Shin Eunju, Hur Mina, Kim Hanah, Lee Gun-Hyuk, Hong Mi-Hyun, Nam Minjeong, Lee Seungho
Department of Laboratory Medicine, Konkuk University School of Medicine, Seoul 05030, Republic of Korea.
Department of Laboratory Medicine, Korea University Anam Hospital, Seoul 02841, Republic of Korea.
Diagnostics (Basel). 2024 Mar 11;14(6):592. doi: 10.3390/diagnostics14060592.
Few studies have evaluated digital morphology (DM) analyzers on body fluids (BF). We evaluated the performance of a DM analyzer, Sysmex DI-60 (Sysmex, Kobe, Japan) for white blood cell (WBC) differentials in BF samples.
In five BF samples (two pleural fluids and three ascites) containing a single, dominant cell type (>80%, neutrophils, lymphocytes, macrophages, abnormal lymphocytes, and malignant cells in each sample), we evaluated the precision of the DI-60 and compared the WBC differentials and turnaround times (TAT) between DI-60 and manual counting.
The precision of the DI-60 pre-classification and verification was excellent (%CV, 0.01-3.16%). After verification, the DI-60 showed high sensitivity, specificity, and efficiency (ranges: 90.8-98.1%, 96.8-97.9%, and 92.5-98.0%, respectively) for the dominant cell types in neutrophil- and lymphocyte-dominant samples. For all samples, the DI-60 and manual counting showed high correlations for major cell types (neutrophils, lymphocytes, macrophages, and others, r = 0.72 to 0.94) after verification. The agreement between the pre-classification and verification of the DI-60 was strong in the neutrophil-dominant sample (κ = 0.81). The DI-60 showed a significantly longer TAT (min: s) than manual counting for all samples (median TAT/slide: 6:28 vs. 1:53, < 0.0001), with remarkable differences in abnormal lymphocyte- and malignant cell-dominant samples (21:05 vs. 2:06; 12:34 vs. 2:25).
The DI-60 may provide reliable data in neutrophil- and lymphocyte-dominant BF samples. However, it may require longer times and higher workloads for WBC differentials especially in BF samples containing atypical cells. Further improvement would be needed before applying DM analyzers for routine clinical practice in BF analysis.
很少有研究评估体液（BF）的数字形态（DM）分析仪。我们评估了一种DM分析仪Sysmex DI - 60（Sysmex，日本神户）对BF样本中白细胞（WBC）分类的性能。
在五个含有单一优势细胞类型（每个样本中>80%，中性粒细胞、淋巴细胞、巨噬细胞、异常淋巴细胞和恶性细胞）的BF样本（两个胸水和三个腹水）中，我们评估了DI - 60的精密度，并比较了DI - 60与手工计数之间的WBC分类及周转时间（TAT）。
DI - 60预分类和验证的精密度极佳（变异系数%CV，0.01 - 3.16%）。验证后，DI - 60对中性粒细胞和淋巴细胞为主的样本中的优势细胞类型显示出高敏感性、特异性和效率（范围分别为：90.8 - 98.1%、96.8 - 97.9%和92.5 - 98.0%）。对于所有样本，验证后DI - 60与手工计数对主要细胞类型（中性粒细胞、淋巴细胞、巨噬细胞和其他细胞）显示出高度相关性（r = 0.72至0.94）。在中性粒细胞为主的样本中，DI - 60预分类和验证之间的一致性很强（κ = 0.81）。对于所有样本，DI - 60显示的TAT（分钟：秒）明显长于手工计数（中位TAT/玻片：6:28对1:53，<0.0001），在异常淋巴细胞和恶性细胞为主的样本中有显著差异（21:05对2:06；12:34对2:25）。
DI - 60可能为中性粒细胞和淋巴细胞为主的BF样本提供可靠数据。然而，特别是在含有非典型细胞的BF样本中，其进行WBC分类可能需要更长时间和更高工作量。在将DM分析仪应用于BF分析的常规临床实践之前，还需要进一步改进。
