Mindray MC-80 자동디지털세포형태분석기와 수동 검사법 비교: 말초혈액 도말의 비정상 세포 분석
Comparison of Mindray MC-80 Automated Digital Cell Morphology Analyzer with Manual Examination: Analysis of Abnormal Cells in Peripheral Blood Smear
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배경: MC-80은 Mindray사(China)에서 개발한 자동디지털세포형태분석기이다. 이 연구는 MC-80이 전단구와 비정상 전골수구의 비율을 계산하는 능력을 평가하고 수기 검사자와 비교해보고자 하였다. 방법: 전단구를 포함한 24개의 검체와 비정상 전골수구를 포함한 16개의 검체가 이용되었다. MC-80이 각각의 검체에서 200개의 백혈구를 감별계산하여 모세포와 모세포에 상응하는 세포들(blast equivalents)의 비율을 계산하였다. 이후 두 명의 검사자가 동일한 방식으로 백혈구감별계산을 실시한 후 MC-80과의 절대적 일치도(absolute reliability)를 급내상관계수(intraclass correlation coef cient)를 이용하여 분석하였다. 결과: 전단구를 포함한 검체들에서 MC-80과 두 명의 수기 검사자 간 얻어진 급내상관계수는 각각 0.772와 0.780이었다. 비정상 전골수구를 포함한 검체들에서 MC-80과 두 명의 수기 검사자 간 얻어진 급내상관계수는 각각 0.926과 0.927이었다. 통계적 결과 해석에 따르면 “good”에서 “excellent” 수준의 절대적 일치도를 보였으나 두 명의 수기 검사자 간의 일치도에 비하면 낮은 수준이었다. 결론: MC-80과 검사자 간의 절대적 일치도는 두 명의 수기 검사자 간의 절대적 일치도에 비해 열등했다. 그러나 검사 후 검증과정을 통한다면 MC-80이 모세포에 상응하는 세포들을 선별하는 업무에 도움을 줄 수 있을 것으로 기대된다.
Abstract
Background: The MC-80 is a digital cell morphology analyzer developed by Mindray (China). This study evaluated the performance of the MC-80 in calculating the proportion of promonocytes and abnormal promyelocytes and compared it with manual examination. Methods: Twenty-four peripheral blood smear samples containing promonocytes and 16 samples with abnormal promyelocytes were analyzed. The MC-80 counted 200 white blood cells from the samples and calculated the proportions of blasts and blast equivalents. Subsequently, two examiners performed the same task, and the absolute reliability between the MC-80 and the examiners, as well as between the two examiners, was evaluated using the intraclass correlation coefficient (ICC). Results: For promonocyte samples, the ICC values obtained between the MC-80 and Examiners 1 and 2 were 0.772 and 0.780, respectively. For samples with abnormal promyelocytes, the ICC values for the MC-80 and Examiners 1 and 2 were 0.926 and 0.927, respectively. These values indicated “good” to “excellent” levels of absolute reliability by statistical interpretation. However, the MC-80 demonstrated lower levels of reliability with each examiner than between the two examiners, indicating a performance inferior to that of manual examination. Conclusions: The absolute reliabilities of the MC-80 and manual examination were inferior to the inter-examiner absolute reliability. However, with post-test validation, it is expected that the MC-80 could provide valuable assistance for the screening of blast equivalents.
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