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Comparison of YD URiSCAN PluScope Urine Microscopic Analyzer and Sysmex UF-1000i Flow Cytometry Systems
J Lab Med Qual Assur 2018;40:223-229
Published online December 31, 2018
© 2018 Korean Association of External Quality Assessment Service.

Jae Won Jung, Ae-Chin Oh, Yoon Hwan Chang, Jin Kyung Lee, Young Jun Hong

Department of Laboratory Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Korea
Correspondence to: Young Jun Hong Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, 75 Nowon-ro, Nowon-gu, Seoul 01812, Korea Tel: +82-2-970-2492 Fax: +82-2-973-7143 E-mail: clinchem@kirams.re.kr
Received September 24, 2018; Revised October 19, 2018; Accepted October 24, 2018.
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

Background:

Urinalysis is one of the most commonly performed tests in clinical laboratories. In this study, we compared YD URiSCAN PluScope (PluScope; YD Diagnostics Corp., Korea) and Sysmex UF-1000i (UF-1000i; Sysmex Corp., Japan) for urine microscopic sediment analysis.

Methods:

A total of 404 fresh urine samples were collected and analyzed using PluScope, UF-1000i, and manual microscopy. Quantitative correlation analyses for red blood cells (RBCs), white blood cells (WBCs), epithelial cells (EC), and casts were performed using Spearman's correlation. We evaluated agreement among the three systems by using weighted Cohen's 觀 and calculating concordance rates within one grade of difference for semiquantitative and qualitative parameters.

Results:

There were moderate-high correlations between PluScope and UF-1000i for RBCs, WBCs, and ECs (r=0.542, 0.714, and 0.571, respectively) but negligible correlation for casts (r=0.186). There were moderate-high correlations between manual microscopy and automated devices for RBCs, WBCs, and ECs (r=0.5500.745) but negligible correlations for casts (PluScope:r=0.247; UF-1000i: r=0.223). The pairwise concordance rates within one grade difference among the three methods were good for RBCs, WBCs, and ECs (95.0%99.0%, 觀=0.410.74). For casts, the concordance rate between PluScope and manual microscopy was fair (96.8%, 觀=0.25), but concordance rates between UF-1000i and manual microscopy and between the two automated devices were poor (81.2% and 81.7%; 觀=0.04 and 0.06, respectively).

Conclusions:

The two automated urine sediment analyzers showed a moderate-high correlation and concordance rate. They showed good correlations and concordance rates for RBCs, WBCs, and ECs. However, manual microscopic examinations are still needed for reviewing and confirming the presence of pathologic particles in urine, such as casts and crystals.

Keywords : Automated urine sediment analyzer, Urinalysis, Urine sediment, URiSCAN PluScope, UF-1000i
꽌 濡

슂寃궗뒗 엫긽쁺뿭뿉꽌 쓷븯寃 떆뻾븯뒗 寃궗濡, 寃泥댁쓽 梨꾩쭛씠 슜씠븯怨 鍮꾩묠뒿쟻씤 寃궗硫, 떊옣, 슂濡쒓퀎 吏덊솚뿉꽌遺꽣 궡遺꾨퉬 諛 궗꽦 吏덊솚 벑쓽 쟾떊꽦 吏덊솚뿉 씠瑜닿린源뚯 떎뼇븳 吏덊솚뿉 븳 젙蹂대 뼸쓣 닔 엳뒗 옣젏씠 엳떎[1].

슂寃궗 以 닔湲곕쾿쓣 씠슜븯뒗 슂移⑥궗寃궗뒗 끂룞吏묒빟쟻씠硫 떆媛꾩씠 留롮씠 냼슂릺怨, 寃궗옄쓽 쟾臾몄쟻씤 뙋룆뒫젰씠 븘슂븯떎. 삉븳 寃泥 以鍮꾧낵젙쓽 李⑥씠뿉 뵲씪 寃궗寃곌낵媛 떖씪吏 닔 엳쑝硫, 寃궗옄 媛 닕젴룄뿉 뵲씪꽌룄 뙋룆뿉 李⑥씠媛 엳쓣 닔 엳떎[2-5]. 씠윭븳 닔湲곕쾿쓽 떒젏쓣 洹밸났븯湲 쐞빐 옄룞 슂移⑥궗 옣鍮꾩쓽 븘슂꽦씠 몢릺뼱 솕쑝硫, 쁽옱 뿬윭 옣鍮꾨뱾씠 떎닔쓽 寃궗떎뿉 룄엯릺뼱 궗슜 以묒씠떎.

