Objective: To evaluate the review criteria for complete blood analysis.
Methods: total of 8820 blood samples taken at our hospital were detected both by the Sysmex XE-2100 automated blood cell analyzer and double-blind method microscopy. The performance of two review criteria were evaluated by statistical analysis. The parameters, such as true and false positive rates, true and false negative rates, sensitivity, specificity, positive predictive value, negative predictive value, total effective rate, test effectiveness and re-examination rate were calculated according to the criteria of XE-2100 hematology analyzer re-examination standards coordination group of Society of Laboratory Medicine of Chinese Medical Association. And a study was conducted to determine the improved clinical effectiveness over the criteria.
Results: The values of true and false positive rates, true and false negative rates, sensitivity, specificity, positive predictive values, negative predictive value, total effective rate, test effectiveness and reexamination rate were 13.0%, 27.2%, 55.3%, 4.5%, 74.3%, 67.0%, 32.4%, 92.5%, 68.3%, 21.2%, and 40.2% respectively. The re-examination rate decreased to 33.8% and the total effective rate increased to 74.7% according to our improved review criteria. And there was no missed diagnosis of leukemic cells. It was found that 2069 samples (23.5%) needed manual microscopy for WBC differential analysis, 847 had abnormal cells and no leukemia was missed.
Conclusions: The automatic blood cell analyzer and WBC differential analysis review criteria have great clinical utilities. The review criteria of blood cell analysis may be improved according to patient source and instrument performance so as to better meet the needs of clinical application.