Department of Laboratory Medicine, Yonsei University College of Medicine, Seoul, Korea.
Department of Laboratory Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea.
Clin Chem Lab Med. 2019 Oct 25;57(11):1744-1753. doi: 10.1515/cclm-2019-0211.
Background While the introduction of automated urine analyzers is expected to reduce the labor involved, turnaround time and potential assay variations, microscopic examination remains the "gold standard" for the analysis of urine sediments. In this study, we evaluated the analytical and diagnostic performance of five recently introduced automated urine sediment analyzers. Methods A total of 1016 samples were examined using five automated urine sediment analyzers and manual microscopy. Concordance of results from each automated analyzer and manual microscopy were evaluated. In addition, image and microscopic review rates of each system were investigated. Results The proportional bias for red blood cells (RBCs), white blood cells (WBCs) and squamous epithelial cells in the automated urine sediment analyzers were within ±20% of values obtained using the manual microscope, except in the cases of RBCs and WBCs analyzed using URiSCAN PlusScope and Iris iQ200SPRINT, respectively. The sensitivities of Roche Cobas® u 701 and Siemens UAS800 for pathologic casts (73.6% and 81.1%, respectively) and crystals (62.2% and 49.5%, respectively) were high, along with high image review rates (24.6% and 25.2%, respectively). The detection rates for crystals, casts and review rates can be changed for the Sysmex UF-5000 platform according to cut-off thresholds. Conclusions Each automated urine sediment analyzer has certain distinct features, in addition to the common advantages of reducing the burden of manual processing. Therefore, laboratory physicians are encouraged to understand these features, and to utilize each system in appropriate ways, considering clinical algorithms and laboratory workflow.
背景 虽然自动化尿液分析仪的引入有望减少人工操作、周转时间和潜在的检测变化，但显微镜检查仍然是尿液沉淀物分析的“金标准”。在这项研究中，我们评估了五种新引入的自动化尿液沉淀物分析仪的分析和诊断性能。
方法 共检查了 1016 个样本，使用了五种自动化尿液沉淀物分析仪和手动显微镜。评估了每个自动化分析仪与手动显微镜的结果一致性。此外，还研究了每个系统的图像和显微镜复查率。
结果 除了使用 URiSCAN PlusScope 分析 RBC 和使用 Iris iQ200SPRINT 分析 WBC 外，自动化尿液沉淀物分析仪分析 RBC 和 WBC 的红细胞（RBCs）、白细胞（WBCs）和鳞状上皮细胞的比例偏差在手动显微镜获得值的±20%以内。罗氏 Cobas®u 701 和西门子 UAS800 对病理性管型（分别为 73.6%和 81.1%）和晶体（分别为 62.2%和 49.5%）的敏感性较高，同时图像复查率也较高（分别为 24.6%和 25.2%）。Sysmex UF-5000 平台可根据截止阈值改变晶体、管型和复查率的检测率。
结论 除了减少手动处理负担的共同优势外，每种自动化尿液沉淀物分析仪都具有某些独特的特点。因此，建议实验室医生了解这些特点，并根据临床算法和实验室工作流程，以适当的方式利用每个系统。
