Search for


TEXT SIZE

search for



씪諛섑삁븸寃궗 떊鍮숇룄議곗궗 寃곌낵蹂닿퀬(2017)
Annual Report on the External Quality Assessment Scheme for Routine Hematology in Korea (2017)
J Lab Med Qual Assur 2018;40:1-8
Published online March 31, 2018
© 2018 Korean Association of External Quality Assessment Service.

씠쁺寃1,2, 源쁺誘2
Young Kyung Lee1,2, Young Min Kim2

1븳由쇰븰援 쓽怨쇰븰 吏꾨떒寃궗쓽븰援먯떎,
2븳由쇰븰援먯꽦떖蹂묒썝 吏꾨떒寃궗쓽븰怨

1Department of Laboratory Medicine, Hallym University College of Medicine, Chuncheon, Korea
2Department of Laboratory Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea
Correspondence to: Young Kyung Lee Department of Laboratory Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, 22 Gwanpyeong-ro 170beon-gil, Dongan-gu, Anyang 14068, Korea Tel: +82-31-380-3930 Fax: +82-31-380-3934 E-mail: lyoungk@hallym.or.kr
援먯떊옄: 씠쁺寃 슦)14068 寃쎄린룄 븞뼇떆 룞븞援 愿룊濡170踰덇만 22, 븳由쇰븰援 쓽怨쇰븰 븳由쇰븰援먯꽦떖蹂묒썝 吏꾨떒寃궗쓽븰援먯떎 Tel: 031)380-3930, Fax: 031)380-3934, E-mail: lyoungk@hallym.or.kr
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
 Abstract

븳엫긽寃궗젙룄愿由ы삊쉶 씪諛섑삁븸寃궗 봽濡쒓렇옩뿉꽌뒗 2017뀈뿉 쟾삁援ш퀎궛(complete blood count, CBC)怨 꽭룷삎깭뿉 븳 떊鍮숇룄議곗궗瑜 떆뻾븯떎. 珥 2쉶 떆뻾븯쑝硫, CBC뒗 留 쉶李 3媛 냽룄쓽 젙룄愿由щЪ吏덉쓣 諛곗넚븯怨, 꽭룷삎깭뒗 留 쉶李 2옣쓽 궗吏꾩쓣 쎒궗씠듃뿉 寃뚯떆븯떎. 씪諛섑삁븸寃궗뒗 珥 1,646湲곌씠 李몄뿬븯怨 CBC뒗 쉶떊쑉씠 96.7%쑝硫, 꽭룷삎깭寃궗뒗 쉶떊쑉씠 42.0%떎. 떊鍮숇룄議곗궗궗뾽뿉 궗슜맂 옣鍮꾩쓽 쁽솴 쟾뀈룄 鍮꾩듂븯떎. 諛깊삁援 닔, 쟻삁援 닔, 삁깋냼, 쟻삁援ъ슜쟻瑜, 삁냼뙋 닔쓽 CV뒗 媛곴컖 3.7%-4.7%, 2.2%-2.4%, 1.5%-3.0%, 5.4%-6.0%, 7.2%-10.2% 踰붿쐞떎. 꽭룷삎깭뒗 HHI-17-03쓣 젣쇅븯怨 紐⑤뱺 쉶李⑥뿉꽌 李몄뿬湲곌 媛꾩뿉 80% 씠긽쓽 씪移섏쑉쓣 蹂댁떎. 쟾뀈룄뿉 鍮꾪빐 2017뀈룄 쇅遺젙룄愿由ъ궗뾽 李몄뿬湲곌쓽 닔뒗 利앷븯쑝硫, 씪諛섑삁븸寃궗쓽 닔뻾뒫 쑀궗븯떎.

Under the Routine Hematology Program of the Korean Association of External Quality Assessment Service, complete blood count (CBC) and blood cell morphology proficiency tests were performed during 2017. We conducted two trials, sent three control materials for CBC testing, and posted two cell morphology pictures on the website for each trial. Of 1,646 laboratories, the mean response rates for CBC and blood cell morphology were 96.7% and 42.0%, respectively. The distribution of equipment for CBC testing was similar to that of the previous year. The coefficient of variations for white blood cell counts, red blood cell counts, hemoglobin, hematocrit, and platelet counts were 3.7%4.7%, 2.2%2.4%, 1.5%3.0%, 5.4%6.0%, and 7.2%10.2%, respectively. More than 80% of the blood cell morphology tests were concordant among all of the trials, except for the HHI-17-03 trial. In 2017, the number of participating laboratories increased, and the performance was similar to that of the previous year.