옄룞 슂移⑥궗 옣鍮꾩쓽 寃궗諛⑸쾿 겕寃 쑀꽭룷遺꾩꽍(flow cytometry)쓣 씠슜븳 諛⑸쾿怨 뵒吏꽭 씠誘몄瑜 珥ъ쁺븯뿬 遺꾩꽍븯뒗 諛⑸쾿쑝濡 굹닃 닔 엳쑝硫, 吏湲덇퉴吏 뿬윭 옣鍮꾨뱾뿉 븳 寃궗닔뻾뒫 諛 옣鍮 媛 긽愿꽦씠 蹂닿퀬릺怨 엳떎[6-14]. YD URiSCAN PluScope (PluScope; YD Diagnostics Corp., Yongin, Korea)뒗 援궛 옣鍮꾨줈뒗 理쒖큹濡 媛쒕컻맂 씠誘몄 湲곕컲 옄룞 슂移⑥궗 옣鍮꾨줈꽌 쁽옱源뚯 PluScope뿉 븳 옣鍮꾪룊媛뒗 嫄곗쓽 뾾뿀떎. 蹂 뿰援ъ뿉꽌뒗 솚옄쓽 냼蹂 寃泥대 긽쑝濡 씠誘몄 珥ъ쁺 諛 遺꾩꽍湲곗닠쓣 씠슜븯뒗 PluScope 쑀꽭룷遺꾩꽍 湲곗닠쓣 씠슜븯뒗 Sysmex UF-1000i (UF-1000i; Sysmex Corp., Kobe, Japan)쓽 寃궗닔뻾뒫쓣 鍮꾧탳븯怨, 媛곴컖 닔湲곕쾿怨쇱쓽 긽愿꽦뿉 빐꽌룄 遺꾩꽍븯떎.

옱猷 諛 諛⑸쾿

1. 긽 寃泥

썝옄젰蹂묒썝 吏꾨떒寃궗쓽븰怨쇱뿉 寃궗媛 쓽猶곕맂 寃泥 以 옍뿬 냼蹂 寃泥 404媛쒕 臾댁옉쐞濡 꽑젙븯떎. 뿰援щ긽 寃泥대뒗 梨꾩랬 썑 1떆媛 씠궡쓽 떊꽑븳 寃泥댁씠硫, 옍뿬 寃泥댁쓽 뼇씠 룊媛瑜 닔뻾븯뒗 뜲 븘슂븳 20 mL 씠긽 궓븘엳뒗 寃껊뱾쓣 湲곗쑝濡 븯떎. 蹂 뿰援щ뒗 븳援썝옄젰쓽븰썝 엫긽뿰援ъ떖쓽쐞썝쉶쓽 떖쓽瑜 넻怨쇳븯떎(IRB approval no., 2018-08-010-002).

2. 寃궗諛⑸쾿

1) YD URiSCAN PluScope

PluScope 옣鍮꾨뒗 썝떖遺꾨━븯吏 븡 냼蹂 寃泥 2.5 mL瑜 씠슜븯뿬 4媛쒖쓽 counting chamber system뿉 寃泥대 二쇱엯븯뿬 鍮좊Ⅸ 떆媛 븞뿉 슚쑉쟻쑝濡 뵒吏꽭 씠誘몄瑜 珥ъ쁺븿쑝濡쒖뜥 슂移⑥궗쓽 怨꾩닔 諛 삎깭븰쟻 遺꾩꽍쓣 떆뻾븯뒗 옄룞솕 옣鍮꾨떎. 쟻삁援(red blood cell), 諛깊삁援(white blood cell), 諛깊삁援 쓳愿(WBC clumping), 긽뵾꽭룷(epithelial cell), 珥덉옄썝二(hyaline cast), 寃곗젙(crystal), 吏꾧퇏(fungus), 誘몃텇瑜(unclassified), 냼썝삎꽭룷(small round cell)쓽 9媛 遺꾩꽍긽뿉 빐 젙웾쟻쑝濡 痢≪젙븯쑝硫, 諛뺥뀒由ъ븘(bacteria) 젏븸吏(mucus)뿉 빐꽌뒗 諛섏젙웾쟻쑝濡 寃곌낵瑜 痢≪젙븯떎.

2) Sysmex UF-1000i

UF-1000i 옣鍮꾨뒗 쑀꽭룷遺꾩꽍 湲곗닠쓣 湲곕컲쑝濡 븯硫, 몢 媛吏쓽 삎愿묒뿼깋怨 635 nm쓽 諛섎룄泥 젅씠瑜 씠슜븯뿬 寃泥대 遺꾩꽍븳떎. 썝떖遺꾨━븯吏 븡 寃泥 4 mL瑜 궗슜븯硫, 슂移⑥궗쓽 援ъ꽦꽦遺꾩뿉 뵲씪 쟾諛섏궛愿, 痢〓갑궛愿, 痢〓갑궛삎愿묒씠 떎瑜닿쾶 痢≪젙맂 젙蹂대 諛뷀깢쑝濡 媛 寃궗빆紐⑸퀎 寃곌낵瑜 뼸쓣 닔 엳떎. 쟻삁援, 諛깊삁援, 긽뵾꽭룷, 썝二, 諛뺥뀒由ъ븘쓽 5媛 遺꾩꽍긽뿉 빐 젙웾쟻쑝濡 痢≪젙븯쑝硫, flag濡 솗씤릺뒗 寃곗젙, 吏꾧퇏, 蹂묒쟻 썝二(pathologic cast), 젏븸吏, 젙옄(spermatozoa), 냼썝삎꽭룷뿉 빐꽌뒗 count/關L濡 寃곌낵瑜 湲곕줉븯떎.

