• Korean Journal of Clinical Laboratory Science
• /
• v.37 no.3
• /
• pp.143-148
• /
• 2005

Automatic hematology analyzers provide the leukocyte differential count and the useful flags of the various hematological parameters. We compared LH 750 (Beckman Coulter Co., Miami, FL, USA) with manual method on differential leukocyte counts and evaluated the usefulness of the suspect flags, provided by this instrument. The comparison of leukocyte differential counts between two methods showed good correlation coefficient (r), which were 0.95 (neutrophil), 0.92 (lymphocyte), 0.82 (monocyte) and 0.95 (eosinophil). The frequency of the total flags displayed on LH 750 were 15.5%, which included immature granulocyte/left shift 63.5%, nucleated RBC 14.6%, platelet clumps 13.1%, variant lymphocyte 50% and blast 16.6%. This instrument showed higher positive predictive value in the flags such as platelet clumps 68.8%, immature granulocyte/left shift 61.5%, nucleated RBC 27.3%, variant lymphocyte 50% and blast 16.7%. In this study, the leukocyte differential counts of LH 750 showed good correlation with manual method and the suspect flags also showed a good performance for applying the criteria of re-examination in the clinical laboratory.

• Korean Journal of Clinical Laboratory Science
• /
• v.36 no.2
• /
• pp.144-152
• /
• 2004

With technological advances in automatic hematology analyzers, primary and screening differential counts of white blood cells (WBC) are done with automatic hematology analyzers. They are using different measurement and analysis principles, so differences in WBC differentials and WBC morphology flag exist. This study was carried out to analyze WBC differential counts and WBC morphology flags comparing them with the manual method. Patient EDTA samples in Vacutainer requested for WBC differentials were analyzed with XE-2100. And those samples with suspect flags messages index over 100 were selected and were analyzed with ADVIA-120. Peripheral blood smear film was subsequently made. Three investigators counted 200 cells each (600 cells) in 111 Wright-Giemsa stained blood films. Between two automatic hematology analyzers, neutrophil, lymphocyte, eosinophil, and monocyte showed good correlations, but basophil had moderate correlation. Among automatic hematology analyzers and manual count, neutrophil, lymphocyte, and eosinophil had good correlations, but monocyte had moderate correlation. XE-2100 had higher monocyte, which was due to atypical lymphocyte and myeloblast. LUC in ADVIA-120 was not due to monocyte in XE-2100. Morphology flagging rates were 146.9% in XE-2100 and was 93.2% in ADVIA-120. Positive predictive values of morphology flag were 58.2% in XE-2100 and 54.4% in ADVIA-120. Flags such as atypical lymphocyte, immature granulocyte, and left shift had higher predictive values and those such as N-RBC, platelets clump, and blast had lower ones. Between automatic hematology analyzers, WBC differentials showed good correlations. Predictive values for morphology flags can be variable with changing criteria. Reviewing criteria for WBC differentials and morphology flags should be established in each laboratory with regards to size of laboratory and patients it serves.

• Korean Journal of Clinical Laboratory Science
• /
• v.44 no.2
• /
• pp.66-74
• /
• 2012

Test turnaround time (TAT) is the lead time from reception to reporting. In the complete blood cell count (CBC), 4 units of the XE-2100 (Sysmex Corp., Japan) processed around 80% of quantity, 1 unit of the LH-780 (Beckman-Coulter Incorp., USA) processed around 10% and 1 unit of ADVIA-2120 (Siemens AG, Munich, Germany) processed around 10%. We analyzed the change in the TAT for the CBC for over 7 years, from January of 2005 to December of 2011. The delta check made alterations of delta to WBC, hemoglobin, hematocrit, platelet and metamyelocyte, however, did not made them to band neutrophil, eosinophil, basophil and monocyte. The panic value check made alterations of panic value to hemoglobin, hematocrit, platelet and monocyte. In the criteria of currently slide review, LH-780 and ADVI-2120 analyzers prepared suspect flags of "Blast, Imm NE2, Immature granulocyte, Imm NE1, Left shift, Variant lymphocyte, Atypical lymphocyte, Platelet clumps and NRBC". The New slide review in the XE-2100 analyzer altered the preparations of a smear slide more than a "Platelet clumps flag(${\geq}200unit$), a single flag excluding the "Platelet clumps flag (${\geq}250unit$) and a multiple flag (${\geq}200unit$)". Also, below the 240 unit, medical technologists prepared manual slides selectively according to their evaluations. The automatic reporting rate was 33.4% without alterations, whereas it was 41.0% without alterations, and was thus improved by 7.6%. The slide review rate was 15.2% before using the Q-flag limit, whereas it was 12.1% for a reduce 3.1%. TAT was 45 minutes without the creation alterations of the delta and panic value checks, whereas it was 35 minutes after making alterations of the delta and panic value checks and thus was shortened by 10 minutes. We came to the conclusion that the establishment and operation of delta and panic value checks and slide review criteria suitable for laboratory environment can reduce unnecessary smear slides, re-checking, re-sampling, re-testing, telephone inquiries and concentrated workloads during specific times of the day.