Keywords : Laboratory proficiency testing, Blood cell count, Blood cell morphology
꽌 濡

븳엫긽寃궗젙룄愿由ы삊쉶(삊쉶) 떊鍮숇룄議곗궗궗뾽씠 2016뀈 李⑥꽭 떊鍮숇룄議곗궗궗뾽쑝濡 겕寃 媛쒗렪맂 씠썑 2017뀈 李⑥꽭 떊鍮숇룄議곗궗궗뾽씠 떆뻾맂 몢 踰덉㎏ 빐떎. 2017뀈 李⑥꽭 떊鍮숇룄議곗궗궗뾽쓽 씪諛섑삁븸寃궗 봽濡쒓렇옩 2016뀈怨 룞씪븯寃 쟾삁援ш퀎궛(complete blood count, CBC)怨 꽭룷삎깭(blood cell morphology), 2媛 寃궗빆紐⑹뿉 빐 뿰 2쉶 떆뻾븯떎[1]. CBC뿉뒗 諛깊삁援 닔(white blood cell count), 쟻삁援 닔(red blood cell count), 삁깋냼(hemoglobin), 쟻삁援ъ슜쟻瑜(hematocrit), 삁냼뙋 닔(platelet count)瑜 룷븿븯룄濡 븯떎.

옱猷 諛 諛⑸쾿

씪諛섑삁븸寃궗 봽濡쒓렇옩뿉꽌뒗 CBC (諛깊삁援 닔, 쟻삁援 닔, 삁깋냼, 쟻삁援ъ슜쟻瑜, 삁냼뙋 닔) 꽭룷삎깭, 2媛 寃궗빆紐⑹쓣 긽쑝濡 媛곴컖 7썡怨 8썡, 珥 2쉶 떎떆븯쑝硫, 媛 쉶李⑤떦 3媛쒖쓽 젙룄愿由щЪ吏덉쓣 룊媛븯룄濡 븯떎.

CBC瑜 쐞빐꽌뒗 Hematology Control (Randox La-oratories Ltd., Crumlin, UK) 젙룄愿由щЪ吏덉쓣 씠슜븯떎. 媛 쉶李⑤쭏떎 3媛吏 냽룄쓽 젙룄愿由щЪ吏덈줈 援ъ꽦븯떎. 꽭룷삎깭寃궗瑜 쐞빐꽌뒗 媛 쉶李⑤쭏떎 2媛쒖쓽 꽭룷궗吏꾩쓣 媛꾨왂븳 엫긽냼寃ш낵 븿猿 솃럹씠吏뿉 寃뚯떆븯怨 李멸湲곌뿉꽌 뙋룆寃곌낵뿉 빐떦븯뒗 꽭룷삎깭寃궗 뙋룆肄붾뱶瑜 엯젰븯룄濡 븯떎.

젙룄愿由щЪ吏덉 怨꾩빟 깮諛곕 씠슜븯뿬 諛쒖넚븯뒗뜲, 1쉶李⑤뒗 7썡 3씪뿉, 2쉶李⑤뒗 8썡 29씪뿉 諛쒖넚븯떎. 寃궗寃곌낵뒗 李⑥꽭 떊鍮숇룄議곗궗궗뾽 솃럹씠吏뿉 엯젰븯룄濡 븯怨, 엯젰湲곌컙 醫낅즺 썑 엯젰寃곌낵뿉 빐 뜲씠꽣 삤瑜섎 寃利앺븳 썑 넻怨꾨텇꽍쓣 떆뻾븯떎.

CBC寃궗씤 諛깊삁援 닔, 쟻삁援 닔, 삁깋냼, 쟻삁援ъ슜쟻瑜, 삁냼뙋 닔 寃곌낵뒗 쟾泥 湲곌, 젣議고쉶궗蹂, 痢≪젙湲곌린蹂 넻怨꾨텇꽍쓣 떆뻾븯떎. 痢≪젙湲곌린蹂 遺꾩꽍뿉꽌뒗 쑀궗紐⑤뜽씤 寃쎌슦 븳 援곗쑝濡 臾띠뼱 넻怨꾨텇꽍쓣 떆뻾븯떎.