3) 닔湲곕쾿

닔湲 슂移⑥궗寃궗뒗 Clinical and Laboratory Standards Institute (CLSI)뿉꽌 젣떆븳 吏移⑥뿉 뵲씪 떆뻾븯떎[15,16]. 쁽誘멸꼍 怨꾩닔뒗 몴以솕맂 KOVA cell chamber system쓣 씠슜븯떎. 12 mL쓽 냼蹂 寃泥대 1,500 rpm뿉꽌(횞400 g) 5遺꾧컙 썝떖遺꾨━븯뿬 긽痢듭븸 踰꾨━怨 1 mL瑜 궓寃 옱遺쑀븳 썑 6.6 關L瑜 slide뿉 뼥뼱쑉由ш퀬 뿼깋븯吏 븡 긽깭뿉꽌 쁽誘멸꼍쑝濡 愿李고븯떎. 쁽誘멸꼍 寃쎄 怨좊같쑉(400諛)뿉꽌 10떆빞 씠긽 愿李고븯뿬 諛깊삁援, 쟻삁援, 긽뵾꽭룷쓽 媛쒖닔瑜 怨꾩닔븯怨 媛곴컖쓽 룊洹좎튂瑜 count/high-power field (HPF)濡 湲곕줉븯怨, 諛곗쑉(100諛)뿉꽌 10떆빞 씠긽 愿李고븯뿬 諛뺥뀒由ъ븘, 吏꾧퇏, 寃곗젙, 썝二, 젏븸吏덉뿉 븳 媛곴컖쓽 룊洹좎튂瑜 count/low-power field (LPF)濡 湲곕줉븯떎.

3. 룊媛諛⑸쾿

1) 젙諛룄 諛 carryover 룊媛

젙諛룄瑜 룊媛븯湲 쐞빐 2媛吏 냽룄쓽 pooled urine 寃泥댁뿉 빐 PluScope UF-1000i뿉꽌 븯猷, 5쉶 諛섎났 痢≪젙븯뿬 媛곴컖 蹂씠怨꾩닔瑜 援ы븯떎. Carryover 룊媛瑜 쐞빐 怨좊냽룄 寃泥 4媛(H1, H2, H3, H4) 냽룄 寃泥 4媛(L1, L2, L3, L4)瑜 PluScope UF-1000i 媛 옣鍮꾨퀎濡 뿰냽 痢≪젙븳 寃곌낵濡 떎쓬쓽 떇쓣 씠슜븯뿬 怨꾩궛븯떎: carryover %={L1(L3+L4)/2}/{(H2+H3)/2-(L3+L4)/2}횞100.

2) 떒쐞쓽 넻씪

몢 옄룞솕 옣鍮꾨 넻빐 닔吏묐맂 寃궗寃곌낵뱾쓽 떒쐞(count/關L)瑜 닔湲곕쾿怨쇱쓽 鍮꾧탳瑜 쐞빐 醫낅ぉ蹂꾨줈 넻씪븯떎. 쟻삁援, 諛깊삁援, 긽뵾꽭룷뒗 count/HPF濡, 썝二, 諛뺥뀒由ъ븘, 吏꾧퇏, 寃곗젙, 젏븸吏덉뿉 빐꽌뒗 count/LPF濡 떒쐞瑜 蹂솚븯떎. 떒쐞 媛 蹂솚뿉 궗슜맂 怨듭떇 떎쓬怨 媛숇떎: count횞106/L=(10떆빞 怨꾩닔븳 꽭룷쓽 珥앺빀)횞(썝떖遺꾨━ 썑 궓 遺뵾, 1 mL)/(愿李고븳 10媛 떆빞쓽 遺뵾, 0.1111 關L)횞(寃泥댁쓽 遺뵾, 12 mL) [17].

3) 젙웾쟻 긽愿꽦 鍮꾧탳

PluScope UF-1000i 옣鍮 媛, 洹몃━怨 옄룞솕 옣鍮꾩 닔湲곕쾿 媛꾩쓽 젙웾쟻 鍮꾧탳瑜 쐞븳 寃궗醫낅ぉ쑝濡 쟻삁援, 諛깊삁援, 긽뵾꽭룷, 썝二쇰 꽑젙븯떎. 珥 404媛쒖쓽 옍뿬 냼蹂 寃泥대 긽쑝濡 遺꾩꽍븯떎. 넻怨꾪봽濡쒓렇옩쑝濡 IBM SPSS ver. 23.0 (IBM Corp., Armonk, NY, USA) 냼봽듃썾뼱瑜 궗슜븯怨, 뜲씠꽣쓽 젙洹쒖꽦 寃젙쓣 쐞빐 Kolmogorov-Smirnov test瑜 떆뻾븳 寃곌낵 紐⑤뱺 遺꾩꽍뜲씠꽣뒗 젙洹쒕텇룷瑜 씠猷⑥ 븡븯떎. 鍮꾨え닔쟻 뜲씠꽣뿉 븳 긽愿꽦 遺꾩꽍쓣 쐞빐 Spearman's correlation 遺꾩꽍쓣 궗슜븯쑝硫, 긽愿怨꾩닔(correlation coefficient, r) 媛믪씠 0.9 씠긽씠硫 留ㅼ슦 넂(very high) 긽愿꽦쓣, 0.7-0.9씪 寃쎌슦 넂(high) 긽愿꽦쓣, 0.5-0.7씪 寃쎌슦 以묐벑룄(moderate)쓽 긽愿꽦, 0.3-0.5쓽 寃쎌슦 궙(low) 긽愿꽦, 0.0-0.3쓣 留ㅼ슦 궙(臾댁떆븷 닔以, negligible) 긽愿꽦쓣 蹂댁씠뒗 寃껋쑝濡 뙋젙븯떎[18]. 넻怨꾨텇꽍寃곌낵뒗 P媛믪씠 0.05 誘몃쭔씪 븣 쑀쓽븳 寃껋쑝濡 媛꾩<븯떎.

