SYSMEX XN-350血液分析仪检测儿童全血样本白细胞分类和Q-Flag标识准确性评估

Evaluation of the Accuracy of White Blood Cell Classification and Q-Flag Identification of Pediatric Whole Blood Samples by SYSMEX XN-350 Hematology Analyzer

目的评估sysmex XN-350血液分析仪白细胞分类和Q-Flag标识在儿童全血标本检测中的准确性。方法收集2020年10月~2021年3月华中科技大学同济医学院附属同济医院124例0~12岁儿童静脉抗凝全血样本,分别进行仪器检测和涂片染色人工镜检分类。对XN-350白细胞分类及Q-Flag标识结果与镜检结果进行比较分析,评价仪器的准确性。结果两种方法的中性粒细胞、淋巴细胞、单核细胞、嗜酸性粒细胞和嗜碱性粒细胞相关系数分别为0.992,0.986,0.893,0.798和0.754(均P<0.001)。仪器各Q-Flag标识特异度较好(均>90%);除Left Shift(90.91%)较高外,其余参数敏感度较低。Left Shift,PLT Clump,NRBC,Aty Lymph和Blast/Abn Lymph的阴性预测值较好(均>85%)。Aty Lymph,PLT Clump和Blast/Abn Lymph的阳性预测值相对较佳,分别为79.41%,80.00%和75.33%。结论应用XN-350血液分析仪检测儿童样本时,白细胞分类结果可靠,是儿科门急诊首选的小型血液分析仪。而仪器Q-Flag的假阳性率较高,需对标识报警的样本进行必要的人工复检。

Objective To evaluate the accuracy of WBC differential count and Q-Flag by sysmex XN-350 hematology analyzer in the detection of whole blood samples in children.Methods A total of 124 samples from children of different genders and ages were collected for instrument detection and manual microscopy classification with smear staining.Comparison and analysis were conducted between the XN-350 WBC differential count and Q-Flag results and the microscopy results to evaluate the accuracy of the instrument.Results The correlation coefficients between two methods for neutrophils,lymphocytes,monocytes,eosinophils,and basophils were 0.992,0.986,0.893,0.798 and 0.754,respectively(all P<0.001).The specificity of each Q-Flag identification parameter was good(>90%),while the sensitivity of most parameters was low,except for Left Shift(90.91%).The negative predictive values for Left Shift,PLT Clump,NRBC,Aty Lymph,and Blast/Abn Lymph were good(>85%).The positive predictive values for Aty Lymph,PLT Clump,and Blast/Abn Lymph were relatively good at 79.41%,80.00%and 75.33%,respectively.Conclusion The white blood cell differential count results using the XN-350 were reliable and it is preferred as a small-sized blood analyzer for pediatric emergencies.However,the false positive rate of Q-Flag was high,and manual rechecks were required when a Q-Flag message appeared in the sample.