Objective: Compared with the method of optical microscopy, to evaluate the accuracy of fragmented red cells(FRC) detection by Sysmex XN-3000.
Methods: A total of 111 samples were collected from patients diagnosed as thrombotic thrombocytopenic purpura, autoimmune disease, hematological disease, malignant tumor and health examination in our hospital from June 2019 to February 2021, including 74 cases in the case group and 37 cases in the healthy control group. All samples were detected by optical microscope and Sysmex XN-3000, respectively. ROC was used to evaluate the detection ability of Sysmex XN-3000 for schistocyte. Bland-Altman method was used to evaluate the consistency of the results of the two methods for detection of schistocyte, and Pearson correlation analysis was conducted for the difference of the results.
Results: The area under the ROC curve was 0.890(95% CI: 0.828-0.952, P<0.01). Sysmex XN-3000 count did not quantitatively agree with schistocyte counts by microscopy in the case group(mean of difference:-1.53, 95% limits of agreement: -8.78~5.72). There was a weak positive correlation between platelet count and the difference of analyzer and microscopic results (r=0.32,P<0.05).
Conclusion: Sysmex XN-3000 can be used as a reference for qualitative determination of schistocyte. However, the sensitivity of Sysmex XN-3000 should be improved. It is still necessary to combine with manual microscopy. The quantitative results are not reliable now and cannot be used as a reference for monitoring the results of schistocyte in clinical patients after treatment.
题目: Sysmex XN-3000对裂红细胞检测的结果评价.
目的: 与光学显微镜方法比较，评价Sysmex XN-3000的检测参数破碎红细胞（FRC）对裂红细胞检测的准确性.
方法: 收集中国医科大学附属第一医院2019年6月-2021年2月诊断为血栓性血小板减少性紫癜、自身免疫病、血液病、恶性肿瘤患者和健康查体者标本共111例，其中病例组74例，健康对照组37例。分别用光学显微镜和Sysmex XN-3000对所有标本进行检测，利用ROC曲线评估Sysmex XN-3000对裂红细胞的检测能力。用Bland-Altman法评价两种方法检测结果的一致性并对造成的结果差异进行Pearson相关性分析.
结果: ROC曲线分析Sysmex XN-3000对裂红细胞检测的曲线下面积为0.890(95%CI：0.828-0.952,P<0.01)。两种方法检测病例组裂红细胞结果不一致（差值平均值-1.53,95%LoA，-8.78~5.72）。血小板计数与检测结果差值呈弱正相关(r=0.32,P<0.05).
结论: Sysmex XN-3000可用于裂红细胞定性检测的参考，但敏感度低，仍需结合光学显微镜检查。定量结果暂不可靠，不作为对临床患者治疗后裂红细胞结果监测的参考.
Keywords: Sysmex XN-3000; fragmented red cells; optical microscope; schistocyte; thrombotic thrombocytopenic purpura.