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

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.