Department of Laboratory Medicine, Ghent University Hospital, Ghent, Belgium.
Department of Nephrology, Ghent University Hospital, Ghent, Belgium.
Clin Chem Lab Med. 2022 Sep 8;60(11):1772-1779. doi: 10.1515/cclm-2022-0617. Print 2022 Oct 26.
Urinary test strip and sediment analysis integrated with intelligent verification criteria can help to select samples that need manual review. This study aimed to evaluate the improvement in the diagnostic performance of combined urinary test strip and urinary sediment analysis using intelligent verification criteria on the latest generation automated test strip and urinary fluoresce flow cytometry (UFFC) analysers.
Urine test strip and sediment analysis were performed using the Sysmex UC-3500 and UF-5000 (Kobe, Japan) on 828 urinary samples at the clinical laboratory of the Ghent University Hospital. The results were compared to manual microscopy using phase-contrast microscopy as a reference. After the application of the intelligent verification criteria, we determined whether the diagnostic performance of urine sediment analysis could be improved.
Application of intelligent verification criteria resulted in an increase in specificity from 88.5 to 96.8% and from 88.2 to 94.9% for red blood cells and white blood cells, respectively. Implementing review rules for renal tubular epithelial cells and pathological casts increased the specificity from 66.7 to 74.2% and from 96.2 to 100.0%, respectively; and improved the diagnostic performance of urinary crystals and atypical cells.
The implementation of review rules improved the diagnostic performance of UFFC, thereby increasing the reliability and quality of urine sediment results.
尿液试带和沉渣分析与智能验证标准相结合，有助于筛选需要人工审核的样本。本研究旨在评估最新一代自动化试带和尿液荧光流式细胞术（UFFC）分析仪结合智能验证标准对尿液试带和沉渣分析联合应用时的诊断性能改善情况。
在根特大学医院临床实验室，对 828 例尿液样本使用 Sysmex UC-3500 和 UF-5000（日本神户）进行尿液试带和沉渣分析。结果以相差显微镜作为参考与人工显微镜进行比较。应用智能验证标准后，我们确定尿液沉渣分析的诊断性能是否可以得到改善。
应用智能验证标准后，红细胞和白细胞的特异性分别从 88.5%提高到 96.8%和从 88.2%提高到 94.9%。实施肾小管上皮细胞和病理性管型的审核规则后，特异性分别从 66.7%提高到 74.2%和从 96.2%提高到 100.0%，同时提高了尿液结晶和非典型细胞的诊断性能。
审核规则的实施提高了 UFFC 的诊断性能，从而提高了尿液沉渣结果的可靠性和质量。
