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| 題 名 | 修改Sysmex XE-2100分析儀中白血球分類異常警示訊號的條件以降低臨床人工閱片的比例=Improving the Clinical Hematology Laboratory Process by Modification of Differential Flag Criteria on the Sysmex XE-2100 |
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| 作 者 | 林宏澤; 鄧金堂; 張永達; 高振強; 翁志昇; 郭明宗; 甯孝眞; | 書刊名 | Journal of Biomedical & Laboratory Sciences |
| 卷 期 | 19:2 2007.06[民96.06] |
| 頁 次 | 頁40-46 |
| 分類號 | 415.124 |
| 關鍵詞 | 白血球分類計數; 白血球分類警示訊號; White blood cell differential count; Differential flag criteria; Sysmex XE-2100; |
| 語 文 | 中文(Chinese) |
| DOI | 10.30046/JBLS.200706.0002 |
| 中文摘要 | 背景:自動化血液分析儀不僅有白血球分類的功能,當偵測到不正常血球時還能產生警示訊號。當檢體分析結果出現警示訊號,操作者就必須進行人工閱片以確認血球是否異常。本科血液檢驗室所使用的Sysmex XE-2100有三種警示訊號,包括形態異常訊號(Morph flag)、分類異常訊號(Diff flag)和計數異常訊號(Count flag),這些警示訊號條件可依使用者需求來做適當調整。目前有許多評估血液分析儀的文獻,但是針對警示訊號的評估卻很少。目的:本研究是評估XE-2100中分類異常訊號的條件,在不影響檢驗品質下,希望降低警示訊號的偽陽性以提高特異性,來改善人工閱片的比例。材料與方法:861件需白血球分類的血液檢體經儀器分析,單獨出現分類異常訊號與同時出現分類和計數異常訊號的有105件。這些血片由兩位經驗豐富的醫檢師獨立看片,統計偽陽性檢體的分類結果並與原廠設定值做比較,將分類異常訊號的設定條件作適度調整。更改設定值後持續追蹤,檢體結果落在儀器分類異常訊號條件更改前後之間的檢體。結果:分類異常訊號的條件經過調整後,偽陽性檢體由原先102件降到28件,人工閱片量約可減少8.6%。結論:每間檢驗室由於病人族群的差異,應該評估適合自己的警示訊號條件,以提升臨床血液檢驗效率與品質。 |
| 英文摘要 | Background: Hematology auto-analyzers could not only perform differential count for white blood cells (WBCs) but also generate warning flags if abnormal cells are detected. Re-analysis of the blood smears by operators is required in such circumstances. The Sysmex XE-2100 flagging system contains three different warning flags: morphology (Morph) flag, differential (Diff) flag, and counting (Count) flag. Criteria for warning flags can be modified by the users according to their clinical needs. So far, reports on evaluation of such warning systems are still scarce, compared to those on the auto-analyzers themselves. Purpose: To improve the overall efficiency in WBC differential count analysis, the warning system was assessed to minimize the false positive alarms and thus reduce the need for manual re-analysis without compromising the quality. Materials and Methods: Among the 861 specimens analyzed by the Sysmex XE-2100, 105 specimens were found to have Diff flags or a combination of both Diff and Count flags. The associated smears were reviewed by two independent experienced medical technologists and the results were used to evaluate the criteria for Diff flags established by the manufacturer. Results: Of the 105 specimens with Diff flags, 102 were confirmed to have been falsely alarmed. Modification of the criteria for the Diff flag system has brought down the number of false flags from 102 to 28, leading to the reduction of manual re-analysis rate by 8.6%. Conclusion: In order to achieve a better efficiency and quality of hematology analysis, laboratories using hematology auto-analyzers should evaluate the built-in flag system and, if necessary, modify the criteria according to their patient populations. |
本系統中英文摘要資訊取自各篇刊載內容。