Sysmex XE-5000 报告的不成熟粒细胞相关报警是否需要显微镜玻片复查？

Do the flags related to immature granulocytes reported by the Sysmex XE-5000 warrant a microscopic slide review?

机构信息

From the Division of Diagnostics and Technology, Akershus University Hospital, Lørenskog, Norway; Faculty of Health Sciences, Oslo, and Akershus University College of Applied Sciences, Oslo, Norway; and

From the Division of Diagnostics and Technology, Akershus University Hospital, Lørenskog, Norway; Institute of Clinical Medicine, University of Oslo, Akershus University Hospital, Oslo, Norway.

出版信息

Am J Clin Pathol. 2014 Oct;142(4):553-60. doi: 10.1309/AJCP4V4EXYFFOELL.

DOI:10.1309/AJCP4V4EXYFFOELL

PMID:25239424

Abstract

OBJECTIVES

The Sysmex XE-5000 instruments (Sysmex, Kobe, Japan) count immature granulocytes (IGs) and use the "Imm Gran?" flag to signal unreliable results. This study investigated the usefulness of the "Imm Gran?" flag and the analytical and diagnostic performance of the IG measurements in a side-by-side evaluation.

METHODS

In total, 408 samples were analyzed on three XE-5000 instruments. The IG count and the "Imm Gran?" flag reports from all three instruments were used for reproducibility studies. The diagnostic performance of the automated IGs and the "Imm Gran?" flag were studied by comparing the XE-5000 results with the results of the manual differential.

RESULTS

The reproducibility of the "Imm Gran?" flagging between instruments was poor (қ, 0.75-0.80). The most significant contributor to the report of the "Imm Gran?" flag was bands, and the flag played a minor role in detecting blasts. The interinstrument reproducibility of the IG counts was high (intraclass correlation, 0.99). The IG count reported by XE-5000s was higher than the manual IG count (36%-55%), and the difference and the variability tended to increase with increasing levels of IGs.

CONCLUSIONS

The "Imm Gran?" flag has a poor analytical quality and gives no substantial information on the presence of blasts in the sample. We therefore suggest reporting the automated IG count without initial microscopic slide review.

摘要

目的

希森美康 XE-5000 仪器（Sysmex，神户，日本）计数未成熟粒细胞（IG）并使用“ Imm Gran？”标志表示结果不可靠。本研究通过并行评估研究了“ Imm Gran？”标志的有用性以及 IG 测量的分析和诊断性能。

方法

总共对 3 台 XE-5000 仪器分析了 408 个样本。所有 3 台仪器的 IG 计数和“ Imm Gran？”标志报告均用于可重复性研究。通过将 XE-5000 结果与手动差异结果进行比较，研究了自动 IG 和“ Imm Gran？”标志的诊断性能。

结果

仪器之间“ Imm Gran？”标记的重现性差（қ，0.75-0.80）。对“ Imm Gran？”标志报告的最大贡献是条带，该标志在检测原始细胞方面作用较小。IG 计数的仪器间重现性很高（组内相关系数，0.99）。XE-5000 报告的 IG 计数高于手动 IG 计数（36％-55％），差异和可变性随着 IG 水平的增加而增加。