Palur Katyayani, Arakeri Surekha U
Department of Pathology, BLDEU's Shri BM Patil Medical College, Vijayapura, Karnataka, India.
Indian J Pathol Microbiol. 2018 Jul-Sep;61(3):360-365. doi: 10.4103/IJPM.IJPM_142_17.
The International Consensus Group for Hematology Review (ICGHR) are essentially review criteria designed to reduce the number of manual smear reviews following analysis in automated hematology analyzers (AHAs). Although AHAs are an indispensable part of the present-day clinical laboratory, manual smear reviews still play an integral role in identifying morphological abnormalities and to confirm the results of the analyzers.
The aim of this study is to evaluate the efficacy of the ICGHR criteria and our laboratory criteria using the Sysmex XN-1000 for manual peripheral smear review (MSR).
A prospective cross-sectional comparative study between the two sets of criteria for MSR was performed.
A total of 860 whole blood samples sent over a period of 19 months for complete blood count testing to our laboratory were collected using systematic random sampling. Truth tables were prepared for each set of criteria. Tests of proportion were used to compare performance specifications between both sets of criteria.
Using ICGHR criteria, sensitivity was 81.58%, specificity was 84.61%, 83.38% positive predictive value, and 82.92% negative predictive value. The microscopic smear review rate was 47.56% and efficiency was 83.14%. Using our laboratory criteria, sensitivity was 98.80%, specificity was 41.40%, positive predictive value of 61.46%, and negative predictive value of 97.34%. The microscopic smear review rate was 78.14% and efficiency 69.30%.
There was a significant reduction in the microscopic smear review rates using the ICGHR criteria compared to our laboratory criteria. The ICGHR criteria can thus be adapted to daily laboratory practice provided they are first optimized and locally validated before use.
国际血液学检查共识小组（ICGHR）制定的标准本质上是用于减少自动血液分析仪（AHA）分析后手工涂片检查数量的审核标准。尽管AHA是当今临床实验室不可或缺的一部分，但手工涂片检查在识别形态学异常和确认分析仪结果方面仍发挥着不可或缺的作用。
本研究旨在使用Sysmex XN - 1000评估ICGHR标准和我们实验室标准对手工外周血涂片检查（MSR）的有效性。
对两组MSR标准进行前瞻性横断面比较研究。
采用系统随机抽样法收集了19个月内送至我们实验室进行全血细胞计数检测的860份全血样本。为每组标准编制真值表。采用比例检验比较两组标准的性能指标。
使用ICGHR标准时，灵敏度为81.58%，特异度为84.61%，阳性预测值为83.38%，阴性预测值为82.92%。显微镜涂片复查率为47.56%，效率为83.14%。使用我们实验室的标准时，灵敏度为98.80%，特异度为41.40%，阳性预测值为61.46%，阴性预测值为97.34%。显微镜涂片复查率为78.14%，效率为69.30%。
与我们实验室的标准相比，使用ICGHR标准可显著降低显微镜涂片复查率。因此，ICGHR标准可应用于日常实验室实践，但前提是在使用前先进行优化和本地验证。
