Cornbleet J, Kessinger S
Am J Clin Pathol. 1985 Nov;84(5):620-6. doi: 10.1093/ajcp/84.5.620.
The authors evaluated the Coulter S-Plus three-part differential and compared it with the total of component cells obtained by manual slide differential. The patient population (N = 989) was strikingly abnormal, in that 109 samples contained nucleated red blood cells, 118 samples contained one or more abnormal cells (blasts, promyelocytes, or lymphoma cells), and 95 samples had greater than 10% monocytes. The GRAN and LYMPH fractions were accurately measured in the specimens that did not display region (R) flags. The MONO fraction correlated poorly with the manual differential and underestimated monocytes when they were increased. Not all samples with small numbers of abnormal cells or nucleated red blood cells were flagged by the three-part differential. Specimens with eosinophilia and reactive lymphocytosis likewise did not always show R-flags. The following findings (prevalence = 23.9%) were arbitrarily defined to constitute an "abnormal" manual differential: nrbc greater than 0%, blasts greater than 0%, promyel greater than 0%, lymphoma cells greater than 0%, baso greater than 5%, myel greater than 5%, meta greater than 5%, eos greater than 10%, reactive lymphs greater than 10%. Sensitivity of R-flagging for these abnormalities was 81.7% and specificity 73.3%. The predictive value of an R-flagged ("positive") result was 48.3% and of an unflagged ("negative") result, 93.0%. Efficiency (accuracy) was calculated to be 75.5%.
作者评估了库尔特S-Plus三分群血细胞分析仪，并将其与手工涂片分类计数所得的各类细胞总数进行比较。患者群体（N = 989）异常情况显著，其中109份样本含有有核红细胞，118份样本含有一种或多种异常细胞（原始细胞、早幼粒细胞或淋巴瘤细胞），95份样本单核细胞比例大于10%。在未显示区域（R）标记的标本中，粒细胞（GRAN）和淋巴细胞（LYMPH）比例测量准确。单核细胞（MONO）比例与手工分类计数的相关性较差，且在单核细胞增多时会低估其数量。并非所有含有少量异常细胞或有核红细胞的样本都会被三分群血细胞分析仪标记。嗜酸性粒细胞增多和反应性淋巴细胞增多的标本同样并非总是显示R标记。以下发现（发生率 = 23.9%）被任意定义为构成“异常”手工分类计数：有核红细胞大于0%、原始细胞大于0%、早幼粒细胞大于0%、淋巴瘤细胞大于0%、嗜碱性粒细胞大于5%、中幼粒细胞大于5%、晚幼粒细胞大于5%、嗜酸性粒细胞大于10%、反应性淋巴细胞大于10%。这些异常情况的R标记敏感性为81.7%，特异性为73.3%。R标记（“阳性”）结果的预测值为48.3%，未标记（“阴性”）结果的预测值为93.0%。计算得出效率（准确性）为75.5%。
