Establishment of the review criteria of blood cell analysis in children and its application in clinical diagnosis

Objective To establish the review criteria for children′s blood cell analysis, ensure the accuracy of blood cell analysis results, and ensure that pathological cells are not missed. Methods A total of 1 420 samples of blood cell analysis were collected from outpatients and inpatients in Shanxi Children′s Hospital from May to June 2018, which were detected by SYSMEXXN-350 and XN-A1 automated blood cell analyzer. Blood smears weredouble-blindly examinedunder microscope. Among them, 463 were used for the establishment of review criteria, 586 were used for the verification and evaluation of review criteria, and 371 were used for the application effect study of review criteria. According tothe 41 rules recommended by ISLH, combining the characteristics of children′s physiology, pathology, disease and abnormal alarming information of hematology analyzer, the review criteria suitable for children′s blood cells were established. Results Through the evaluation and optimization of 41 rules recommended by ISLH, 23 rules for reexamination of children′s blood cell analysis were formulated, with a reexamination rate of 25.09%, and a false positive rate was 14.16%. A total of 371 samples of patients with hematological diseases were selected for the application of the review criteria. The false negative rate was 2.96%, and no pathological cells were missed. Conclusion The children′s blood cell review criteria established in this study has been verified and evaluated, which not only ensures the quality of the report, but also improves the work efficiency, and provides an important basis for the diagnosis and differential diagnosis of childhood leukemia, infectious mononucleosis and other hematological diseases. Key words: Review criteria; Hematology analyzer; Children; Hematologic disease