4) 諛섏젙웾쟻 삉뒗 젙꽦쟻 씪移섎룄 鍮꾧탳

PluScope UF-1000i 옣鍮 媛, 洹몃━怨 옄룞솕 옣鍮꾩 닔湲곕쾿 媛 꽌濡 鍮꾧탳 媛뒫븳 8媛쒖쓽 寃궗醫낅ぉ뿉 븳 遺꾩꽍寃곌낵瑜 諛섏젙웾쟻 삉뒗 젙꽦쟻쑝濡 遺꾨쪟븯뿬 Table 1怨 媛숈씠 벑湲(grade)쓣 굹늻뿀떎. 븯굹쓽 옣鍮꾩뿉꽌留 痢≪젙릺뒗 寃궗빆紐⑹ 遺꾩꽍뿉꽌 젣쇅릺뿀떎. 넻怨꾪븰쟻 鍮꾧탳諛⑸쾿쑝濡 weighted Cohen's kappa 遺꾩꽍쓣 씠슜븯뿬 珥 404媛쒖쓽 옍뿬 냼蹂 寃泥댁뿉 빐 kappa 怨꾩닔(觀) 씪移섎룄(concordance rate)瑜 怨꾩궛븯쑝硫, 쟻삁援ъ 諛깊삁援, 긽뵾꽭룷, 썝二, 諛뺥뀒由ъ븘뿉 빐꽌뒗 1벑湲 李⑥씠 궡쓽 씪移섎룄瑜 援ы븯떎. 씪移섏쓽 젙룄뒗 觀媛믪씠 0.81-1.00씪 븣 留ㅼ슦 醫뗭(very good) 씪移, 0.61-0.80씪 븣 醫뗭(good) 씪移, 0.41-0.60씪 븣 以묐벑룄(moderate)쓽 씪移, 0.21-0.40씪 븣 빟媛꾩쓽(fair) 씪移, 0.20 誘몃쭔씪 븣 醫뗭 븡(poor) 씪移섎 蹂댁씠뒗 寃껋쑝濡 빐꽍븯怨[19], P媛믪씠 0.05 誘몃쭔쓽 寃쎌슦 쑀쓽븳 寃껋쑝濡 媛꾩<븯떎.

Table 1 . Semi-quantitative and qualitative range classification of urine sediment results of three different examination methods.

꺿꺿긘ariableGrade

123456
Red blood cell (counts/HPF)<1145910293099돟100
White blood cell (counts/HPF)<1145910293099돟100
Epithelial cell (counts/HPF)<1145910293099돟100
Casts (counts/LPF)<112356101120돟20
BacteriaRareA fewSomeMany
Fungus()(+)
Crystal()(+)
Mucus()(+)

Abbreviations: HPF, high-power field; LPF, low-power field..


寃 怨

1. 젙諛룄 諛 carryover 룊媛

젙諛룄 룊媛寃곌낵 PluScope쓽 쟻삁援ъ뿉 븳 寃궗 궡 蹂씠怨꾩닔뒗 쟻삁援ъ뿉꽌 2.8%, 2.3% (媛곴컖 怨좊냽룄, 냽룄)怨, 諛깊삁援ъ뿉 빐 7.0%, 2.8%떎. UF-1000i쓽 쟻삁援ъ뿉 븳 寃궗 궡 蹂씠怨꾩닔뒗 2.8%, 1.5%怨, 諛깊삁援ъ뿉 빐 1.4%, 3.3%떎(Table 2). Carryover 룊媛寃곌낵 PluScope쓽 carryover뒗 쟻삁援ъ 諛깊삁援 紐⑤몢뿉꽌 0.0%怨, UF-1000i쓽 carryover뒗 쟻삁援ъ 諛깊삁援ъ뿉 빐 媛곴컖 0.1% 0.2%떎.

Table 2 . Within-run imprecision of two automated urine sediment analyzers (N=404).

꺿긘ariableLevel 1 (low)Level 2 (high)


Mean짹SD (counts/關L)CV (%)Mean짹SD (counts/關L)CV (%)
URiSCAN PluScope
긓BC276.00짹6.282.3377.20짹10.552.8
긙BC40.40짹1.142.8659.60짹46.107.0
UF-1000i
긓BC493.52짹7.241.5622.42짹17.142.8
긙BC56.14짹1.883.31074.00짹15.441.4

Abbreviations: SD, standard deviation; CV, coefficient of variation; RBC, red blood cell; WBC, white blood cell..


