SYSMEX XT-4000i全自动血细胞分析仪检测胸腹水细胞与手工法的比较

Comparison between Automated Blood Cell Analyzer and Microscope Assay in Hydrothorax and Ascites Detection

目的:通过与手工法计数胸腹水细胞结果的比较,探讨SYSMEX XT-4000i全自动血细胞分析仪(XT-4000i)在胸腹水细胞检测中的可靠性。方法:应用XT-4000i体液模式及手工法分别计数120例住院患者胸腹水标本的细胞总数、白细胞总数及白细胞分类,对检测结果分别采用Bland-Altman法、相关性检验以及《白细胞分类计数参考方法》等进行统计学分析。结果:2种方法检测,Bland-Altman分析95%的一致性界限分别为细胞总数(-521,884)×106/L、白细胞总数(-397,599)×106/L,中性粒细胞百分比(-0.159,0.22)%、淋巴细胞百分比(-0.14,0.19)%、间皮细胞百分比(-0.07,0.16)%,Bland-Altman图显示XT-4000i及手工法检测具有较好的一致性。以血细胞分析仪计数结果分类统计,细胞总数>10 000×106/L、>1 000×106/L且<10 000×106/L、<1 000×106/L,与手工法比较,相关系数r分别为0.99、0.96、0.86;白细胞总数<250×106/L、>250×106/L且<1 000×106/L、>1 000×106/L,与手工法比较,相关系数r分别为0.89、0.85、0.91;白细胞分类百分比与手工法比较,中性粒细胞百分比r=0.92,淋巴细胞百分比r=0.88,间皮细胞百分比r=0.86。XT-4000i检测白细胞分类淋巴细胞和间皮细胞百分比符合《白细胞分类计数参考方法》手工比对标准。结论:SYSMEX XT-4000i全自动血细胞分析仪检测胸腹水细胞具有准确、快速的特点,可以替代大部分手工法检测,提高了检测效率。

Objective To compare the counts of pleural-peritoneal fluid cell with manual operation and SYSMEX XT-4000i automated blood cell analyzer, so as to determine the reliability of the analyzer for hydrothorax and ascites detection. Methods Hydrothorax and ascites of 120 eases collected from inpatients were tested with the analyzer and manual method respectively, the total cell number, white cell number （VCBC） and differential leukocyte count were detected and the results were statistically analyzed by Bland-Ahman method, correlation test and reference leukocyte differential count method. Results The Bland- Altman method results showed that the 95% consistency limit of total cell number, WBC, the percentages of neutrophils, lymphocytes and mesothelial ceils were（-521,884）x106/L,（-397,599）x106/L, （-0.159,0.22）%, （-0.14,0.19）%, （-0.07,0.16）% respectively. Bland-Altman plot illustrated a good agreement between the analyzer and manual method in hydrothorax and ascites detection. The results of total cell numbers by the analyzer were divided into three groups, which was more than 10 000× 106/L, less than 10 000×106/L and more than 1 000×106/L, or less than 1 000×106/L, and the correlation coefficient r in each group between the analyzer and manual method were 0.99, 0.96, 0.86 respectively. The results of WBC numbers by the analyzer were also divided into three groups, which was less than 250×106/L, more than 250×106/L and less than 1 000×106/L, or more than 1 000×106/L, and r in each group between the analyzer and manual method were 0.89, 0.85, 0.91 respectively. The r of the percentages of neutrophils, lymphocytes and mesothelial cells between two methods were 0.92, 0.88 and 0.86 respectively. Differential leukocyte count such as percentage of lymphocytes and mesothelial cells by the analyzer was reliable according to Reference Leukocyte Differential Count Method. Conclusion SYSMEX XT-4000i automated blood cell analyzer is accurate and rapid in hydrothorax and ascites detection, and thus can replace the manual operation mostly.