자동혈구분석기 Sysmex XN-2000의 성능 및 Low WBC Mode를 이용한 백혈구 감별계산 정확성 평가 = Evaluation of the Automated Hematology Analyzer Sysmex XN-2000 and the Accuracy of Differential Leukocyte Counts Using the Low WBC Mode

국문 초록 (Abstract)

배경: XN- series (Sysmex, Japan)는 Sysmex사의 최신 혈액분석기로 새로운 채널 도입을 통해 낮은 세포수 범위에서 백혈구 감별계산 및 혈소판 수 계산의 정확성을 향상시켰다. 저자들은 XN-2000의 분석 성능 및 low white blood cell (WBC) mode를 평가하고자 하였다.
방법: 상기 장비의 정밀도, 직선성 및 잔효를 평가하였다. 200건의 정상인 및 환자 검체를 이용하여 XN-2000의 전혈구계산, 망상적혈구 계산 및 백혈구 감별계산을 XE-2100 (Sysmex)과 비교하여 상관성을 분석하였다. 백혈구 수 1.5×109/L 미만인 80검체를 대상으로 low WBC mode를 이용한 백혈구 감별계산 결과를 참고방법인 수기법과 비교하여 평가하였다.
결과: 정밀도 분석에서 변이계수는 대부분 전혈구계산 지표에서 <5%, 백혈구 감별계산에서 <10%였다. XN-2000의 모든 분석 결과는 XE-2100 결과와 우수한 상관성을 보였다. 상관계수(r)는 평균적혈구혈색소농도, 평균혈소판용적, 혈소판분포폭을 제외한 전혈구계산 지표에서 >0.9800이었고, 단구 및 호염기구를 제외한 백혈구 감별계산에서 >0.9900이었다. Low WBC mode는 백혈구 수 0.1-1.5×109/L 범위에서 호중구 및 림프구의 감별계산결과가 수기법과 r>0.9300를 보여 정확한 백혈구 감별계산 결과를 제공하는 것을 확인하였다.
결론: XN-2000은 우수한 분석수행능을 보이고, 기존 모델인 XE-2100과 우수한 상관성을 보였다. XN-2000의 low WBC mode는 백혈구 수 0.1-1.5×109/L 일 때 정확한 백혈구 감별계산 결과보고가 가능하므로 수기법을 통한 슬라이드 검토시간을 줄여줄 수 있다.

다국어 초록 (Multilingual Abstract)

Background: The XN-series (Sysmex, Japan) is the new hematology analyzer from Sysmex, with new channels to improve the accuracy of differential leukocyte count and platelet count in the low cell count range. We evaluated the analytical performance and low white blood cell (WBC) mode of the XN-2000.
Methods: Precision, linearity, and carryover were evaluated for the analyzer. We analyzed the accordance of complete blood count (CBC), reticulocyte count, and differential leukocyte count between the XN-2000 and XE-2100 (Sysmex), using 200 samples from normal controls and patients. For 80 samples with a WBC count <1.5×109 cells/L, the low WBC mode was evaluated by comparing the automated count with a manual differential count as the reference.
Results: The coefficients of variation of precision were <5% for most CBC parameters and <10% for differential leukocyte count. All results obtained with the XN-2000 showed good correlation with those obtained with the XE-2100. The correlation coefficients (r) were >0.9800 for all CBC parameters except mean corpuscular hemoglobin concentration, mean platelet volume, and platelet distribution width, and >0.9900 for differential leukocyte count except monocytes and basophils. The low WBC mode provided accurate counts for neutrophils and lymphocytes, with r >0.9300 for samples with a WBC count of 0.1-1.5×109 cells/L.
Conclusions: The XN-2000 showed good analytical performance and correlation with the existing model, the XE-2100. The XN-2000 provided accurate results for differential leukocyte count in samples with a WBC count of 0.1-1.5×109 cells/L, and reduced manual slide reviews.

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