2. 긽愿꽦 遺꾩꽍

Spearman correlation쓣 씠슜븯뿬 遺꾩꽍븳 긽愿꽦 寃곌낵뒗 Table 3 媛숇떎. PluScope UF-1000i 몢 옣鍮 媛 긽愿꽦 遺꾩꽍寃곌낵 諛깊삁援ъ뿉 빐꽌뒗 r媛믪씠 0.714濡 넂 긽愿愿怨꾨, 쟻삁援ъ 긽뵾꽭룷뿉 빐꽌뒗 媛곴컖 r媛믪씠 0.542 0.571濡 以묐벑룄쓽 긽愿愿怨꾨 蹂댁쑝硫, 썝二쇱뿉 빐꽌뒗 r媛믪 0.186쑝濡 留ㅼ슦 궙 긽愿愿怨꾨 蹂댁떎.

Table 3 . Spearman correlation analysis of pairwise results among URiSCAN PluScope, UF-1000i, and manual microscopy (N=404).

꺿꺿긘ariableURiSCAN PluScope vs. UF-1000iURiSCAN PluScope vs. manual microscopyUF-1000i vs. manual microscopy



rP-valuerP-valuerP-value
Red blood cell0.542<0.0010.586<0.0010.644<0.001
White blood cell0.714<0.0010.599<0.0010.745<0.001
Epithelial cell0.571<0.0010.585<0.0010.550<0.001
Casts0.186<0.0010.247<0.0010.223<0.001

Abbreviation: r, Spearman correlation of coefficient..


닔湲곕쾿怨 媛 옄룞솕 옣鍮 媛 긽愿꽦 遺꾩꽍寃곌낵 쟻삁援ъ뿉 빐꽌뒗 PluScope UF-1000i쓽 r媛믪 媛곴컖 0.586怨 0.644濡 以묐벑룄쓽 긽愿愿怨꾨 蹂댁怨, 諛깊삁援ъ뿉 빐꽌뒗 PluScope뿉꽌 以묐벑룄(r=0.599)쓽 긽愿愿怨, UF-1000i뿉꽌뒗 넂(r=0.745) 긽愿愿怨꾨 蹂댁떎. 긽뵾꽭룷뿉꽌 PluScope UF-1000i쓽 r媛믪 媛곴컖 0.585 0.550쑝濡 以묐벑룄쓽 긽愿愿怨꾨 蹂댁쑝硫, 썝二쇱뿉 븳 PluScope UF-1000i쓽 r媛믪 媛곴컖 r=0.247 0.223쑝濡 留ㅼ슦 궙 긽愿愿怨꾨 蹂댁떎.

3. 遺꾩꽍醫낅ぉ蹂 씪移섎룄 鍮꾧탳

몢 옣鍮 媛, 洹몃━怨 옣鍮꾩 닔湲곕쾿 媛꾩쓽 씪移섎룄 遺꾩꽍怨 weighted Cohen셲 kappa 遺꾩꽍寃곌낵뒗 Table 4 媛숇떎. 쟻삁援ъ뿉 븳 씪移섎룄 遺꾩꽍寃곌낵 PluScope 옣鍮꾩 닔湲곕쾿 媛꾩쓽 1벑湲 궡 씪移섎룄뒗 98.5% (398/404)怨(觀=0.65), 6媛쒖쓽 寃泥댁뿉꽌 2벑湲 씠긽쓽 遺덉씪移섎 蹂댁떎. UF-1000i 옣鍮꾩 닔湲곕쾿 媛꾩쓽 1벑湲 궡 씪移섎룄뒗 96.3% (389/404)쑝硫(觀=0.50), 15媛쒖쓽 寃泥댁뿉꽌 닔湲곕쾿뿉 鍮꾪븯뿬 2벑湲 씠긽 넂寃 痢≪젙릺뿀떎. PluScope UF-1000i 몢 옣鍮 媛 1벑湲 궡 씪移섎룄뒗 95.0% (384/404)怨(觀=0.51), 2벑湲 씠긽 李⑥씠瑜 蹂댁씤 20媛쒖쓽 寃泥 以 16媛쒖뿉꽌 UF-1000i쓽 寃궗寃곌낵媛 PluScope쓽 寃곌낵蹂대떎 넂寃 痢≪젙릺뿀떎.

Table 4 . Pairwise concordance rates within one grade difference and kappa coefficients (觀) for comparison among the three methods (N=404).

