Sysmex UF-5000 Automatic Urine Sediment Analyzer Can Improve the Accuracy of Epithelial Cell Detection.
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Objective The aim of this study was to evaluate the consistency and accuracy of all the parameters of the urine samples detected by two automated urine sediment analyzers from Sysmex Corporation. Methods Two automated analyzers and manual microscopy examined 1,059 urine samples. The sensitivity, specificity, positive predictive value, and negative predictive value were evaluated. The consistency of all the parameters was tested. The influencing factors of false positive and false negative samples were analyzed and compared. Results All the parameters had good specificity, negative predictive value, and coincidence rate (83.95%-99.61%). The RBC, WBC, and X'TAL analyzed by UF-5000 and UF-1000i exhibited good agreement (Kappa=0.597-0.784) with those by manual microscopy. The overall concordance rates of RBC and WBC were good (RBC: r=0.9842, CCC=0.9693; WBC: r=0.9955, CCC=0.9711). Among the influencing factors, mucus filament accounted for a large proportion, which mainly affected the detection of CAST. Concurrently, the false-positive factors of EC detection were reduced, and CAST did not affect the detection of EC. Conclusion The parameters of the two instruments tested have shown high accuracy, consistency, coincidence rate, and low negative predictive value for RBC and WBC, which has ensured that UF-5000 and UF-1000i meet the clinical requirements for urine tests for disease screening. For the samples with poor consistency and false-positive factors, a conventional microscopic examination should be applied to verify the accuracy of the instrument detection.Keywords:
Concordance
Urinary sediment
False positive rate
Repeatability
Kappa
Positive predicative value
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Objective To evaluate positive results of UF-1000i Urinary sediment analyzer and analyze false positive results.Methods A total of 500 urine samples were collected randomly and determined by UF-1000i full automatic urinary sediment analyzer(UF-1000i),urine strips and microscopic analysis.positive results of samples were deemed as false when results were abnormal with UF-1000i analyzing but normal with urine strips and microscopic analysis.Two results of urine formed elements were contrasted between UF-1000i and microscopic analysis in samples with false positive results.Results Totally 178 of 500 samples showed positive results with UF-1000i analysis,in which 20 samples were determined as false positive results in main examined items with microscopic analysis.In 178 positive results,the false positive rate of erythrocyte(RBC),leukocyte(WBC),cast and epithelial cells(EC) were 10.8%,8.2%,23.1% and 14.3% separately.Conclusion The analyses on urinary sediments by UF-1000i full automatic urinary sediment analyzer was effective.But it is important to observe sediments by microscope to avoid false positive results when results were abnormal with UF-1000i analysis.
Urinary sediment
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Objective To discuss the difference of Sysmex UF1000-i automatic urinalysis analyzer,AX-4280 urine dry chemistry analyzer and microscopy for detection of urine leukocyte. Methods Urine samples were collected from 968 patients for leukocyte detection by the three methods,then the results were compared to analyze the difference. Results The positive rates of UF-1000i,urine dry chemistry analyzer and microscopy were 27. 07%,15. 29% and 18. 08% respectively. The difference had statistical insignificance between UF-1000i and microscopy( P 0. 05,χ2= 22. 37),and the coincidence rate was 90. 81%. While there was no statistical significance between urine dry chemistry analyzer and microscopy,and the coincidence rate was 91. 84%. With microscopy result as reference standard,there were 88 false-positive samples by UF-1000i,mainly small round epithelial cells. But by urine dry chemistry analyzer,there were 53 false-negative samples in lymphocyte cells and 26 false-positive samples in squamous cells. Conclusion Three methods should be combined in urine analysis to improve the accuracy and quality of detection.
Statistical Analysis
False positive rate
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Objective To investigate the value of UF 100 flow cytometer,dipstick test and microscopic observation.Methods 530 random samples were tested respectively by using UF 100 flow cytometer,dipstick fest and microscopic observation.Results Compared with microscopic sediment data,the positive corresponding rate,false positive rate and false negative rate in UF 100 test for RBC were 89%,15.12% and 11% respectively,and for WBC,92.31%,8.23% and 7.69% respectively.The positive corresponding rate for EC,SRC,CAST,X'TAL and YLC were 80.6%,50%,66.7%,68.89% and 57.12% respectively.In 530 urine samples,267 samples of RBC,WBC,protein and nitrite were all negative for dipstick test,among which UF 100 detected 22 samples RBC positive and 25 samples WBC positive,while manual microscopy detected 7 samples RBC positive and 19 samples WBC positive.Compared with microscopic sediment data the positive corresponding rate,false positive rate and false negative rate in dipstick test for RBC were 93%,15.2% and 7% and for WBC,50.43%,3.11% and 49.57%.Conclusion Joint application of UF 100 flow cytometer,dipstick test and manual microscopy could compensate each others inadequacy and satisty the standardization of urinalysis.Morever cross checking the results of UF 100 and dipstick test could greatly reduce the labor intension and improve the effectiveness.