넻怨꾨텇꽍 룊洹, 몴以렪李(standard deviation, SD), 蹂씠怨꾩닔(coefficient of variation, CV), 以묎컙媛, 理쒖냼媛, 理쒕媛믪쓣 援ы븯쑝硫, 媛 湲곌뿉 빐 몴以렪李⑥닔(standard deviation index, SDI)瑜 궛젙븯떎[2]. 룊洹, SD, CV뒗 빐떦 遺꾨쪟蹂 遺꾩꽍뿉꽌 75 percentile 媛(Q3)怨 25 percentile 媛(Q1)쓽 李(Q3-Q1; interquartile range, IQR)쓽 1.5諛곕 珥덇낵븯뿬 Q1蹂대떎 궙嫄곕굹, Q3蹂대떎 넂 寃곌낵媛(竊쏲1-1.5횞IQR 삉뒗 竊얫3+1.5횞IQR) 씠긽移(outlier)濡 젣嫄고븳 썑 遺꾩꽍븯떎[3]. 媛 遺꾨쪟뿉 빐떦븯뒗 湲곌 닔媛 10媛 誘몃쭔씤 寃쎌슦뿉뒗 룊洹좉낵 SD, CV, SDI瑜 援ы븯吏 븡븯怨, 湲곌 닔媛 3媛 誘몃쭔씤 寃쎌슦뿉뒗 以묎컙媛믩룄 援ы븯吏 븡븯떎.

꽭룷삎깭寃궗뿉 븳 遺꾩꽍 媛 꽭룷蹂꾨줈 떟븳 湲곌 닔 諛깅텇쑉쓣 援ы븯떎. 媛 湲곌蹂 遺꾩꽍寃곌낵뒗 솃럹씠吏뿉꽌 吏곸젒 議고쉶 諛 異쒕젰븷 닔 엳룄濡 븯떎.

寃 怨

1. 떊鍮숇룄議곗궗궗뾽 李몄뿬湲곌

2017뀈 씪諛섑삁븸寃궗 봽濡쒓렇옩 珥 1,646湲곌씠 떊泥븯怨, 1쉶李⑥뿉 1,474湲곌, 2쉶李⑥뿉 1,505湲곌뿉 寃泥대 諛곗넚븯떎. CBC(諛깊삁援 닔, 쟻삁援 닔, 삁깋냼, 쟻삁援ъ슜쟻瑜, 삁냼뙋 닔) 寃곌낵瑜 쉶떊븳 湲곌 1쉶李 1,447湲곌, 2쉶李 1,435湲곌쑝濡 룊洹 寃곌낵 쉶떊쑉 96.7%떎. 꽭룷삎깭寃궗 寃곌낵瑜 쉶떊븳 湲곌 1쉶李 628湲곌, 2쉶李 621湲곌쑝濡 룊洹 寃곌낵 쉶떊쑉 42.0%떎(Table 1).

Table 1 . Response rate of laboratories that participated in the proficiency tests that were performed under the Routine Hematology Program.

긖est itemsTrialParticipantsSample delivery dateParticipating laboratoriesResponse dateParticipants who respondedResponse rate (%)
Complete blood count1st1,6462017. 7. 31,4742017. 7. 141,44798.2
2nd1,6462017. 8. 291,5052017. 9. 81,43595.3
Mean1,489.51,44196.7
Blood cell morphology1st1,6462017. 7. 31,4742017. 7. 1462842.6
2nd1,6462017. 8. 291,5052017. 9. 862141.3
Mean1,489.5624.542.0

2. Complete blood count 痢≪젙湲곌린 궗슜쁽솴

寃곌낵瑜 쉶떊븳 湲곌뿉꽌 CBC 痢≪젙뿉 씠슜븳 옄룞遺꾩꽍湲곌린뒗 젣議곗궗蹂꾨줈 遺꾨쪟븯쓣 븣 Sysmex (Kobe, Japan)媛 42.9%濡 媛옣 留롮븯怨, Nihon Kohden Corp. (Tokyo, Japan) 10.0%, Siemens Healthcare Diagnostics Inc. (Tarrytown, NY, USA)媛 9.1%, Shenzhen Mindray Bio-Medical Electronics Co. Ltd. (Shenzhen, China)媛 9.0%, Horiba Medical (Montpellier, France)媛 8.2%, Beckman Coulter Inc. (Miami, FL, USA)媛 7.5% 닚씠뿀떎(Table 2).

