[全血细胞分析审核标准的临床应用]
[Clinical application of review criteria for complete blood analysis].
作者信息
Jiang Hong, Zeng Ting-Ting, Huang Ji-Bin, Mao Zhi-Gang, Zeng Su-Gen
机构信息
Department of Laboratory Medicine, Huaxi Hospital, Sichuan University, Chengdu 610041, China.
出版信息
Zhonghua Yi Xue Za Zhi. 2010 Jun 8;90(22):1522-5.
OBJECTIVE
To evaluate the review criteria for complete blood analysis.
METHODS
total of 8820 blood samples taken at our hospital were detected both by the Sysmex XE-2100 automated blood cell analyzer and double-blind method microscopy. The performance of two review criteria were evaluated by statistical analysis. The parameters, such as true and false positive rates, true and false negative rates, sensitivity, specificity, positive predictive value, negative predictive value, total effective rate, test effectiveness and re-examination rate were calculated according to the criteria of XE-2100 hematology analyzer re-examination standards coordination group of Society of Laboratory Medicine of Chinese Medical Association. And a study was conducted to determine the improved clinical effectiveness over the criteria.
RESULTS
The values of true and false positive rates, true and false negative rates, sensitivity, specificity, positive predictive values, negative predictive value, total effective rate, test effectiveness and reexamination rate were 13.0%, 27.2%, 55.3%, 4.5%, 74.3%, 67.0%, 32.4%, 92.5%, 68.3%, 21.2%, and 40.2% respectively. The re-examination rate decreased to 33.8% and the total effective rate increased to 74.7% according to our improved review criteria. And there was no missed diagnosis of leukemic cells. It was found that 2069 samples (23.5%) needed manual microscopy for WBC differential analysis, 847 had abnormal cells and no leukemia was missed.
CONCLUSIONS
The automatic blood cell analyzer and WBC differential analysis review criteria have great clinical utilities. The review criteria of blood cell analysis may be improved according to patient source and instrument performance so as to better meet the needs of clinical application.
目的
评估全血细胞分析的复检标准。
方法
采用Sysmex XE - 2100全自动血细胞分析仪和双盲法显微镜检查对我院采集的8820份血样进行检测。通过统计分析评估两种复检标准的性能。根据中华医学会检验医学分会血细胞分析仪复检标准协作组制定的XE - 2100血液学分析仪复检标准，计算真阳性率、假阳性率、真阴性率、假阴性率、灵敏度、特异度、阳性预测值、阴性预测值、总有效率、检验效能和复检率等参数。并开展研究以确定相对于该标准而言改进后的临床效果。
结果
真阳性率、假阳性率、真阴性率、假阴性率、灵敏度、特异度、阳性预测值、阴性预测值、总有效率、检验效能和复检率分别为13.0%、27.2%、55.3%、4.5%、74.3%、67.0%、32.4%、92.5%、68.3%、21.2%和40.2%。根据我们改进后的复检标准，复检率降至33.8%，总有效率升至74.7%。且未出现白血病细胞漏诊情况。发现2069份样本（23.5%）需要进行白细胞分类的手工显微镜检查，其中847份有异常细胞，且未漏诊白血病。
结论
血细胞自动分析仪及白细胞分类复检标准具有较大临床实用价值。血细胞分析复检标准可根据患者来源及仪器性能进行改进，以更好地满足临床应用需求。
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