백혈구감소증 검체에서 디지털 세포형태 분석기 UIMD PBIA의 임상적 유용성 평가
Assessment of Clinical Utility of Digital Morphology Analyzer UIMD PBIA in Leukopenia Samples
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배경: 최근 백혈구 감별계산에서 수기법의 단점을 보완하기 위해디지털 세포형태 분석기의 사용이 증가하고 있다. 본 연구에서는백혈구감소증이 있는 검체들을 대상으로 새로 개발된 디지털 세포형태 분석기인 UIMD PBIA (ANI CO., Korea)의 성능을 평가하였다. 방법: 백혈구감소증이 있는 총 159건의 검체를 백혈구감소증의 정도에 따라 4개의 그룹으로 나누었다(그룹 1: 백혈구 ≤1.0×109/L, 그룹 2: 1.0–2.0×109/L, 그룹 3: 2.0–3.0×109/L, 그룹 4: 3.0–4.0×109/L). 검체에서 얻은 23,358개의 백혈구 세포 이미지를 이용하여 UIMD PBIA의 정확도와 처리속도를 분석하고 비교하였다. 결과: UIMD PBIA는 전체 검체에서 97.5%의 정확도를 보였고, 비정상 림프구를 제외한 모든 세포군에서 90% 이상의 높은 정확도를 보였다. 모세포는 수기법과 UMID PBIA 간 통계적으로 유의미한 상관관계를 보였다(r>0.7). 두 검사자 모두 모세포 및 미성숙 과립구를 1% 초과하여 계수하였을 때 UIMD PBIA는 수기법과100% 양성일치율을 보였다. 그룹 3, 4에 비해 그룹 1, 2에서 UIMD PBIA의 소요시간이 수기법보다 짧았다. 결론: 비정상 세포의 분류오류는 여전히 개선이 필요하지만, UIMD PBIA는 백혈구감소증이 있는 검체에서 백혈구 감별계산에대해 빠르고 정확한 결과를 제공한다. 백혈구수 및 환자의 진단에따라 선택적으로 적용한다면 UIMD PBIA는 임상에서 유용하게사용할 수 있을 것이다.
Abstract
Background: Recently, digital morphology analyzer use to compensate for the disadvantages of manual counting in white blood cell (WBC) differentials is increasing. In this study, we evaluated the accuracy and throughput of UIMD PBIA (ANI CO., Korea), a newly developed digital morphology analyzer, in samples from patients with leukopenia. Methods: A total of 159 samples from patients with leukopenia were divided into four groups according to the degree of leukopenia (group 1: WBC ≤1.0×109/L, group 2: 1.0–2.0×109/L, group 3: 2.0–3.0×109/L, group 4: 3.0–4.0×109/L). We analyzed and compared the accuracy and throughput of UIMD PBIA using 23,358 WBC images obtained from the samples. Results: UIMD PBIA was 97.5% accurate in all samples and over 90% accurate in cell types except abnormal lymphocytes. Blasts showed a statistically significant correlation (r> 0.7) between manual count and UIMD PBIA. When both experts counted more than 1% blasts or immature granulocytes, the UIMD PBIA showed 100% positive agreement with the manual count. The turnaround time of UIMD PBIA was shorter than that of manual count in groups 1 and 2 compared to that in groups 3 and 4. Conclusions: Although some areas in abnormal cell misclassification need to be improved, UIMD PBIA provides quick and accurate results for WBC differentials in samples from patients with leukopenia. If applied selectively according to the WBC count and patient diagnosis, UIMD PBIA could be useful in clinical practice.
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