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Annual Report of the Korean Association of External Quality Assessment Service on Routine Hematology (2018)
J Lab Med Qual Assur 2019;41:1-8
Published online March 31, 2019
© 2019 Korean Association of External Quality Assessment Service.

Young Kyung Lee1, Young Min Kim2

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
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

Two trials were conducted with proficiency tests for complete blood cell count (CBC) and blood cell morphology as part of the 2018 Routine Hematology Program of the Korean Association of External Quality Assessment Service. Three different control samples were sent for CBC testing and two blood cell morphology pictures were posted on the laboratory website during each trial. The mean response rates of the 1,719 participating laboratories were 97.4% and 37.2% for CBC and blood cell morphology, respectively. The distribution of equipment for CBC testing was comparable to that of the previous year. The coefficient of variation (CV) ranges were determined as 3.5%–4.1%, 1.9%–2.7%, 1.4%–2.8%, 4.5%–5.3%, and 5.4%–6.9% for white blood cell counts, red blood cell counts, hemoglobin, hematocrit, and platelet counts, respectively. The concordance rate ranged from 83.0% to 97.5% in blood cell morphology tests. We observed a continuous increase in the number of participating laboratories and a trend towards a decrease in the CVs of platelet counts compared to those in 2016. Values of the other assessed parameters were similar to those 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 2018뀈 李⑥꽭 떊鍮숇룄議곗궗궗뾽씠 떆뻾맂 꽭 踰덉㎏ 빐떎. 2018뀈 李⑥꽭 떊鍮숇룄議곗궗궗뾽쓽 씪諛섑삁븸寃궗 봽濡쒓렇옩 쟾뀈룄 룞씪븯寃 쟾삁援ш퀎궛(complete blood cell 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 [RBC] 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 4썡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寃궗뒗 CBC-3K Hematology Controls (R&D system Inc., Minneapolis, MN, USA) 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궗뒗 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 4썡 23씪뿉, 2쉶李⑤뒗 8썡 20씪뿉 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(<Q1–1.5×QR 삉뒗 >Q3+1.5×IQR) 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

2018뀈 씪諛섑삁븸寃궗 봽濡쒓렇옩 珥 1,719湲곌씠 떊泥븯怨, 1쉶李⑥뿉 1,708湲곌, 2쉶李⑥뿉 1,719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 1,653湲곌, 2쉶李 1,686湲곌쑝濡 룊洹 寃곌낵 쉶떊쑉 97.4%떎. 꽭룷삎깭寃궗 寃곌낵瑜 쉶떊븳 湲곌 1쉶李 645湲곌, 2쉶李 629湲곌쑝濡 룊洹 寃곌낵 쉶떊쑉 37.2%떎(Table 1).

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

Test itemsTrialParticipantsSample delivery dateParticipating laboratoriesResponse dateParticipants who respondedResponse rate (%)
Complete blood cell count1st1,7192018. 4. 231,7082018. 5. 31,65396.8
2nd1,7192018. 8. 201,7192018. 8. 301,68698.1
Mean1,713.51,669.597.4
Blood cell morphology1st1,7192018. 4. 231,7082018. 5. 364537.8
2nd1,7192018. 8. 201,7192018. 8. 3062936.6
Mean1,713.563737.2

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 42.1%濡 媛옣 留롮븯怨, Nihon Kohden Corp. (Tokyo, Japan) 10.5%, Shenzhen Mindray Bio-Medical Electronics Co. Ltd. (Shenzhen, China)媛 10.2%, Siemens Healthcare Diagnostics Inc. (Tarrytown, NY, USA)媛 8.9%, Horiba Medical (Montpellier, France)媛 8.7%, Beckman Coulter Inc. (Miami, FL, USA)媛 6.9% 닚씠뿀떎(Table 2).

Table 2 . Equipment used for complete blood cell count.

