BECKMAN-COULTER LH750血液分析仪“WBC Correct”功能评估

引用本文

方美容, 陈效黎. BECKMAN-COULTER LH750血液分析仪“WBC Correct”功能评估. 检验医学2014, 29(4): 337-338[FANG Meirong, CHEN Xiaoli. Evaluation on the "WBC Correct" function performance of BECKMAN-COULTER LH750 hematology system. Labratory Medicine, 2014, 29(4): 337-338] 复制到剪切板

Permissions

BECKMAN-COULTER LH750血液分析仪“WBC Correct”功能评估

方美容, 陈效黎

宁波市医疗中心李惠利医院,浙江宁波 315010

作者简介:方美容,女,1978年生,学士,主管技师,主要从事基础临床检验工作。

摘要

目的

对BECKMAN-COULTER LH750血液分析仪(简称LH750)关于白细胞(WBC)计数的一项特殊功能——“WBC Correct”的准确性及可靠性进行统计及评估。

方法

以卫生部推荐的《红细胞和白细胞计数的参考方法》对WBC计数结果受到仪器自动修正的样本进行手工计数,并将计数结果与仪器结果进行统计学分析。

结果

WBC Correct修正后的WBC计数结果与手工法计数结果具有非常好的相关性,比没有该功能的同系列机型的WBC计数结果更准确、可靠,但在420例被检的标本中有5例结果有明显误修正。

结论

LH750修正功能有较高的实用价值,但也不排除误修正的可能性,因此在工作中应密切注意仪器的修正提示,必要时应进行手工复检。

关键词: LH750全自动血液分析仪; 白细胞计数; 白细胞直方图; “WBC Correct”; “Cellular Interference”

中图分类号:R446.11 文献标志码:A 文章编号:1673-8640(2014)04-0337-02

Evaluation on the "WBC Correct" function performance of BECKMAN-COULTER LH750 hematology system

FANG Meirong, CHEN Xiaoli

Ningbo Medical Treatment Center Lihuili Hospital, Zhejiang Ningbo 315010, China

Abstract

Objective

To analyze statistically the accuracy and reliability of a special function for white blood cell (WBC) count in BECKMAN-COULTER LH750 hematology system (LH750)——"WBC Correct" function.

Methods

According to theReference

Method

forRedCellandWhiteCellCounting published by the Ministry of Health, the WBC counts of the samples corrected automatically by machine had been counted manually. The results were analyzed statistically.

Results

There was a good correlation for the results by LH750 WBC Correct function and manual counting method, and LH750 WBC Correct function had good accuracy and reliability. There were 5 wrong corrections among 420 samples.

Conclusions

The LH750 WBC Correct function is practically significant. However, there are some wrong corrections. Therefore, it should be paid more attention to the correction flags. Manual counting method should be carried on when a wrong correction occurs.

Keyword: LH750 automatic hematology system; White blood cell count; White blood cell histogram; "WBC Correct"; "Cellular interference"

Show Figures

引言

作为贝克曼库尔特公司血液分析仪的高端产品——BECKMAN-COULTER LH750血液分析仪(简称LH750)具有众多的专利技术,其中关于白细胞(white blood cell, WBC)计数的“WBC Correct”是一项较独特的功能^[1]。为了减少35 fL以下诸如聚集的血小板、红细胞碎片、有核红细胞等非WBC颗粒对WBC计数的影响^[2],LH750通过在WBC直方图35 fL处建立第二纵坐标,根据其与左侧第一峰的相交值经统计学处理后,将可疑的非WBC物质从WBC计数结果中直接剔除,从而保证WBC计数结果最大程度地接近真值。然而在实际工作中我们发现,这一功能存在误修正的情况,由于修正功能是直接修改样本的最终报告值,故而对报告的准确性影响较大,所以我们决定对这一功能进行实用性评估。

材料和方法

一、仪器与试剂

LH750及原厂配套试剂;BECKMAN-COULTER STKS血液分析仪(简称STKS)及原厂配套试剂;WBC稀释液;血细胞计数板;奥林帕斯CX-21光学显微镜。

