RELIABILITY OF REACTIVE LYMPHOCYTES RESULTS ON ADVIA HEMATOLOGY ANALYZER

UVOD: Imunost posredovana stanicama je važna u obrani domaćina protiv virusnih infekcije i zloćudnih novotvorina. Reaktivni limfocit je ne-maligni leukocit nađen u perifernoj krvi. Pojavljuje se kao nespecifični odgovor na stres. Danas je to atipični limfocit, Downey-ova stanica, ili reaktivni limfocit te je on marker bolesti kada se pronađe u perifernoj krvi. Laboratorijska automatizacije sve se više razvija po pitanju hematoloških analizatora i algoritama kako bi na odgovarajući način otkriti abnormalne uzorke među kojima i reaktivne limfocite čiji nalaz nam jako pomaže u samoj dijagnostici stanja pacijenta. CILJ ISTRAŽIVANJA: Odrediti pouzdanost nalaza reaktivnih limfocita u 60 uzoraka pacijenata. Od ukupnog broj uzoraka, 30 uzoraka se odnosilo na zdrave uzorke u usporedbi sa 30 pozitivnih nalaza reaktivnih limfocita. MATERIJALI I METODE: Uzorci krvi (n=60) korišteni za analizu bili su podjeljeni u dvije skupine: 30 uzoraka je pripadalo zdravim ispitanicima sa negativnim nalazom reaktivnih limfocita. Preostalih 30 uzoraka je pripadalo ispitanicima s pozitivnim nalazom reaktivnih limfocita. Mjerni instrument korišten u svrhe analize je hematološki analizator ADVIA 2120. Kao kontrola korišten je mikroskopski pregled krvnog razmaza. REZULTATI: Grafičkim prikazom Passing – Bablok regresije određivali smo reaktivne limfocite metodama ADVIA- hem.analizator i mikroskopski za grupu zdravih ispitanika. Rezultati regresije za rezultate određivanja reaktivnih limfocita na analizatoru ADVIA i mikrosposki s 95% -tnom pouzdanosti nemaju značajno odstupanje među izmjerenim vrijednostima ( y=1,000+0,500 x) uz P> 0,10. Grafičkim prikazom Passing – Bablok regresije određivali smo reaktivne limfocite metodama ADVIA- hem.analizator i mikroskopski za grupu ispitanika s patofiziološkim promjenama. Rezultati regresije za rezultate određivanja reaktivnih limfocita na analizatoru ADVIA i mikrosposki s 95% -tnom pouzdanosti nemaju značajno odstupanje među izmjerenim vrijednostima ( y=1,300+0,8083 x) uz P> 0,10. ZAKLJUČAK: 1. Potvrđena je pouzdanost nalaza prisustva reaktivnih limfocita na hematološkom analizatoru ADVIA 120 provjerom reproduciblnosti- preciznost na jednom uzorku ponavljanom 10 puta uz KV =4,5%. 2. Utvrđivana je prihvatljiva razine usporedivosti udjela ( postotka ) reaktivnih limfocita određenih na hematološkom analizatoru i pregledom razmaza obojenog metodom MGG jer uz 95% pouzdanost nema bitnih odstupanja u rezultatima u grupi zdravih ispitanika. 3. Utvrđivana je prihvatljiva razine usporedivosti udjela ( postotka ) reaktivnih limfocita određenih na hematološkom analizatoru i pregledom razmaza obojenog metodom MGG jer uz 95% pouzdanost nema bitnih odstupanja u rezultatima u grupi ispitanika s patofiziološkim promjenama. 4. Utvrđena je razina osjetljivosti ( najniži broj reaktivnih limfocita ) koji analizator klasificira na vrijednost 1% .Ova vrijednost je zaokružena jer u klasifikaciji analizator izražava vrijednosti u postotku s jednom decimalom što treba uzeti u obzir pri interpretaciji rezultata. INTRODUCTION: Cell mediated immunity is important in host defense against viral infections and malignancies. Reactive lymphocyte is a non-malignant leukocytes that was found in the peripheral blood. It appears as a nonspecific response to stress. Today it is an atypical lymphocyte, Downey's cells, or reactive lymphocytes and is a marker of disease when it is found in the peripheral blood. Laboratory automation is increasingly developing in terms of hematology analyzers and algorithms in order to adequately detect abnormal patterns including reactive lymphocytes whose findings we really helpful in the diagnosis of the patient's condition. AIM OF RESEARCH: To determine the reliability of the findings of reactive lymphocytes in 60 patient samples. Of the total number of samples, 30 samples were related to healthy samples compared with 30 positive findings reactive lymphocytes. MATERIALS AND METHODS: Blood samples (n = 60) were used for the analysis were divided into two groups of 30 samples belonging to the healthy subjects with negative findings reactive lymphocytes. The remaining 30 samples belonged to subjects with positive findings reactive lymphocytes. The measuring instrument used for the purposes of analyzing is the hematology analyzer ADVIA 2120. As control was used microscopic examination of blood smears. RESULTS: Graphic display of Passing - Bablok regression was used to determine the reactive lymphocytes methods ADVIA-hem. analizator and microscopically for a group of healthy subjects. Results of regression results for the determination of reactive lymphocytes analyzer ADVIA and microscopic with 95% confidence with no significant deviation between the measured values. (Y = 1.000 +0.500 x) with P> 0.10. Graphic display of Passing - Bablok regression was used to determine the reactive lymphocytes methods ADVIA-hem. analizator and microscopically for a group of patients with pathophysiological changes. Results of regression results for the determination of reactive lymphocytes analyzer ADVIA and microscopic with 95% confidence with no significant deviation between the measured values. (Y = 1.300 +0.8083 x) with P> 0.10. CONCLUSION: 1. The reliability of the findings of the presence of reactive lymphocytes in hematology analyzer ADVIA 120 is confirmed reproducibility-checking the accuracy of a single sample repeated 10 times with CV = 4.5%. 2. Acceptable level of comparability share (percentage) of reactive lymphocytes specific to the hematology analyzer and examination of smears stained using MGG is determined because with 95% confidence there are no significant differences in the results in a group of healthy subjects. 3. Acceptable level of comparability share (percentage) of reactive lymphocytes specific to the hematology analyzer and examination of smears stained using MGG is determined because with 95% confidence there are no significant differences in the results in the group of patients with pathophysiological changes. 4. The level of sensitivity (the lowest number of reactive cells) is determined by analyzer which classifies the value of 1%. This value is rounded because the classification of the analyzer expressed as a percentage of the value to one decimal place which should be taken into account when interpreting the results.