꺿꺿긘ariableConcordance rates within one grade difference % (觀)

Red blood cellWhite blood cellEpithelial cellCastsBacteriaYeastCrystalMucus
URiSCAN PluScope vs. UF-1000i95.0 (0.51)95.5 (0.64)98.8 (0.41)81.7 (0.06)95.0 (0.44)98.0 (NS)98.5 (0.56)66.1 (0.03)
URiSCAN PluScope vs. manual microscopy98.5 (0.65)97.0 (0.69)99.0 (0.50)96.8 (0.25)96.5 (0.51)99.5 (NS)97.3 (0.41)79.7 (0.56)
UF-1000i vs. manual microscopy96.3 (0.50)98.0 (0.74)99.0 (0.47)81.2 (0.04)96.8 (0.56)98.5 (NS)97.8 (0.39)61.1 (NS)

Abbreviations: 觀, kappa coefficient; NS, not significant..

P>0.05..


諛깊삁援ъ뿉 븳 씪移섎룄 遺꾩꽍寃곌낵 PluScope 옣鍮꾩 닔湲곕쾿 媛 씪移섎룄뒗 97.0% (392/404)쑝硫(觀=0.69), 2벑湲 씠긽 李⑥씠瑜 蹂댁씤 12媛쒖쓽 寃泥 以 10媛쒖뿉꽌 닔湲곕쾿 寃곌낵媛 PluScope쓽 寃궗寃곌낵蹂대떎 넂寃 痢≪젙릺뿀떎. UF-1000i 닔湲곕쾿 媛 씪移섎룄뒗 98.0% (396/404)怨(觀=0.74), 2벑湲 씠긽 李⑥씠瑜 蹂댁씤 8媛쒖쓽 寃泥 以 7媛쒖뿉꽌 닔湲곕쾿蹂대떎 넂寃 痢≪젙릺뿀떎. 몢 옄룞솕 옣鍮 媛 씪移섎룄뒗 95.5%怨(觀=0.64), UF-1000i쓽 寃궗寃곌낵媛 PluScope蹂대떎 넂寃 痢≪젙릺뒗 寃쏀뼢씠 愿李곕릺뿀떎.

긽뵾꽭룷뿉 븳 씪移섎룄 遺꾩꽍寃곌낵 PluScope 닔湲곕쾿 媛, UF-1000i 닔湲곕쾿 媛 諛 PluScope UF-1000i 媛꾩쓽 씪移섎룄뒗 媛곴컖 99.0% (400/404), 99.0% (400/404), 98.8% (399/404)쑝굹(媛곴컖 觀=0.50, 0.47, 0.41), 遺遺꾩쓽 寃泥 寃곌낵뱾씠 10-29/HPF 誘몃쭔쑝濡 grade 1, 2, 3 궡쓽 렪뼢쟻씤 遺꾪룷瑜 蹂댁씠怨 엳뿀떎.

썝二쇱뿉 븳 씪移섎룄 遺꾩꽍寃곌낵 PluScope 닔湲곕쾿 媛 씪移섎룄媛 96.8% (391/404)쑝硫(觀=0.25), 2벑湲 씠긽 李⑥씠瑜 蹂댁씤 13媛쒖쓽 寃泥댁뿉꽌 PluScope쓽 寃궗寃곌낵媛 닔湲곕쾿蹂대떎 궙寃 痢≪젙릺뿀떎. UF-1000i 닔湲곕쾿 媛 씪移섎룄뒗 81.2% (328/404)怨(觀=0.04), 2벑湲 씠긽쓽 李⑥씠瑜 蹂댁씤 76媛쒖쓽 寃泥 以 71媛쒖뿉꽌 UF-1000i쓽 寃궗寃곌낵媛 닔湲곕쾿蹂대떎 넂寃 痢≪젙릺뿀떎. 몢 옄룞솕 옣鍮 媛 씪移섎룄뒗 81.7% (330/404)쑝硫(觀=0.06), UF-1000i쓽 寃궗寃곌낵媛 PluScope뿉 鍮꾪빐 넂寃 痢≪젙릺뿀떎.

諛뺥뀒由ъ븘뿉 븳 씪移섎룄 遺꾩꽍寃곌낵 옣鍮 媛 씪移섎룄뒗 95.0% (384/404)怨(觀=0.44), 옣鍮꾩 닔湲곕쾿 媛 씪移섎룄뒗 PluScope UF-1000i 媛곴컖 96.5% (390/404) 96.8% (391/404)떎(媛곴컖 觀=0.51, 0.56). 吏꾧퇏뿉 븳 씪移섎룄 遺꾩꽍뿉꽌쓽 옣鍮 媛 씪移섎룄뒗 98.0% (396/404), 옣鍮꾩 닔湲곕쾿 媛 씪移섎룄뒗 PluScope UF-1000i 媛곴컖 99.5% (402/404), 98.5% (398/404)쑝굹, kappa 遺꾩꽍뿉꽌뒗 觀媛믪 紐⑤몢 0쑝濡 굹궗怨 넻怨꾩쟻쑝濡쒕룄 쑀쓽븯吏 븡븯떎(P>0.05).