Table 2 . Equipment used for complete blood count.

꺿꺿꺿꺿긎anufacturer1st2ndMean%
Sysmex619618618.542.9
Nihon Kohden Corp.14614214410.0
Siemens Healthcare Diagnostics Inc.128133130.59.1
Shenzhen Mindray Bio-Medical Electronics Co. Ltd.132127129.59.0
Horiba Medical118117117.58.2
Beckman Coulter Inc.1081081087.5
Abbott474043.53.0
Boule3232322.2
Orphee SA2828281.9
Erba Diagnostics9109.50.7
URIT Medical Electronic Co. Ltd.9109.50.7
Samsung Electronics5550.3
Shenzhen Genius Electonics Co. Ltd.3330.2
Others6262624.3
Total1,4471,4351,441100

The instruments used were from the following companies: Sysmex (Kobe, Japan), Nihon Kohden Corp. (Tokyo, Japan), Siemens Healthcare Diagnostics Inc. (Tarrytown, NY, USA), Shenzhen Mindray Bio-Medical Electronics Co. Ltd. (Shenzhen, China), Horiba Medical (Montpellier, France), Beckman Coulter Inc. (Miami, FL, USA), Abbott (Abbott Park, IL, USA), Boule (Stockholm, Sweden), Orphee SA (Geneva, Switzerland), Erba Diagnostics (Mannheim, Germany), URIT Medical Electronic Co. Ltd. (Guangxi, China), Samsung Electronics (Suwon, Korea), and Shenzhen Genius Electonics Co. Ltd. (Shenzhen, China).


3. Complete blood count

諛깊삁援ъ닔뒗 룊洹좉컪 2,515/關L-16,305/關L 踰붿쐞뿉꽌 쟾泥닿린愿 CV媛 3.7%-4.7%怨, 쟻삁援 닔뒗 룊洹좉컪 2.047횞106/關L-5.505횞106關L 踰붿쐞뿉꽌 쟾泥닿린愿 CV媛 2.2%-2.4%떎. 삁깋냼뒗 룊洹좉컪 6.07 g/dL-15.70 g/dL 踰붿쐞뿉꽌 쟾泥닿린愿 CV媛 1.5%-3.0%怨, 쟻삁援ъ슜쟻瑜좎 룊洹좉컪 18.78%-44.19% 踰붿쐞뿉꽌 쟾泥닿린愿 CV媛 5.4%-6.0%떎. 삁냼뙋 닔뒗 룊洹좉컪 76.8횞103/關L-466.4횞103/關L 踰붿쐞뿉꽌 쟾泥닿린愿 CV媛 7.2%-10.2%떎(Table 3).

Table 3 . Proficiency test results for complete blood count.

