LH750自动血细胞分析仪白细胞分类的可靠性研究

Reliability Study of differential count by LH 750 automatic hematology analyzer

目的研究LH 750血细胞分析仪白细胞分类(DC)的可靠性。方法按照有关文件规定对该仪器DC的性能进行测试,并与人工分类进行比较。结果该仪器DC中性粒细胞(Neut)、淋巴细胞(Lym)、单核细胞(Mon)、嗜酸性粒细胞(Eos)和嗜碱性粒细胞(Baso)的精密度良好/符合仪器说明书要求,CV值分别为①手动进样模式:1.62%、2.03%、7.14%、5.66%和16.45%;②自动进样模式:1.77%、2.29%、7.51%、5.37%和17.38%。WBC形态正常的标本,仪器与人工DC的结果比较,Neut、Lym和Eos相关性较好(r2值:0.9508、0.9443和0.9327);Mon次之(r2值0.7978),Baso的相关性欠佳(r2值0.4995)。白细胞分类报警的假阳性18.71%、假阴性6.35%、准确度85.95%、特异度81.29%和敏感度93.65%。白血病细胞灵敏度(报警次数)测试结果显示,急非淋白血病的原幼细胞报警灵敏度较高(1%~3%:1/6、5%:2/6、10%~40%:24/24)。急淋白血病的原幼细胞报警灵敏度较低(1%~5%:0/8、10%:2/4、20%:3/4、30%~40%:8/8)。高胆红素、脂肪乳和老化标本,也可干扰LH750仪器的白细胞分类结果。结论该仪器白细胞分类计数结果的精密度良好,形态正常的标本准确、可靠,主要性能指标符合实验要求。对怀疑WBC分类异常或有报警的标本,仪器DC结果必须经显微镜复核后才能报告。

Objective To study the reliability of LH 750 hematology analyzer in differential count(DC). Methods To determinate the performance of this instrument in DC according to the provisions of the relevant documents, and compared with the manual classification. Results The results of DC--neutrophil(Neut), lymphocytes(Lym), monocytes(Mon), eosinophils(Eos) and basophils(Baso), given by this instrument, show a good precision / in line with the requirements of the equipment manual. CV: ①Manual sampling mode: 1.62%, 2.03%, 7.14%, 5.66% and 16.45%; ②Automatic sampling mode: 1.77%, 2.29%, 7.51%, 5.37% and 17.38%. For the samples with normal WBC morphology,comparing the DC results of automatic and manual mode, the correlation of Neut, Lym and Eos is well(r2: 0.9508, 0.9443 and 0.9327); Mon second(r2: 0.7978), and the correlation of Baso is poor( r2:0.4995). The false positive rate is 18.71%, the false negative rate is 6.35%,the accuracy is 85.95%、the specificity is 81.29% and the sensitivity is 93.65% when it is alarmed in DC. The test results of the sensitivity(alarm number) of leukemic cells indicate that, the alarm sensitivity of the blast cells is high in ANLL(1~3% blast cells:1/6, 5% blast cells:2/6, 10%~40% blast cells:24/24), and it is low in ALL(1~5% blast cells:0/8, 10% blast cells:2/4, 20% blast cells:3/4, 30%~40% blast cells:8/8). The results of DC given by this instrument were interfered with bilirubin, chylaemia and aging samples. Conclusions There is a good precision of DC results given by this hematology analyzer. It is accurate and reliable when WBC morphology of the samples are normal, and the main performance indicators are in line with the experimental requirements. For the samples which are suspected to be abnormal or alarmed, the DC results must be reported after checking under the microscope.