背景:很少有研究评估了体液(BF)上的数字形态学(DM)分析仪。我们评估了DM分析仪的性能,SysmexDI-60(Sysmex,神户,日本)用于BF样品中的白细胞(WBC)差异。
方法:在5个BF样本(2个胸膜液和3个腹水)中,优势细胞类型(>80%,中性粒细胞,淋巴细胞,巨噬细胞,异常淋巴细胞,和每个样本中的恶性细胞),我们评估了DI-60的精确度,并比较了DI-60和手动计数之间的白细胞差异和周转时间(TAT).
结果:DI-60预分类和验证的精度非常好(%CV,0.01-3.16%)。经过验证,DI-60显示出高灵敏度,特异性,和效率(范围:90.8-98.1%,96.8-97.9%,和92.5-98.0%,分别)用于中性粒细胞和淋巴细胞显性样品中的显性细胞类型。对于所有样品,DI-60和手动计数显示主要细胞类型(中性粒细胞,淋巴细胞,巨噬细胞,和其他人,验证后r=0.72至0.94)。在中性粒细胞占优势的样本中,DI-60的预分类和验证之间的一致性很强(κ=0.81)。对于所有样品,DI-60显示出比手动计数明显更长的TAT(min:s)(中位TAT/载玻片:6:28vs.1:53,p<0.0001),在异常淋巴细胞和恶性细胞优势样本中具有显着差异(21:05vs.2:06;12:34vs.2:25)。
结论:DI-60可能在中性粒细胞和淋巴细胞占优势的BF样本中提供可靠的数据。然而,WBC差异可能需要更长的时间和更高的工作量,特别是在含有非典型细胞的BF样品中。在将DM分析仪用于BF分析的常规临床实践之前,需要进一步改进。
BACKGROUND: Few studies have evaluated digital morphology (DM) analyzers on body fluids (BF). We evaluated the performance of a DM analyzer, Sysmex DI-60 (Sysmex, Kobe, Japan) for white blood cell (WBC) differentials in BF samples.
METHODS: In five BF samples (two pleural fluids and three ascites) containing a single, dominant cell type (>80%, neutrophils, lymphocytes, macrophages, abnormal lymphocytes, and malignant cells in each sample), we evaluated the precision of the DI-60 and compared the WBC differentials and turnaround times (TAT) between DI-60 and manual counting.
RESULTS: The precision of the DI-60 pre-classification and verification was excellent (%CV, 0.01-3.16%). After verification, the DI-60 showed high sensitivity, specificity, and efficiency (ranges: 90.8-98.1%, 96.8-97.9%, and 92.5-98.0%, respectively) for the dominant cell types in neutrophil- and lymphocyte-dominant samples. For all samples, the DI-60 and manual counting showed high correlations for major cell types (neutrophils, lymphocytes, macrophages, and others, r = 0.72 to 0.94) after verification. The agreement between the pre-classification and verification of the DI-60 was strong in the neutrophil-dominant sample (κ = 0.81). The DI-60 showed a significantly longer TAT (min: s) than manual counting for all samples (median TAT/slide: 6:28 vs. 1:53, p < 0.0001), with remarkable differences in abnormal lymphocyte- and malignant cell-dominant samples (21:05 vs. 2:06; 12:34 vs. 2:25).
CONCLUSIONS: The DI-60 may provide reliable data in neutrophil- and lymphocyte-dominant BF samples. However, it may require longer times and higher workloads for WBC differentials especially in BF samples containing atypical cells. Further improvement would be needed before applying DM analyzers for routine clinical practice in BF analysis.