꺿꺿긆temNo. of participantsMedianMinMaxMean짹SDCV (%)No. except outliersOutliers (%)
1st
긙BC count
꺿긅H-17-011,44616.320.4419.4016.305짹0.6313.91,3784.7
꺿긅H-17-021,4465.700.1559.805.703짹0.2113.71,3725.1
꺿긅H-17-031,4469.100.2692.809.083짹0.3794.21,3913.8
긓BC count
꺿긅H-17-011,4465.501.936.225.505짹0.1222.21,3933.7
꺿긅H-17-021,4465.161.787.915.150짹0.1132.21,4042.9
꺿긅H-17-031,4464.561.266.864.553짹0.1082.41,3705.3
긅emoglobin
꺿긅H-17-011,44715.76.148.315.70짹0.281.81,3993.3
꺿긅H-17-021,4714.99.545.714.91짹0.271.81,4172.1
꺿긅H-17-031,44713.712.543.413.74짹0.221.61,3685.5
긅ematocrit
꺿긅H-17-011,44644.515.457.844.19짹2.605.91,4142.2
꺿긅H-17-021,44642.713.565.142.42짹2.325.51,3993.3
꺿긅H-17-031,44639.37.958.738.91짹2.346.01,3864.1
긑latelet count
꺿긅H-17-011,446381724,240381.0짹30.88.11,3903.9
꺿긅H-17-021,44677418,00076.8짹7.910.21,3715.2
꺿긅H-17-031,446234102,640233.4짹17.07.31,3437.1
2nd
긙BC count
꺿긅H-17-041,4337.800.2288.007.804짹0.3204.11,3724.3
꺿긅H-17-051,4332.502.0224.002.515짹0.1194.71,3982.4
꺿긅H-17-061,4339.000.2988.008.976짹0.3553.91,3605.1
긓BC count
꺿긅H-17-041,4332.050.075.622.047짹0.0462.31,3674.6
꺿긅H-17-051,4332.080.475.282.080짹0.0462.21,3754.0
꺿긅H-17-061,4334.711.555.614.704짹0.1042.21,3694.5
긅emoglobin
꺿긅H-17-041,4356.55.415.86.47짹0.193.01,4012.4
꺿긅H-17-051,4356.15.115.06.07짹0.162.61,3982.6
꺿긅H-17-061,43513.81.415.213.84짹0.211.51,3545.6
긅ematocrit
꺿긅H-17-041,43319.40.447.819.37짹1.075.51,3724.3
꺿긅H-17-051,43318.84.246.218.78짹1.055.61,3585.2
꺿긅H-17-061,43340.313.885.739.98짹2.175.41,3535.6
긑latelet count
꺿긅H-17-041,4334651351,369466.4짹33.87.31,3982.4
꺿긅H-17-051,43314178446142.1짹11.88.31,4042.0
꺿긅H-17-061,433250126515250.2짹18.07.21,3754.0

Abbreviations: WBC, white blood cell; RBC, red blood cell.


4. 꽭룷삎깭

꽭룷삎깭뒗 留 쉶李⑤쭏떎 2媛쒖쓽 궗吏꾩쓣 寃뚯떆븯떎. 異쒖젣 쓽룄 理쒕떎鍮덈룄濡 씪移섑븯뒗 寃곌낵瑜 湲곗쑝濡 룊媛븯쓣 븣, 1쉶李 HHI-17-01 (Fig. 1A)뒗 basophil뿉 95.4%, HHI-17-02 (Fig. 1B)뒗 rouleaux formation뿉 97.3%쓽 씪移섏쑉 蹂댁떎. 2쉶李 HHI-17-03 (Fig. 1C) blast뿉 68.1%濡 鍮꾧탳쟻 궙 씪移섏쑉쓣 蹂댁쑝硫, 씠 쇅쓽 떟쑝濡 reactive lymphocyte (14.8%), lymphocyte (7.2%)濡 떟븳 寃쎌슦룄 엳뿀떎. 2쉶李 HHI-17-04 (Fig. 1D)뒗 fragmented cell (schistocyte)뿉 90.8% 씪移섏쑉쓣 蹂댁떎(Table 4).

Figure 1.

Cell morphology pictures posted for the blood cell morphology proficiency tests. (A) HHI-17-01 ba짯sophil (arrow). (B) HHI-17-02 rouleaux formation (arrows). (C) HHI-17-03 blast (arrows). (D) HHI-17-04 fragmented cell (schistocyte) (arrows).


Table 4 . Proficiency test results for blood cell morphology.