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[Objective]To valucate the performance of the method used in detecting red blood cells(RBC) in urine by Sysmex UF-100 automatic flow urine Analysis(UF-100).[Methods]Collecting 750 cases of clinical urine samples under the requirement of NCCLS Literature GP16-A,analysis by above method.[Results]It has a favorable relativity in detecting of urine RBC by UF-100 and Neubauer’s Counting Board.RBC γ=0.973,t examination(P0.05);Good linearity in range of 5 000 RBC/μl and high degree.CV6% when the number of RBC is samller than 40 RBC/μl.The bacteria and candida、have different effects in RBC detection in urine.[Conclusions]UF-100 is a fast and easy testing methond to perform urine sediments quantitative erinalysis.We sugest to choose the Sysmex UF-100 as sieving rule testing RBCs methond.
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Objective: To investigate the value of UF-100 flow cytometer,dry chemistry test and diasys fecal monitor.Methods:390 random samples were tested respectively by using UF-100 flow cytometer,dry chemistry test and Diasys Fecal Monitor.Results: Compared with Diasys Fecal Monitor data,the positive corresponding rate,false positive rate and false negative rate in dry chemistry test for RBC were 92.68%,13.96% and 7.32% respectively,and for WBC,58.91%,9.58% and 41.09% respectively;Compared with Diasys Fecal Monitor data,the positive corresponding rate,false positive rate and false negative rate in UF-100 test for RBC were 82.93%,7.47% and 17.07% respectively,and for WBC,81.40%,12.26% and 18.60% respectively.The positive corresponding rate for EC,SRC,CAST,X'TAL and YLC were 69.09%,60.53% 68.18% 78.95% and 57.14% respectively.In 176 negative samples of 4 items in dry chemistry test,14 samples RBC positive and 19 samples WBC positive were detected in UF-100 test,while Diasys Fecal Monitor detect-ed 5 samples RBC positive rate and 11 samples WBC positive.Conclusion: Joint application of Diasys Fecal Monitor of urinalysis,more-over cross-checking the results of UF-100 and dry chemistry test could greatly reduce the labor-intension and improve the effectiveness.At the same time,multi-instrument urinalysis conform to the demand of Standard suggestion of urine sediments analysis,and it is the ideal project to construct workstation of laboratory standardization.
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Objective To compare the consistency of the results output from Comboi-Scan XS automatic urine analyzer(before and after the re-classisfication),Sysmex UF-1000i urine analyzer and microscopic examination.Methods Obtain 129 specimen of fresh urine from the outpatients and conduct the test with Comboi and UF-1000i automatic urine analyzer respectively.In the meantime,conduct the test through microscopic examination.Manually re-classify the data output from Comboi for urine RBC,urine WBC and urine EPI and take the results of microscopic examination as the reference,then compare these results.Results For Comboi,the sensitivity for urine WBC,urine RBC and EPI are 87.9%,72.3% and 87.1%;the specificity are 76.3%,100%,70.4%;PV+ are 89.9%,100% and 48.2%;PV-are 72.5%,66.7% and 97.2%;the Youden index are 0.64,0.72,0.58;the value of Kappa are 0.633、0.650、0.451.After adjustment,Comboi's sensitivity for urine WBC,urine RBC and EPI are 97.8%,97.6%,96.8%;the specificity are 81.6%,84.8% and 61.2%;PV+ are 92.7%,92.0% and 44.1%;PV-are 93.9%,95.1% and 98.4%;the Youden index are 0.79,0.82 and 0.58;the value of Kappa are 0.829,0.844,0.412.Therefore,after the re-classisfication,most of the indices are better.For UF-1000i,the sensitivity of the test for urine WBC,urine RBC and EPI are 90.1%,79.5% and 77.4%;the specificity are 89.47%,80.5% and 71.4%;PV+ are 95.3%,88.0% and 46.1%;PV-are 79.1%,68% and 90%;the Youden index are 0.79,0.60 and 0.49;the value of Kappa are 0.766,0.577,0.397.Conclusion Comboi XS and UF-1000i can both provide reliable and stable test result to the visible component of urine.And the concept of design of Comboi XS is closer to the reference method,which makes the operation more convenient and its test result after the manual adjustment is more ideal.
