Department of Laboratory Medicine, Yonsei University College of Medicine, Seoul, Korea.
Arch Pathol Lab Med. 2012 Nov;136(11):1408-13. doi: 10.5858/arpa.2010-0757-OA.
In the clinical laboratory, it is important both to reduce the number of peripheral blood slide reviews to save time and money and to avoid reporting false results.
To determine differences in the slide review rates of 3 widely used automated hematologic analyzers, the Unicel DxH 800 (Beckman Coulter Inc, Fullerton, California), ADVIA 2120i (Siemens Diagnostics, Tarrytown, New York), and XE 2100 (Sysmex, Kobe, Japan), using International Consensus Group for Hematology Review guidelines.
A total of 1485 samples were tested, and 300 were manually reviewed. Slide review rates, sensitivity, specificity, and false-positive and false-negative rates were estimated using consensus group rules and compared using χ(2) tests, Fisher exact tests, or generalized estimating equations.
Unicel DxH 800, ADVIA 2120i, and XE 2100 showed 22.8%, 20.2%, and 28.6% slide review rates; 14.3%, 14.3%, and 9.7% false-negative rates; and 13.7, 11.3%, and 17.3% false-positive rates, respectively. All analyzers showed significantly higher false-negative rates than that of the consensus group (2.9%).
False-negative rates were higher than the recommended levels. Among 3 automated hematologic analyzers, XE 2100 showed the highest rate of slide review. Because the present study clearly shows that the slide review rates have distinct characteristics among the studied analyzers, each individual laboratory should consider selecting the most appropriate analyzer according to clinical characteristics. Analyzers with high sensitivity may be advantageous in outpatient settings for screening patients, whereas analyzers with high specificity may be beneficial in inpatient settings for efficient patient care.
在临床实验室中，既要减少外周血涂片复查的次数以节省时间和金钱，又要避免报告假结果，这一点很重要。
根据国际血液学复核专家组（International Consensus Group for Hematology Review）的指南，确定 3 种广泛使用的自动化血液分析仪（Unicel DxH 800 [贝克曼库尔特公司（Beckman Coulter Inc），富勒顿，加利福尼亚州]、ADVIA 2120i [西门子诊断公司（Siemens Diagnostics），塔里敦，纽约州]和 XE 2100 [希森美康公司（Sysmex），神户，日本]）的涂片复查率的差异。
共检测了 1485 个样本，其中 300 个进行了人工复查。使用专家组规则估计涂片复查率、敏感性、特异性以及假阳性和假阴性率，并使用 χ(2)检验、Fisher 确切检验或广义估计方程进行比较。
Unicel DxH 800、ADVIA 2120i 和 XE 2100 的涂片复查率分别为 22.8%、20.2%和 28.6%；假阴性率分别为 14.3%、14.3%和 9.7%；假阳性率分别为 13.7%、11.3%和 17.3%。所有分析仪的假阴性率均明显高于专家组推荐的水平（2.9%）。
假阴性率高于推荐水平。在 3 种自动化血液分析仪中，XE 2100 的涂片复查率最高。由于本研究清楚地表明，所研究的分析仪之间的涂片复查率具有明显的特征，因此每个实验室都应根据临床特征选择最合适的分析仪。高敏感性的分析仪可能有利于门诊患者的筛查，而高特异性的分析仪可能有利于住院患者的高效护理。