꺿긖rialCode꺿꺿긎orphologyNo. (%)
HHI-17-01Total628 (100.0)
110Basophil599 (95.4)
462Basophilic stippling12 (1.9)
109Immature basophil4 (0.6)
119Toxic granulation3 (0.5)
103Myelocyte2 (0.3)
108Eosinophil2 (0.3)
106Segmented neutrophil1 (0.2)
468Rouleaux formation1 (0.2)
115Myeloblast with Auer rod1 (0.2)
104Metamyelocyte1 (0.2)
328Large granular lymphocyte1 (0.2)
105Band neutrophil1 (0.2)
HHI-16-02Total628 (100.0)
468Rouleaux formation611 (97.3)
469Red cell agglutinates11 (1.8)
110Basophil2 (0.3)
434Normal red cell2 (0.3)
462Basophilic stippling1 (0.2)
454Spherocyte1 (0.2)
HHI-17-03Total621 (100.0)
693Blast423 (68.1)
329Reactive lymphocyte92 (14.8)
327Lymphocyte45 (7.2)
330Lymphoma cell21 (3.4)
224Monocyte14 (2.3)
328Large granular lymphocyte7 (1.1)
103Myelocyte6 (1.0)
115Myeloblast with Auer rod4 (0.6)
104Metamyelocyte3 (0.5)
102Promyelocyte3 (0.5)
223Immature monocyte2 (0.3)
453Fragmented cell (schistocyte)1 (0.2)
HHI-17-04Total621 (100.0)
453Fragmented cell (schistocyte)564 (90.8)
456Sickle cell29 (4.7)
457Acanthocyte (spur cell)17 (2.7)
473Bite cell4 (0.6)
454Spherocyte2 (0.3)
693Blast1 (0.2)
458Burr cell1 (0.2)
689Hairy cell1 (0.2)
576Normal platelet1 (0.2)
450Target cell1 (0.2)

怨 李

2016뀈 李⑥꽭 떊鍮숇룄議곗궗궗뾽 떆뻾뿉 뵲씪 씪諛섑삁븸寃궗 봽濡쒓렇옩룄 洹 씠쟾怨쇰뒗 긽떦엳 겙 蹂솕媛 엳뿀떎[1,4]. 2015뀈뿉뒗 珥 4李⑥뿉 嫄몄퀜 留 쉶李⑤쭏떎 CBC뒗 젙룄愿由щЪ吏 1媛, 꽭룷삎깭뒗 궗吏 2媛쒖뵫 떆뻾릺뿀쑝굹[4], 2016뀈遺꽣뒗 2李⑥뿉 嫄몄퀜 留 쉶李⑤쭏떎 CBC뒗 젙룄愿由щЪ吏 3媛, 꽭룷삎깭뒗 궗吏 2媛쒖뵫 떆뻾븯쑝硫[1], 2017뀈 李⑥꽭 떊鍮숇룄議곗궗궗뾽 泥닿퀎濡 떆뻾맂 몢 踰덉㎏ 빐떎. 2017뀈 씪諛섑삁븸寃궗 봽濡쒓렇옩뿉뒗 1, 2쉶李 룊洹 1,490湲곌씠 李몄뿬븯뿬 2016뀈쓽 룊洹 1,455湲곌뿉 鍮꾪빐 35湲곌씠 뒛뼱굹 2.4%쓽 利앷瑜 蹂댁떎[1].

寃곌낵 쉶떊쑉 CBC뒗 96.7%濡 2016뀈쓽 96.3% 鍮꾧탳븯뿬 鍮꾩듂븳 닔以쓣 蹂댁쑝硫, 꽭룷삎깭寃궗쓽 寃곌낵 쉶떊쑉 42.0%濡 2016뀈쓽 40.4%뿉 鍮꾪빐 利앷븯떎. 꽭룷삎깭寃궗쓽 寃곌낵 쉶떊쑉씠 궙 媛믪쓣 蹂댁씠뒗 寃껋 2016뀈 李⑥꽭 떊鍮숇룄議곗궗궗뾽遺꽣 CBC 꽭룷삎깭瑜 援щ텇븯吏 븡怨 씪諛섑삁븸 봽濡쒓렇옩쓣 떊泥븯硫 몢 寃궗빆紐 紐⑤몢 떊泥릺룄濡 븯湲 븣臾몄쑝濡, 쉶떊븳 湲곌쓽 닔瑜 鍮꾧탳븯硫 李⑥꽭 떊鍮숇룄議곗궗궗뾽 씠쟾씤 2015뀈뿉 503湲곌쑝濡, 씠썑씤 2016뀈뿉뒗 588湲곌, 2017뀈뿉뒗 625湲곌쑝濡 젏李 利앷븯怨 엳뒗 뼇긽씠떎[1,4].

