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Abstract：
Sysmex DI-60 enumerates and classifies leukocytes. Limited research has evaluated the performance of Sysmex DI-60 in abnormal samples, and most focused on leukopenic samples. We evaluate the efficacy of DI-60 in determining white blood cell (WBC) differentials in normal and abnormal samples in different WBC count. Peripheral blood smears (n = 166) were categorised into normal control and disease groups, and further divided into moderate and severe leucocytosis, mild leucocytosis, normal, mild leukopenia, and moderate and severe leukopenia groups based on WBC count. DI-60 preclassification and verification and manual counting results were assessed using Bland-Altman and Passing-Bablok regression analyses. The Kappa test compared the concordance in the abnormal cell detection between DI-60 and manual counting. DI-60 exhibited notable overall sensitivity and specificity for all cells, except basophils. The correlation between the DI-60 preclassification and manual counting was high for segmented neutrophils, band neutrophils, lymphocytes, and blasts, and improved for all cell classes after verification. The mean difference between DI-60 and manual counting for all cell classes was significantly high in moderate and severe leucocytosis (WBC > 30.0 × 109/L) and moderate and severe leukopenia (WBC < 1.5 × 109/L) groups. For blast cells, immature granulocytes, and atypical lymphocytes, the DI-60 verification results were similar to the manual counting results. Plasma cells showed poor agreement. In conclusion, DI-60 demonstrates consistent and reliable analysis of WBC differentials within the range of 1.5-30.0 × 109. Manual counting was indispensable in examining moderate and severe leucocytosis samples, moderate and severe leukopenia samples, and in enumerating of monocytes and plasma cells.
摘要：
SysmexDI-60对白细胞进行计数和分类。有限的研究已经评估了SysmexDI-60在异常样品中的性能，最关注白细胞减少的样本。我们评估了DI-60在确定不同WBC计数中正常和异常样品中白细胞（WBC）差异中的功效。外周血涂片（n=166）分为正常对照组和疾病组，进一步分为中度和重度白细胞增多，轻度白细胞增多症,正常,轻度白细胞减少症,根据白细胞计数，中度和重度白细胞减少症。使用Bland-Altman和Passing-Bablok回归分析评估DI-60预分类和验证以及手动计数结果。Kappa检验比较了DI-60和手动计数在异常细胞检测中的一致性。DI-60对所有细胞表现出显著的总体敏感性和特异性，除了嗜碱性粒细胞.对于分段中性粒细胞，DI-60预分类和手动计数之间的相关性很高，带中性粒细胞，淋巴细胞，和爆炸，并在验证后对所有单元格类别进行了改进。在中度和重度白细胞增多症（WBC>30.0×109/L）和中度和重度白细胞减少症（WBC<1.5×109/L）组中，所有细胞类别的DI-60和手动计数之间的平均差异均显着高。对于母细胞，未成熟粒细胞，和非典型淋巴细胞，DI-60验证结果与人工计数结果相似.浆细胞显示较差的一致性。总之,DI-60显示出在1.5-30.0×109范围内的WBC差异的一致和可靠的分析。在检查中度和重度白细胞增多症样本时，手动计数是必不可少的，中度和重度白细胞减少症样本，以及单核细胞和浆细胞的计数。
