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KMID : 1101320040360020144
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Korean Journal of Clinical Laboratory Science
2004 Volume.36 No. 2 p.144 ~ p.152
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Correlation of XE-2100, ADVIA-120 and Manual Differential Count and Evaluation of Morphology Flag
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Lee Bum-Hee
Byun Nam-Sub
Gee Myung-Suk
Song Soon-Young
You Seon-Woo
Park Hyo-Soon
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Abstract
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With technological advances in automatic hematology analyzers, primary and screening differential counts of white blood cells (WBC) are done with automatic hematology analyzers. They are using different measurement and analysis principles, so differences in WBC differentials and WBC morphology flag exist. This study was carried out to analyze WBC differential counts and WBC morphology flags comparing them with the manual method. Patient EDTA samples in Vacutainer requested for WBC differentials were analyzed with XE-2100. And those samples with suspect flags messages index over 100 were selected and were analyzed with ADVIA-120. Peripheral blood smear film was subsequently made. Three investigators counted 200 cells each (600 cells) in 111 Wright-Giemsa stained blood films. Between two automatic hematology analyzers, neutrophil, lymphocyte, eosinophil, and monocyte showed good correlations, but basophil had moderate correlation. Among automatic hematology analyzers and manual count, neutrophil, lymphocyte, and eosinophil had good correlations, but monocyte had moderate correlation. XE-2100 had higher monocyte, which was due to atypical lymphocyte and myeloblast. LUC in ADVIA-120 was not due to monocyte in XE-2100. Morphology flagging rates were 146.9% in XE-2100 and was 93.2% in ADVIA-120. Positive predictive values of morphology flag were 58.2% in XE-2100 and 54.4% in ADVIA-120. Flags such as atypical lymphocyte, immature granulocyte, and left shift had higher predictive values and those such as N-RBC, platelets clump, and blast had lower ones. Between automatic hematology analyzers, WBC differentials showed good correlations. Predictive values for morphology flags can be variable with changing criteria. Reviewing criteria for WBC differentials and morphology flags should be established in each laboratory with regards to size of laboratory and patients it serves.
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KEYWORD
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XE-2100, ADVIA-120, Manual count, Correlation, Morphology flag, Evaluation
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