Stirn Martina, Moritz Andreas, Bauer Natali
Department of Veterinary Clinical Sciences, Clinical Pathology and Clinical Pathophysiology, Justus-Liebig University Giessen, Frankfurterstr, 126, Giessen 35392, Germany.
BMC Vet Res. 2014 Jun 5;10:125. doi: 10.1186/1746-6148-10-125.
Modern automated haematology instruments are capable of performing leukocyte differentials faster, cheaper and with a higher precision than the traditional 100-cell manual differential count. Thus, in human laboratories, criteria are defined for performing a manual review of the blood smear resulting in a marked reduction of manual differential counts. While common in human laboratories, this approach to reducing the number of manual differentials in veterinary laboratories is still not commonly performed. Thus, our aim was to determine the rate and causes of manual leukocyte differentials in a university clinical pathology laboratory using the automated laser-based haematology analyser ADVIA 120. Overall, 14,953 complete blood cell counts from dogs, cats and horses were reviewed. Manual leukocyte differentials were requested if abnormal ADVIA peroxidase and baso cytograms were detected (i.e. suspicion of left shift or atypical lymphocytes/blasts, inappropriate separation of cell populations).
In 21% of canine, 32% of feline and 20% of equine samples, a manual differential was requested. Indistinct separation of the cell population was present in 10% to 15% of the cases. Depending on the species, atypical lymphocytes were suspected in 2% to 12%, left shift in 13% to 25% and suspicion of blasts was present in less than 0.4% of the cases.
The obtained results are comparable to those published for human medicine and the rate of manual differentiation could be markedly reduced in veterinary laboratories if microscopic examination was used as a validation procedure rather than as a reflexive substitute for automated differentiation.
现代自动化血液学仪器能够比传统的100个细胞的手工分类计数更快、更便宜且更精确地进行白细胞分类。因此,在人类实验室中,定义了进行血涂片手工复查的标准,从而显著减少了手工分类计数。虽然这种方法在人类实验室中很常见,但在兽医实验室中减少手工分类数量的这种方法仍未普遍采用。因此,我们的目的是使用基于激光的自动化血液学分析仪ADVIA 120,确定一所大学临床病理实验室中手工白细胞分类的比例及原因。总共审查了来自犬、猫和马的14953份全血细胞计数。如果检测到ADVIA过氧化物酶和嗜碱性粒细胞直方图异常(即怀疑有核左移或非典型淋巴细胞/原始细胞,细胞群分离不当),则要求进行手工白细胞分类。
在21%的犬类样本、32%的猫类样本和20%的马类样本中,要求进行手工分类。10%至15%的病例存在细胞群分离不明显的情况。根据物种不同,2%至12%的病例怀疑有非典型淋巴细胞,13%至25%的病例怀疑有核左移,不到0.4%的病例怀疑有原始细胞。
所获得的结果与人类医学发表的结果相当,如果将显微镜检查用作验证程序而非自动分类的替代方法,兽医实验室中的手工分类比例可显著降低。