寃곗젙뿉 븳 씪移섎룄 遺꾩꽍뿉꽌쓽 옣鍮 媛 씪移섎룄뒗 98.5% (398/404)怨(觀=0.56), 옣鍮꾩 닔湲곕쾿 媛 씪移섎룄뒗 PluScope UF-1000i 媛곴컖 97.3% (393/404), 97.8% (395/404)떎(媛곴컖 觀=0.41, 0.39). 젏븸吏덉뿉 븳 씪移섎룄 遺꾩꽍寃곌낵 옣鍮 媛 씪移섎룄뒗 66.1% (267/404)怨(觀=0.03), 옣鍮꾩 닔湲곕쾿 媛 씪移섎룄뒗 PluScope 닔湲곕쾿 媛 씪移섎룄뒗 79.7% (322/404)쑝硫(觀=0.56), UF-1000i 닔湲곕쾿 媛 씪移섎룄뒗 61.1% (247/404)떎(觀=0.01, P>0.05濡 넻怨꾩쟻쑝濡 쑀쓽븯吏 븡쓬).

怨 李

닔湲 슂移⑥궗寃궗뒗 寃궗떎뿉 뵲씪 理쒖큹 寃泥대웾, 썝떖遺꾨━쓽 젙룄, 寃泥 냽異 젙룄, 뒳씪씠뱶뿉 뼥뼱쑉由щ뒗 寃泥대웾, 愿李 諛 湲곕줉諛⑸쾿 벑뿉 뵲씪 寃궗寃곌낵媛 떖씪吏 닔 엳떎. 슂移⑥궗 닔湲곕쾿뿉 븳 援젣쟻씤 媛씠뱶씪씤룄 뿬윭 媛쒓 議댁옱븯뿬 寃궗諛⑸쾿뿉 李⑥씠媛 엳怨[15,16,20,21], 뿬윭 寃궗떎留덈떎 怨좎쑀쓽 봽濡쒗넗肄쒖뿉 뵲씪 슂移⑥궗寃궗瑜 吏꾪뻾븯뿬 諛⑸쾿怨 빐꽍뿉 李⑥씠媛 엳쓣 닔 엳湲 븣臾몄뿉 몴以솕맂 쇅遺젙룄愿由ъ뿉 뼱젮씠 엳떎[2-5]. 씠윭븳 寃궗諛⑸쾿쓽 떎뼇꽦쓣 以꾩씠怨, 寃궗냼슂떆媛꾧낵 踰덇굅濡쒖슫 닔옉뾽쓣 以꾩뿬 슚쑉쟻씤 寃궗닔뻾쓣 븷 닔 엳뒗 옣젏씠 엳뼱 옄룞 슂移⑥궗 옣鍮꾧 젏젏 留롮 엫긽寃궗떎뿉 룄엯릺怨 엳떎.

蹂 뿰援ъ뿉꽌뒗 理쒖큹쓽 援궛 씠誘몄 湲곕컲 옣鍮꾩씤 PluScope 쑀꽭룷遺꾩꽍 湲곕컲쓽 UF-1000i 옣鍮꾩뿉 븯뿬 젙諛룄 carryover, 옣鍮 媛 諛 닔湲곕쾿怨쇱쓽 긽愿꽦怨 씪移섎룄뿉 빐 遺꾩꽍븯떎. 쟻삁援, 諛깊삁援, 긽뵾꽭룷뿉 븳 긽愿꽦 遺꾩꽍뿉꽌뒗 PluScope UF-1000i 媛, 洹몃━怨 옄룞솕 옣鍮꾩 닔湲곕쾿 媛꾩뿉 紐⑤몢 以묐벑룄 씠긽쓽 긽愿꽦쓣 蹂댁吏留 UF-1000i뿉꽌 쟻삁援, 諛깊삁援ш PluScope뿉 鍮꾪빐 떎냼 넂寃 痢≪젙릺뒗 寃쏀뼢쓣 蹂댁떎. 씠뿉 븳 썝씤 紐낇솗븯吏 븡吏留, 븘留덈룄 寃궗諛⑸쾿 媛 痢≪젙썝由ъ쓽 李⑥씠 븣臾몄뿉 諛쒖깮븳 寃껋쑝濡 깮媛곷맂떎. PluScope 닔湲곕쾿寃궗뒗 怨듯넻쟻쑝濡 쁽誘멸꼍쟻 삎깭(morphology)瑜 諛뷀깢쑝濡 슂移⑥궗瑜 遺꾨쪟븯뒗 諛섎㈃, UF-1000i쓽 寃쎌슦 쑀꽭룷遺꾩꽍쓣 씠슜븯뿬 슂移⑥궗 엯옄瑜 遺꾨쪟븯硫, 쓷븯吏뒗 븡吏留 쑀궗븳 겕湲곗 꽭룷蹂듭옟룄瑜 媛吏 엯옄瑜 쟻삁援 삉뒗 諛깊삁援щ줈 옒紐 씤떇븷 닔 엳湲 븣臾몄씠떎. Chien 벑[6]쓽 쑀꽭룷遺꾩꽍 옣鍮 UF-100怨 씠誘몄遺꾩꽍 옣鍮 iQ-200쓽 鍮꾧탳뿰援ъ뿉꽌뒗 UF-100쓽 쟻삁援 諛 諛깊삁援 痢≪젙寃곌낵媛 iQ-200뿉 鍮꾪빐 議곌툑 넂븯怨, Lee 벑[10]쓽 뿰援ъ뿉꽌 쑀꽭룷遺꾩꽍 옣鍮 UF-1000i 씠誘몄遺꾩꽍 옣鍮 cobas u 701瑜 鍮꾧탳븳 寃곌낵 쟻삁援 諛 諛깊삁援 痢≪젙뿉꽌 UF-1000i媛 cobas u 701蹂대떎 빟媛 넂 寃쏀뼢쓣 蹂댁쑝굹 洹 씠쑀뒗 紐낇솗븯吏 븡븯떎.