Manufacturer1st2ndMean%
Sysmex698707702.542.1
Nihon Kohden Corp.17417617510.5
Shenzhen Mindray Bio-Medical Electronics Co. Ltd.16417817110.2
Siemens Healthcare Diagnostics Inc.1411551488.9
Horiba Medical148143145.58.7
Beckman Coulter Inc.1161141156.9
Boule4246442.6
Orphee SA404140.52.4
Abbott373435.52.1
URIT Medical Electronic Co. Ltd.161716.51.0
Erba diagnostics1012110.7
Samsung Electronics8880.5
Shenzhen Genius Electonics Co. Ltd.3330.2
Dirui Industrial433.50.2
Others524950.53.0
Total1,6531,6861,669.5100

3. Complete blood count

諛깊삁援 닔뒗 룊洹좉컪 3,236/uL-22,519/uL 踰붿쐞뿉꽌 쟾泥닿린愿 CV媛 3.5%-4.1%怨, 쟻삁援 닔뒗 룊洹좉컪 2.016×106/uL-5.133×106/uL 踰붿쐞뿉꽌 쟾泥닿린愿 CV媛 1.9%-2.7%떎. 삁깋냼뒗 룊洹좉컪 5.52 g/dL-15.94 g/dL 踰붿쐞뿉꽌 쟾泥닿린愿 CV媛 1.4%-2.8%怨, 쟻삁援ъ슜쟻瑜좎 룊洹좉컪 16.56%-47.92% 踰붿쐞뿉꽌 쟾泥닿린愿 CV媛 4.5%-5.3%떎. 삁냼뙋 닔뒗 룊洹좉컪 81.0×103/uL-494.2×103/uL 踰붿쐞뿉꽌 쟾泥닿린愿 CV媛 5.4%-6.9%떎(Table 3).

Table 3 . Proficiency test results for complete blood cell count.

ItemNo. of participantsMedianMinMaxMean±SDCV(%)No. except outliersOutliers (%)
1st
 WBC count
  HH-18-011,6513.221.2822.503.236±0.1133.51,5605.5
  HH-18-021,6517.491.2574.007.484±0.3024.01,5983.2
  HH-18-031,65121.702.8328.3021.637±0.8844.11,5844.1
 RBC count
  HH-18-011,6512.131.356.642.131±0.0502.41,5933.5
  HH-18-021,6514.602.087.714.602±0.0881.91,5814.2
  HH-18-031,6515.062.096.355.060±0.1052.11,5714.8
 Hemoglobin
  HH-18-011,6535.64.716.95.57±0.152.71,5913.8
  HH-18-021,65313.26.022.513.18±0.201.61,5824.3
  HH-18-031,65315.85.549.215.80±0.291.81,5844.2
 Hematocrit
  HH-18-011,65017.27.849.917.07±0.855.01,6241.6
  HH-18-021,65041.013.286.940.68±1.904.71,6042.8
  HH-18-031,65048.515.899.247.92±2.525.31,5913.6
 Platelet count
  HH-18-011,65183528,50082.6±5.76.91,5695.0
  HH-18-021,651240772,540239.1±13.25.51,5784.4
  HH-18-031,651496755,720494.2±31.16.31,5625.4
2nd
 WBC count
  HH-18-041,6843.300.0023.003.296±0.1293.91,6412.6
  HH-18-051,6847.551.3022.467.548±0.2763.71,6243.6
  HH-18-061,68422.562.7441.4022.519±0.8904.01,6213.7
 RBC count
  HH-18-041,6842.020.006.082.016±0.0552.71,6531.8
  HH-18-051,6844.523.927.734.519±0.0851.91,6283.3
  HH-18-061,6845.141.997.995.133±0.1042.01,5826.1
 Hemoglobin
  HH-18-041,6865.50.017.15.52±0.152.81,6343.1
  HH-18-051,68613.211.138.813.20±0.181.41,5587.6
  HH-18-061,68615.95.244.915.94±0.241.51,5577.7
 Hematocrit
  HH-18-041,68316.60.078.216.56±0.814.91,6601.4
  HH-18-051,68340.517.785.640.20±1.824.51,6511.9
  HH-18-061,68347.516.093.346.90±2.365.01,6203.7
 Platelet count
  HH-18-041,68481049381.0±5.06.21,6024.9
  HH-18-051,684244164680243.0±13.05.41,6412.6
  HH-18-061,68448021,283476.8±31.06.51,5567.6

Abbreviations: SD, standard deviation; CV, coefficient of variation; 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 쓳떟湲곌쓽 80% 씠긽뿉꽌 씪移섑븯뒗 寃곌낵瑜 湲곗쑝濡 룊媛븯쓣 븣, 1쉶李 HHI-18-01 (Fig. 1A)뒗 segmented neutrophil뿉 97.5%, HHI-18-02 (Fig. 1B)뒗 platelet aggregates뿉 95.8%쓽 씪移섏쑉 蹂댁떎. 2쉶李 HHI-18-03 (Fig. 1C) monocyte뿉 83.0%濡 떎냼 궙 씪移섏쑉쓣 蹂댁쑝硫, HHI-18-04 (Fig. 1D)뒗 Malaria infected RBC뿉 90.6% 씪移섏쑉쓣 蹂댁떎(Table 4).

