İnce Fatma Demet, Ellidağ Hamit Yaşar, Koseoğlu Mehmet, Şimşek Neşe, Yalçın Hülya, Zengin Mustafa Osman
Department of Medical Biochemistry, Tepecik Education and Research Hospital, Izmir, Turkey.
Medical Biochemistry, Atatürk Education and Research Hospital, Izmir, Turkey.
Pract Lab Med. 2016 Mar 11;5:14-20. doi: 10.1016/j.plabm.2016.03.002. eCollection 2016 Aug 1.
Urinalysis is one of the most commonly performed tests in the clinical laboratory. However, manual microscopic sediment examination is labor-intensive, time-consuming, and lacks standardization in high-volume laboratories. In this study, the concordance of analyses between manual microscopic examination and two different automatic urine sediment analyzers has been evaluated.
209 urine samples were analyzed by the Iris iQ200 ELITE (İris Diagnostics, USA), Dirui FUS-200 (DIRUI Industrial Co., China) automatic urine sediment analyzers and by manual microscopic examination. The degree of concordance (Kappa coefficient) and the rates within the same grading were evaluated.
For erythrocytes, leukocytes, epithelial cells, bacteria, crystals and yeasts, the degree of concordance between the two instruments was better than the degree of concordance between the manual microscopic method and the individual devices. There was no concordance between all methods for casts.
The results from the automated analyzers for erythrocytes, leukocytes and epithelial cells were similar to the result of microscopic examination. However, in order to avoid any error or uncertainty, some images (particularly: dysmorphic cells, bacteria, yeasts, casts and crystals) have to be analyzed by manual microscopic examination by trained staff. Therefore, the software programs which are used in automatic urine sediment analysers need further development to recognize urinary shaped elements more accurately. Automated systems are important in terms of time saving and standardization.
尿液分析是临床实验室最常进行的检测之一。然而，手工显微镜下沉淀物检查劳动强度大、耗时，且在高样本量实验室中缺乏标准化。在本研究中，评估了手工显微镜检查与两种不同的自动尿沉渣分析仪之间分析结果的一致性。
采用Iris iQ200 ELITE（美国Iris诊断公司）、迪瑞FUS-200（中国迪瑞实业有限公司）自动尿沉渣分析仪以及手工显微镜检查对209份尿液样本进行分析。评估一致性程度（kappa系数）和相同分级内的比率。
对于红细胞、白细胞、上皮细胞、细菌、晶体和酵母，两种仪器之间的一致性程度优于手工显微镜检查方法与单个仪器之间的一致性程度。对于管型，所有方法之间均无一致性。
自动分析仪对红细胞、白细胞和上皮细胞的检测结果与显微镜检查结果相似。然而，为避免任何误差或不确定性，一些图像（特别是：异形细胞、细菌、酵母、管型和晶体）必须由经过培训的工作人员进行手工显微镜检查分析。因此，自动尿沉渣分析仪所使用的软件程序需要进一步开发，以更准确地识别尿液有型成分。自动系统在节省时间和标准化方面具有重要意义。
