血细胞分析仪检测有核红细胞的临床应用评价

Clinical Evaluation on Automatic Nucleated Red Blood Cell Count by Blood Cell Analyzer

目的分析Sysmex XE-2100全自动血细胞分析仪对有核红细胞(NRBC)提示信息的可靠性,以及仪器自动计数外周血NRBC的性能评价。方法收集XE-2100血细胞分析仪报警信号(Q-Flag)有NRBC的标本85例和无NRBC的标本200例,用XE-2100血细胞分析仪及显微镜计数法计数其外周血中NRBC数量。结果85例提示有NRBC中,镜检37例有NRBC,其阳性符合率为43.5%。其中,71例有NRBC的同时有未成熟粒细胞(Imm Gran)、原始细胞(Blasts)、异型/异常淋巴细胞(Aty/Abn Ly)以及核左移(Left)中的1项或多项提示。71例中,镜检36例标本有NRBC阳性反应,阳性符合率为50.7%。200例无NRBC报警提示的标本中,镜检提示2例有NRBC,假阴性率为1.0%。在36例NRBC阳性标本显型,XE-2100与显微镜计数法计数外周血中NRBC数量有极好的相关性(r=0.974),且两者计数结果无显著性差异(P>0.05)。而另有32例NRBC阳性标本,在使用或未使用NRBC计数通道检测时,WBC计数结果有显著性差异(P<0.05)。结论Sysmex XE-2100血细胞分析仪检测出现NRBC,提示且同时伴有其他白细胞异常提示时,与人工镜检阳性符合率较好,可信度较高,发挥了仪器对NRBC的良好过筛功能。且仪器对NRBC计数结果快速、准确,可替代人工显微镜方法计数NRBC。并且可在NRBC增高的标本中准确计数白细胞数量。

Objective To analyze the clue reliability of nucleated red blood cell（NRBC） by blood cell analyzer Sysmex XE-2100,and to evaluate the performance of an automatic nucleated red blood cell（NRBC） count.Methods 85 cases with NRBC clue in WBC column and 200 cases with non-NRBC from blood cell analyzer XE-2100 were collected,they were all counted by both XE-2100 automatic blood cell analyzer and manual method with microscope.Results There were 37 cases with NRBC by microscopic test in 85 cases with NRBC clue and the positive rate was 43.5%.There were 71 cases that had NRBC with one or more abnormal clues as Imm Gran,Blasts,Aty/Abn Ly and Left by analyzer test,among which 36 cases by microscopic test had NRBC and the positive rate was 50.7%.There were 200 cases with non-NRBC by analyzer test,among which two cases had NRBC by microscopic test and the false negative rate was 1.0%.In 36 cases with increased NRBC,there was a very good correlation between the manual and automatic method（r=0.974）.No significant difference was observed between the counting results of two methods（P〉0.05）.In 32 cases with increased NRBC,there was significant difference in the counting of WBC between NRBC and non-NRBC counting route by analyzer test（P〈0.05）.Conclusion The positive rate of NRBC clue with WBC anomaly clue is better of blood cell analyzer XE-2100 than that of microscopic test,So blood cell analyzer XE-2100 has higher reliability lower false negative rate.It plays a role in sifting NRBC test.The NRBC counting by the XE-2100 was sensitive,accurate and reliable.The XE-2100 can measure the WBC accurately in sample with increased NRBC.