Youden's J statistic
Kappa
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Objective To evaluate the function of Sysmex UF-100 fully automated Urine sediment analyzer in detection of red blood cell(RBC) and leukocyte(WBC).Methods To evaluate precision,linearity,carryover rate of the UF-100.select RBC,WBC samples in the range of 2~100/μl,100~500/μl, 500/μl,35 cases in each group,the samples were tested by the Neubauer Count Board and the UF-100 count method.The results of the two methods were compared.Results The precision of the RBC and WBC was 3.8% and 5.6% respectively,linear(r) were 0.997 and 0.999 respectively,the pollution carryover rate of 0.14% and 0.17%;Compare the results of the UF-100 and the Neubauer blood cell count board : There were no significant difference in RBC 500/μl(P 0.05),There were significant difference in RBC 500/μl(P 0.05);WBC,no significant difference in the range of 2~100/μl(P0.05), 100/μl were significant difference(P0.05).Conclusions Use the UF-100 fully automated urine sediment analyzer to test RBC and WBC,its precision,linearity were well,and its carryover rate were low but it should not completely replace the microscopic examination,the UF-100t,he Dry chemistry and microscopic examination can greatly improve the efficiency of detection.
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Objective To investigate the clinical application values of Sysmex UF-1000i automated urinary sediment analyzer.Methods 2 000 urine samples were determined by UF-1000i automated urinary sediment analyzer and microscopy.The results were contrasted,and the reasons of false positive in UF-1000i analyzer were analyzed.Results When using Sysmex UF-1000i analyzer,the detecting sensitivities of white blood cell(WBC),red blood cell(RBC),cast and small round epithelial cell were 99.2%,99.3%,94.7% and 95.1%,and the false positive rates of them were 5.8%,6.1%,10.4% and 4.6%,respectively.Many factors,like viscose rayon,crystals,bacteria,yeast-like fungus,small round epithelial cells,fat droplets and lecithin body may affect the determination of urine formed elements.Conclusions It is an effectual method to detect urinary sediments by Sysmex UF-1000i analyzer.It is very important to observe sediments by microscopy when all above interferences are positive or increase.
Urinary sediment
White blood cell
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Objective To study the method of improving the consistency of the analytic results of RBC and WBC which between different SYSMEX UF-1000i automatic urine sediment analyzers.Methods To Use fresh and pure RBC and WBC urine sample to fine-tune laser optical index(S-FSC,S-SSC) of two SYSMEX UF-l000i urinary sediment analyzers,which had already calibrated by supporting calibrator,and compared and statistical analyzed with the results of RBC and WBC checked by two UF-l000i sediment analyzers before and after that fine-tuning.Results With a analyzer for the internal standard device,Before fine-tuning,the statistical bias of RBC and WBC were 16.12%and 16.65%,after fine-tuning the statistical bias of RBC and WBC were 8.16%and 2.44%,which decreased to 49.3%and 85.3%respectively;RBC slope(a) value decreased from 1.113 to 1.057,WBC decreased from 1.177 to 1.046 by correlation analysis of two UF-l000i urine sediment analyzers;and fine-tuning made no statistical difference between RBC and WBC internal quality control.Conclusion Calibrated by supporting calibrator, The resell of fresh urine RBC and WBC checked by different UF-1000 urine sediment analyzers may differ;By adjusting the SYSMEX UF-l000i laser optical index(S-FSC,S-SSC) can effectively improve the consistency of the results of RBC and WBC checked between different SYSMEX UF-l000i automatic urine sediment analyzers.
Statistical Analysis
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Evaluation of a new automated cell analyzer (Sysmex UF-1000i) for bacteriological screening of urine
Introduction. Sysmex UF-1000 is a new flow cytometry for the analysis of urine based on a laser diode technology using specific compounds for the staining nucleic acids, characterized by a threshold of detection of bacteria equal to 1000 CFU/ml.The purpose of this study was to compare the positivity or negativity of the urine samples using standard procedures and with the response obtained from the instrument UF-1000i. Methods. During the period May and July 2011, 1024 urine samples obtained from the laboratory of the hospital in Genoa-Voltri were analyzed with the instrument Sysmex UF-1000i.The samples were stored at a temperature of 5°C during transport.The instrument after loading of the sample is able to assess the bacterial load in about 1 minute per sample. Results. 1024 samples were analyzed with Sysmex UF-1000 analyzed in parallel by the hospital laboratory in Genoa Voltri. 228 are positive results for Sysmex UF-1000 (bacterial loads in excess of 1000 CFU/ml).The data obtained were consistent with those recorded with traditional analysis. 18 samples were positive only for our instrument, but not with the traditional system used in the laboratory for comparison. Conclusion. The advantage of Sysmex UF-1000 is certainly due to obtain immediate results after the reading of each individual sample that is higher than any other instrument or method of analysis used. The slight discrepancy of the results obtained may be due to the extremely low calibration of UF-1000. This allows in a very short time to discard all negative samples with enormous saving of time and material. For positive samples and applies the criterion of the routine ie, the bacterial load has a meaning according to the type of patient considered, as in the case of pediatric or catheterized patients
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