二、样本

使用乙二胺四乙酸二钾抗凝的全血标本,抗凝浓度为2.0 mg/mL^[3]。

三、方法

对LH750 WBC计数结果中有“Cellular Interference”修正提示的样本在2 h内按卫生部推荐的《红细胞和白细胞计数的参考方法》^[4]进行手工WBC计数,同时用STKS进行复测,并记录LH750修正前计数结果、修正后计数结果,手工法计数结果,STKS计数结果,连续累积420份数据,进行统计学分析。(STKS同为BECKMAN-COULTER公司的全自动五分类血液分析仪,但其不具备“WBC Correct”这一功能。)

结果

一、在与手工计数结果的相关性和可信度上,LH750WBC计数修正后结果比未修正结果更好,同样LH750修正后结果比STKS计数结果更好,见表1:

表1 LH750修正前后、STKS与手工法WBC计数结果的相关性比较

二、420例样本中有5例结果有明显误修正,见表2:

表2 420份LH750自动WBC修正的样本中5例误修正样本的结果(×10⁹/L)

讨论

虽然在绝大多数样本的日常检测中,具备“WBC Correct”功能与不具备“WBC Correct”功能的2台BECKMAN-COULTER公司的血液分析仪的WBC计数结果的重复性相当优秀,但对于部分特殊样本的检测,从统计结果来看,带有“WBC Correct”功能的LH750计数可靠性、准确性比不具备“WBC Correct”功能的STKS更胜一筹^[5],由此看来“WBC Correct”这一功能的确能够有效减少35 fL以下非WBC物质对WBC计数的影响。

在420份LH750的WBC计数结果中我们发现5例误修正,经过与WBC染色分类及临床诊断相结合,我们确定引起误修正的原因是该2份血样本都有高比例的小淋巴细胞(体积小于或接近35 fL,即修正的临界点),导致仪器将小淋巴细胞误认为干扰物^[6]而自动从WBC计数结果中剔除。同时,由于LH750直接将修正后的结果显示于报告数据中,因而可能误导操作者,所以我们在日常工作中有必要密切关注血液分析仪的“Cellular Interference”修正提示,尤其是诸如淋巴瘤、慢性淋巴性白血病等可能具有大量小淋巴细胞的病例样本应及时进行手工对照,切不可麻痹大意。

The authors have declared that no competing interests exist.

参考文献

View Option

[1]	Igout J, Fretigny M, Vasse M, et al. Evaluation of the coulter LH750 haematology analyzer compared with flow cytometry as the reference method for WBC, platelet and nucleated RBC count[J]. Clin Lab Haematal, 2004, 26(1): 1-7. [本文引用:1]
[2]	丛玉隆. 当代血液分析技术与临床[M]. 北京: 人民卫生出版社, 1997: 26-33. [本文引用:1]
[3]	叶应妩, 王毓三. 全国临床检验操作规程[M]. 第2版. 南京: 东南大学出版社, 1997: 4-5. [本文引用:1]
[4]	中华人民共和国卫生部. 红细胞和白细胞计数参考方法[S]. WS/T245—2005, 中华人民共和国卫生部, 2005. [本文引用:1]
[5]	李占君, 侯兴宁. COULTER LH750全血自动血液分析仪性能的评价[J]. 实用医技杂志, 2005, 12(19): 2739-2740. [本文引用:1]
[6]	彭黎明, 王兰兰. 检验医学自动化及临床应用[M]. 北京: 人民卫生出版社, 2003: 229-233. [本文引用:1]

2004

0.0

. 2004, 26(1):1-7

Evaluation of the coulter LH 750 haematology analyzer compared with flow cytometry as the reference method for WBC, platelet and nucleated RBC count