Figure 1.

Cell morphology pictures posted for the proficiency tests of blood cell morphology. (A) HHI-18-01 segmented neutrophil (arrow). (B) HHI-18-02 platelet aggregates (arrows). (C) HHI-18-03 monocyte (arrows). (D) HHI-18-04 Malaria infected RBC (arrows). Abbreviation: RBC, red blood cell.


Table 4 . Proficiency test results for blood cell morphology.

TrialCodeMorphologyNo. (%)
HHI-18-01Total645 (100.0)
106Segmented neutrophil629 (97.5)
114Hypersegmented neutrophil11 (1.7)
105Band neutrophil3 (0.5)
110Basophil1 (0.2)
471Macrocyte1 (0.2)
HHI-16-02Total645 (100.0)
583Platelet aggregates618 (95.8)
582Platelet satellitism16 (2.5)
579Giant platelet5 (0.8)
576Normal platelet2 (0.3)
332Abnormal plasma cell1 (0.2)
462Basophilic stippling1 (0.2)
700Fungi1 (0.2)
682Mast cell1 (0.2)
HHI-17-03Total629 (100.0)
224Monocyte522 (83.0)
329Atypical lymphocyte70 (11.1)
104Metamyelocyte12 (1.9)
223Immature monocyte10 (1.6)
327Lymphocyte6 (1.0)
105Band neutrophil4 (0.6)
328Large granular lymphocyte3 (0.5)
107Immature eosinophil1 (0.2)
103Myelocyte1 (0.2)
HHI-17-04Total629 (100.0)
465Malaria infected RBC570 (90.6)
327Lymphocyte17 (2.7)
579Giant platelet15 (2.4)
329Atypical lymphocyte8 (1.3)
438Nucleated RBC5 (0.8)
462Basophilic stippling2 (0.3)
328Large granular lymphocyte2 (0.3)
224Monocyte2 (0.3)
449Polychromatic erythrocyte2 (0.3)
110Basophil1 (0.2)
463Cabot ring1 (0.2)
697Chediak-Higashi anomaly inclusion1 (0.2)
689Hairy cell1 (0.2)
573Megakaryocyte1 (0.2)
690Sezary cell1 (0.2)

Abbreviation: RBC, red blood cell..


怨 李

2016뀈 李⑥꽭 떊鍮숇룄議곗궗궗뾽 떆뻾뿉 뵲씪 뿰 2李⑥뿉 嫄몄퀜 留 쉶李⑤쭏떎 CBC뒗 젙룄愿由щЪ吏 3媛, 꽭룷삎깭뒗 궗吏 2媛쒖뵫 떆뻾븯寃 릺뿀쑝硫[1], 2018뀈 李⑥꽭 떊鍮숇룄議곗궗궗뾽 泥닿퀎濡 떆뻾맂 꽭 踰덉㎏ 빐떎. 2018뀈 씪諛섑삁븸寃궗 봽濡쒓렇옩뿉뒗 1, 2쉶李 룊洹 1,713.5湲곌씠 李몄뿬븯뿬 2017뀈쓽 룊洹 1,490湲곌뿉 鍮꾪빐 224湲곌씠 뒛뼱굹 15.0%쓽 利앷瑜 蹂댁떎[4].

寃곌낵 쉶떊쑉 CBC뒗 97.4%濡 2017뀈쓽 96.7%怨 鍮꾧탳븯뿬 떎냼 利앷븯쑝硫, 꽭룷삎깭寃궗쓽 寃곌낵 쉶떊쑉 2017뀈 42.0%쑝굹, 2018뀈 37.2%濡 珥 李몄뿬湲곌씠 利앷븿쑝濡 씤빐 媛먯냼븳 뼇긽쓣 蹂댁떎. 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곌, 2018뀈뿉뒗 637湲곌쑝濡 젏李 利앷븯怨 엳뒗 뼇긽씠떎[1,4,5] (Fig. 2).