2016뀈 李⑥꽭 떊鍮숇룄議곗궗궗뾽 씠썑 蹂솕맂 泥닿퀎뿉 뵲씪 2017뀈뿉룄 紐⑤뱺 봽濡쒓렇옩뿉 빐 젙룄愿由щЪ吏덉쓽 諛쒖넚遺꽣 寃곌낵엯젰, 蹂닿퀬꽌 諛쒖넚源뚯 쟾 怨쇱젙쓣 삊쉶 以묒븰뿉꽌 씪愿릺寃 愿由, 吏꾪뻾븯떎. 寃泥 諛쒖넚 떎瑜 봽濡쒓렇옩쓽 젙룄愿由щЪ吏덇낵 븿猿 삁빟맂 깮諛곕줈 吏꾪뻾릺뿀떎. 1쉶李⑥뿉꽌뒗 2017뀈 7썡 3씪, 2쉶李⑥뿉꽌뒗 2017뀈 8썡 29씪뿉 CBC 젙룄愿由щЪ吏덉씠 諛쒖넚릺뿀뒗뜲, 湲곗삩씠 넂 뿬由꾩쿋뿉 諛곗넚븿쑝濡 씤빐 썝嫄곕━씠嫄곕굹 諛곗넚씠 뼱젮슫 吏뿭뿉꽌 寃泥 슜삁씠 諛쒖깮릺뒗 寃쎌슦媛 엳뼱 뼢썑 醫 뜑 湲곗삩씠 궙 떆湲곗뿉 諛곗넚븿쑝濡쒖뜥 寃泥댁쓽 븞젙꽦쓣 넂씪 닔 엳쓣 寃껋쑝濡 깮媛곹븳떎.

寃泥 닔졊 떆 媛 湲곌뿉꽌뒗 삊쉶 李⑥꽭 떊鍮숇룄議곗궗궗뾽 솃럹씠吏뿉꽌 寃泥 젒닔瑜 븳 썑, 寃궗瑜 떆뻾븯怨 寃곌낵瑜 솃럹씠吏뿉 吏곸젒 엯젰븳 썑, 理쒖쥌쟾넚쓣 빐빞 寃곌낵媛 쟾넚릺룄濡 븯떎. 엯젰湲곌컙 醫낅즺 썑 엯젰寃곌낵뿉 븯뿬 삤瑜섎 젏寃븯怨, 넻怨꾨텇꽍쓣 떆뻾븯쑝硫, 寃곌낵넻蹂 뿭떆 李⑥꽭 떊鍮숇룄議곗궗궗뾽 솃럹씠吏뿉꽌 李몄뿬湲곌蹂꾨줈 吏곸젒 議고쉶 諛 異쒕젰쓣 븷 닔 엳룄濡 븯떎. 寃곌낵蹂닿퀬꽌뒗 怨듯넻蹂닿퀬꽌 湲곌蹂꾨낫怨좎꽌 몢 媛吏 삎깭濡 젣怨듯븯쑝硫, 怨듯넻蹂닿퀬꽌뿉뒗 쟾泥닿린愿, 洹몃━怨, 젣議곗궗蹂, 湲곌린蹂 넻怨꾨 젣怨듯븯떎. 湲곌蹂 蹂닿퀬꽌뿉꽌뒗 媛 湲곌쓽 寃곌낵媛믨낵 쟾泥, 洹몃━怨 湲곌뿉꽌 궗슜븯뒗 湲곌린쓽 젣議곗궗, 湲곌린遺꾨쪟뿉 뵲瑜 넻怨꾧컪怨 SDI瑜 젣怨듯븯쑝硫, 쟾泥닿린愿 諛 룞씪 젣議곗궗瑜 궗슜븯뒗 湲곌뱾뿉꽌 빐떦 湲곌쓽 寃곌낵媛믪쓽 쐞移섎 엳뒪넗洹몃옩쑝濡 젣怨듯븯怨, 빐떦 湲곌쓽 SDI쓽 늻쟻遺꾪룷瑜 洹몃옒봽濡 몴떆븯뿬 젣怨듯븯떎(Fig. 2).

Figure 2.

Summary report of the Routine Hematology Program. (A) Summary of all participants. (B) Summary of each laboratory.


