples were screened from the Kobe University Hospital patients, by means of the 600 eye counts differentials. Blasts flag missed 8 of 28 cases, and immature granulocytes flag missed 25 of 56 cases. These missed cases contained either relatively few abnormal cells; less than 3% immature granulocytes, or absolutely few cells; less than 201 per micro liter blasts. Platelet clumps flag missed only 2 of 23 cases. But nucleated red blood cells and atypical lymphocytes flags missed all of 7 and 4 cases respectively. Left shift flag missed 36 of 64 cases, but it could help marking immature granulocytes or blasts. To use the NE-7000 as a screening tool, we compared the NE's all 35 flags versus abnormal cells or status based on the 100 eye counts. 1,153 cases were analyzed. Full agreement; 1047 (90.8%), partial agreement; 61 (5.2%), distributional false normal; 7 (1.6%), and morphological false normal; 4 (4.6%), were obtained. The more flags were used, the less abnormal cases were missed. But it accompanied the increase of the flag positive cases that must be confirmed by eye.