Figure 2.

The trends of the numbers of participants who responded in CBC and blood cell morphology from 2016 to 2018. Abbreviation: CBC, complete blood cell count.


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. 2017뀈뿉뒗 1쉶李⑥뿉꽌뒗 7썡 3씪, 2쉶李⑥뿉꽌뒗 8썡 29씪뿉 諛쒖넚릺뼱 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 엳뿀뒗뜲[4], 2018뀈뿉뒗 씠瑜 媛쒖꽑븯湲 쐞빐 1쉶李⑤ 湲곗삩씠 꼫臾 넂吏 븡 떆湲곕줈 醫 뜑 븵떦寃 5썡 3씪뿉 諛곗넚븿쑝濡쒖뜥 寃泥댁쓽 븞젙꽦쓣 넂씠怨좎옄 븯떎.

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쒖쥌 쟾넚쓣 븯뿬빞 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. 3).

Figure 3.

Summary report of 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’[3]쓽 씠긽移 젣嫄곕 쟻슜븯뿬 넻怨꾨텇꽍뿉꽌 젣쇅븯떎. 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 1쉶李⑥뿉꽌뒗 1.6%-5.5%, 2쉶李⑥뿉꽌뒗 2.4%-5.6%떎(Table 3).

CBC뿉 궗슜맂 湲곌린쓽 쁽솴 Sysmex媛 42.1%濡 媛옣 留롮븯怨, 떎쓬쑝濡, Nihon Kohden Corp., Shenzhen Mindray Bio-Medical Electronics Co. Ltd., Siemens Healthcare Diagnostics Inc., Horiba Medical, Beckman Coulter Inc. 벑씠 遺꾪룷븯뿬 二쇱슂 궗슜湲곌린쓽 遺꾪룷뒗 삁뀈怨 쑀궗븯떎[1,4].

닔뻾뒫 痢〓㈃뿉꽌 CBC쓽 諛깊삁援 닔, 쟻삁援 닔, 삁깋냼, 쟻삁援ъ슜쟻瑜, 삁냼뙋 닔쓽 CV뒗 媛곴컖 3.5%-4.1%, 1.9%-2.7%, 1.4%-2.8%, 4.5%-5.3%, 5.4%-6.9% 踰붿쐞濡, 삁냼뙋 닔쓽 CV뒗 2016뀈 씠썑 吏냽쟻쑝濡 媛먯냼瑜 蹂댁씠怨 엳쑝硫, 떎瑜 寃궗빆紐⑹ 삁뀈怨 鍮꾩듂븳 遺꾪룷떎[1,4] (Fig. 4). 꽭룷삎깭뒗 2쉶李⑥쓽 HHI-18-03쓽 寃쎌슦 monocyte뿉 빐 83.0%濡 떎냼 궙 씪移섏쑉쓣 蹂댁뿬 monocyte쓽 媛먮퀎씠 떎냼 뼱젮쓣 븣 닔 엳뿀쑝硫, 洹 쇅 紐⑤뱺 쉶李⑥뿉꽌 李몄뿬湲곌 媛꾩뿉 90% 씠긽쓽 씪移섏쑉쓣 蹂댁떎.

Figure 4.

The trends of the CVs of CBC parameters from 2016 to 2018. (A) WBC. (B) RBC. (C) Hgb. (D) Hct. (E) Platelet count. Abbreviations: L, low level; M, middle level; H, high level; CV, coefficient of variation; CBC, complete blood cell count; WBC, white blood cell count; RBC, red blood cell count; Hgb, hemoglobin; Hct, hematocrit.


2018뀈 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 吏냽쟻쑝濡 利앷븯뒗 異붿꽭씠怨, 닔뻾뒫 痢〓㈃뿉꽌 삁냼뙋 닔뒗 吏냽쟻쑝濡 CV媛 媛먯냼븯뒗 뼇긽쓣 蹂댁씠硫, 洹 쇅 떎瑜 寃궗빆紐⑹쓽 닔뻾뒫 삁뀈怨 鍮꾩듂븳 寃곌낵瑜 蹂댁떎.

References
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