XE-2100白细胞分类报警信息阈值的探讨

Study on alarm threshold values of WBC classification in XE-2100 blood analyzer

目的应用受试者工作特征曲线(ROC)对XE-2100血液分析仪白细胞分类报警系统(Q-flags)的阈值进行评估和验证。方法在Sysmex XE-AlphaN工作站随机检测样本中,对Q-flags的6项白细胞分类报警信息大于80的各取200份标本进行涂片镜检,应用SPSS17.0统计软件中ROC曲线对其进行分析,建立最佳报警阈值,并用237例标本进行验证。结果经ROC曲线分析,原幼细胞、未成熟粒细胞、核左移、异型淋巴细胞、异常淋巴/原始淋巴细胞、有核红细胞的阈值分别为130、120、150、100、130、230。新阈值对显微镜分类正常和异常标本的判别敏感度、特异度和准确度分别为0.96、0.84、0.90,明显优于仪器原设置阈值。结论实验室应建立自己的Q-flags报警阈值,在不降低准确性的情况下以提高镜检协同工作的有效性。

Objective To evaluate and verify the alarm threshold values of WBC classification alarm system（Q-flags） in the XE-2100 blood analyzer by using the receiver operating characteristic curve （ROC）. Methods Among the random detection samples in the Sysmex XE-AlphaN workstation,each 200 specimens with the WBC classification alarm information 〉80 in 6 items of Q-flag were taken for conducting the smear microscopy. ROC in SPSS17.0 statistical software was applied to perform the analysis for es-tablishing the best alarm threshold values,which were verified by 237 samples. Results by the ROC analysis,the threshold values of blasts, immaturate granulocytes, nuclear left shift, annormal lymphocytes, annormal lymphocytes/blasts, nucleated red blood cells （NRBCs） were 130,120,150,100,130,230, respectively. The sensitivity, specificity and accuracy of the new alarm threshold values for judging the normal and the abnormal samples in the microscopic classification were 0.96,0.84 and 0.90, respectively. Conclusion Laboratory should establish its own alarm threshold values in Q-flags so as to improve the effectiveness of the cooperative work under the condition of without reducing the accuracy.