넻怨꾨텇꽍 떆 냼닔젏 몴떆 李⑹삤 벑 엯젰삤瑜섎줈 뙋떒릺뒗 寃껋 닔湲곕줈 젣쇅븯怨, 씠긽移섏뿉 빐떦븯뒗 寃곌낵媛믪 Turkey쓽 box-plot諛⑹떇쓣 씠슜븳 궗遺꾩쐞踰 쓽 씠긽移 젣嫄곕 쟻슜븯뿬 넻怨꾨텇꽍뿉꽌 젣쇅븯떎[3]. 넻怨꾨쾾쐞뿉 뱾뼱삤뒗 湲곌留뚯쓣 긽쑝濡 룊洹좉낵 SD, CV瑜 怨꾩궛븯쑝硫, 媛 湲곌쓽 룊媛寃곌낵뒗 SDI濡 젣떆븯떎. 씠뿉 뵲씪 씪諛섑삁븸寃궗쓽 넻怨꾨텇꽍 젣쇅湲곌 1李⑥뿉꽌뒗 2.1%-7.1%, 2李⑥뿉꽌뒗 2.4%-5.6%떎(Table 3).

CBC뿉 궗슜맂 湲곌린쓽 쁽솴 Sysmex媛 42.9%濡 媛옣 留롮븯怨, 떎쓬쑝濡 Nihon Kohden Corp., Siemens Healthcare Diagnostics Inc., Shenzhen Mindray Bio-Medical Electronics Co. Ltd., Horiba Medical, Beckman Coulter Inc. 벑씠 遺꾪룷븯뿬 二쇱슂 궗슜湲곌린쓽 遺꾪룷뒗 2016뀈怨 쑀궗븯떎[1].

닔뻾뒫 痢〓㈃뿉꽌 CBC쓽 諛깊삁援 닔, 쟻삁援 닔, 삁깋냼, 쟻삁援ъ슜쟻瑜, 삁냼뙋 닔쓽 CV뒗 媛곴컖 3.7%-4.7%, 2.2%-2.4%, 1.5%-3.0%, 5.4%-6.0%, 7.2%-10.2% 踰붿쐞濡, 2016뀈쓽 媛 寃궗빆紐⑹쓽 CV 3.8%-4.5%, 1.9%-2.3%, 1.4%-2.8%, 4.8%-5.8%, 6.2%-9.4% 鍮꾩듂븳 遺꾪룷떎[1]. 꽭룷삎깭뒗 2쉶李⑥쓽 HHI-17-03쓽 寃쎌슦 blast뿉 빐 68.1%濡 떎냼 궙 씪移섏쑉쓣 蹂댁쑝굹, 洹 쇅 紐⑤뱺 쉶李⑥뿉꽌 李몄뿬湲곌 媛꾩뿉 80% 씠긽쓽 씪移섏쑉쓣 蹂댁떎.

2017뀈 씪諛섑삁븸寃궗 봽濡쒓렇옩 2016뀈 李⑥꽭 떊鍮숇룄議곗궗궗뾽씠 떆뻾맖뿉 뵲씪 쟾 怨쇱젙씠 쟾泥 봽濡쒓렇옩怨 븿猿 삊쉶 以묒븰뿉꽌 씪愿 떆뻾릺뿀쑝硫, 李몄뿬湲곌 쟾뀈뿉 鍮꾪빐 떎냼 利앷瑜 蹂댁怨, 닔뻾뒫 痢〓㈃뿉꽌뒗 鍮꾩듂븳 寃곌낵瑜 蹂댁떎.

References
  1. Lee YK. Routine Hematology Program, Korean Association of External Quality Assessment Service. Annual report on the external quality assessment scheme for routine hematology in Korea (2016). J Lab Med Qual Assur 2017;39:53-60.
    CrossRef
  2. Klee GG, Westgard JO. Quality management. In: Burtis CA, Ashwood ER, Bruns DE, editors. Teitz textbook of clinical chemistry and molecular diagnostics. 5th ed. St. Louis (MO): Elsevier Saunders, 2012:163-203.
    CrossRef
  3. Turkey JW. Exploratory data analysis. Reading (MA): Addison-Wesley, 1977.
  4. Kwon GC, Kim J, Ra GS. Diagnostic Hematology Subcommittee;Korean Association of External Quality Assessment Service. Annual report on the external quality assessment for diagnostic hematology in Korea (2015). J Lab Med Qual Assur 2016;38:1-10.
    CrossRef