J. Igout,M. Fretigny,M. Vasse,M. P. Callat,M. Silva,L. Willemont,M. Gelle andB. Lenormand

Laboratoire d'hématologie, CHU Charles Nicolle, Rouen, France<br/><sup>*</sup>Bernard Lenormand, Laboratoire d'Hématologie, CHU Charles Nicolle, 1, rue de Germont, 76031 Rouen Cédex, France. Tel./Fax: (33) 2 32 88 83 66; E-mail: <a href="mailto:bernard.lenormand@chu%E2%80%90rouen.fr" title="Link to email address" shape="rect">bernard.lenormand@chu-rouen.fr</a>

The Coulter LH 750^® is a new haematology analyser with several new features: a count of nucleated red blood cells (NRBCs), automated WBC correction in presence of a flag indicating a cellular interference and a lower incidence of platelet or WBC interference flags when compared with the GEN.S, our current instrument. We had three main goals in our study: evaluating the LH 750 WBC counts when a GEN.S flag suggests a risk of WBC interference, ascertaining whether the platelet counts not flagged by the LH 750 were accurately assessed in samples flagged by the GEN.S and evaluating the NRBC assay provided by the LH 750. Flow cytometry, using CD45 and CD41, respectively for WBC and platelet labelling, was used as a reference method to assess the accuracy of the LH 750 counts. NRBC were identified by double labelling with propidium iodide (PI) and CD45, NRBCs being CD45−/PI+. A significant relationship was found between LH 750 and flow cytometric WBC counts, whether a WBC correction was made by the LH 750 (r = 0.9809, n = 54) or not (r = 0.9901, n = 23). A highly significant relationship was observed for platelets not only in the range from 0 to 450 × 10⁹/l (r = 0.981, n = 108) but also in cases of thrombocytopenia (range: 0–80 × 10⁹/l; r = 0.956, n = 51). In samples with NRBCs, the NRBC percentages given by the LH 750 and by flow cytometry were highly correlated (r = 0.977, n = 60) and WBC counts were accurate. In conclusion, the reduction in flagging by the LH 750, the accuracy of the results, and the availability of a NRBC count, constitute major advantages.

... 引言作为贝克曼库尔特公司血液分析仪的高端产品——BECKMAN-COULTER LH750血液分析仪(简称LH750)具有众多的专利技术,其中关于白细胞(white blood cell, WBC)计数的“WBC Correct”是一项较独特的功能^[1] ...

1997

0.0

... 为了减少35 fL以下诸如聚集的血小板、红细胞碎片、有核红细胞等非WBC颗粒对WBC计数的影响^[2],LH750通过在WBC直方图35 fL处建立第二纵坐标,根据其与左侧第一峰的相交值经统计学处理后,将可疑的非WBC物质从WBC计数结果中直接剔除,从而保证WBC计数结果最大程度地接近真值 ...

1997

0.0

... 0 mg/mL^[3] ...

2005

0.0

... 三、方法对LH750 WBC计数结果中有“Cellular Interference”修正提示的样本在2 h内按卫生部推荐的《红细胞和白细胞计数的参考方法》^[4]进行手工WBC计数,同时用STKS进行复测,并记录LH750修正前计数结果、修正后计数结果,手工法计数结果,STKS计数结果,连续累积420份数据,进行统计学分析 ...

2005

0.0

... 讨论虽然在绝大多数样本的日常检测中,具备“WBC Correct”功能与不具备“WBC Correct”功能的2台BECKMAN-COULTER公司的血液分析仪的WBC计数结果的重复性相当优秀,但对于部分特殊样本的检测,从统计结果来看,带有“WBC Correct”功能的LH750计数可靠性、准确性比不具备“WBC Correct”功能的STKS更胜一筹^[5],由此看来“WBC Correct”这一功能的确能够有效减少35 fL以下非WBC物质对WBC计数的影响 ...

2003

0.0

... 在420份LH750的WBC计数结果中我们发现5例误修正,经过与WBC染色分类及临床诊断相结合,我们确定引起误修正的原因是该2份血样本都有高比例的小淋巴细胞(体积小于或接近35 fL,即修正的临界点),导致仪器将小淋巴细胞误认为干扰物^[6]而自动从WBC计数结果中剔除 ...