썝二쇱뿉꽌뒗 紐⑤몢 궙 긽愿꽦쓣 蹂댁怨 씪移섎룄 鍮꾧탳뿉꽌룄 썝二쇱뿉꽌 궙 씪移섎 蹂댁떎. 썝二쇱뿉꽌 愿李곕릺뒗 궙 긽愿꽦, 굹걶 씪移섎룄쓽 썝씤쑝濡 癒쇱 옣鍮 媛 썝二 痢≪젙쓽 썝由ъ 怨꾩닔諛⑸쾿쓽 李⑥씠뿉 쓽븳 寃껋쓣 깮媛곹빐 蹂 닔 엳떎. UF-1000i뒗 썝二쇱뿉 빐꽌뒗 젙웾쟻 痢≪젙쓣 븯怨 蹂묒쟻 썝二쇱뿉 빐꽌뒗 젙빐吏 cut-off뿉 뵲씪 flag瑜 쓣썙 議댁옱 쑀臾대 솗씤븯뒗 諛섎㈃, PluScope뒗 二쇰줈 珥덉옄썝二쇱쓽 삎깭瑜 씤떇븯뿬 痢≪젙븯湲 븣臾몄뿉 怨꾩닔긽쓽 李⑥씠濡 씤빐 궙 씪移섎룄 긽愿꽦쓣 蹂댁쓣 媛뒫꽦씠 엳떎. 蹂 遺꾩꽍뿉꽌뒗 UF-1000i쓽 썝二쇱 蹂묒쟻 썝二쇱쓽 痢≪젙寃곌낵瑜 援щ텇븯吏 븡怨 빀爾먯꽌 遺꾩꽍븯怨, UF-1000i쓽 蹂묒쟻 썝二쇱뿉 븳 flag쓽 cut-off媛 긽쟻쑝濡 궙寃 꽕젙릺뼱 쟾泥 썝二쇱뿉 븳 怨꾩닔媛 PluScope 닔湲곕쾿쓽 寃곌낵蹂대떎 긽쟻쑝濡 뜑 넂寃 痢≪젙릺뿀쓣 닔 엳떎怨 깮媛곷맂떎. 떎瑜 썝씤쑝濡쒕뒗 닔湲 슂移⑥궗寃궗쓽 寃泥 以鍮꾧낵젙 以 븯굹씤 썝떖遺꾨━怨쇱젙뿉꽌 遺덉븞젙븳 썝二쇨 뙆愿대릺뼱 닔湲곕쾿쓽 寃곌낵뿉꽌 긽쟻쑝濡 궙寃 怨꾩닔릺뿀쓣 닔룄 엳떎. 삉떎瑜 썝씤쑝濡쒕뒗 PluScope 닔湲곕쾿 옣鍮 紐⑤몢 쁽誘멸꼍 愿李 삉뒗 뵒吏꽭 씠誘몄 遺꾩꽍쑝濡 삎깭븰쟻 援щ텇쓣 넻빐 怨꾩닔븯뒗뜲, 珥덉옄썝二쇱쓽 寃쎌슦 愿묓븰 쁽誘멸꼍뿉꽌 닾紐낇븯寃 愿李곕릺誘濡 怨꾩닔媛 릺吏 븡븯쓣 닔 엳떎.

씪移섎룄 遺꾩꽍寃곌낵 諛뺥뀒由ъ븘, 寃곗젙뿉 빐꽌뒗 뼇샇븳 씪移섎 蹂댁쑝굹 吏꾧퇏怨 젏븸吏덉뿉 빐꽌뒗 씪移섎룄媛 留ㅼ슦 醫뗭 븡븯떎. 吏꾧퇏쓽 寃쎌슦 씪移섎룄뒗 넂븯吏留 Cohen셲 kappa 遺꾩꽍뿉꽌 넻怨꾩쟻 쑀쓽꽦씠 뾾뿀뒗뜲, 씠뒗 遺꾩꽍 寃泥댁쓽 떎닔媛 吏꾧퇏뿉 빐 쓬꽦 寃泥대뱾씠뿀怨, kappa 遺꾩꽍뿉꽌뒗 슦뿰뿉 쓽븳 씪移섎룄瑜 諛곗젣븯뿬 룊媛븯湲 븣臾몄씪 寃껋쑝濡 깮媛곷맂떎.

PluScope 옣鍮꾩뿉꽌 섎몃텇瑜(unclassified)숇줈 굹삩 寃곌낵 UF-1000i뿉꽌 flag媛 몴떆맂 寃곌낵뿉 빐꽌뒗 씠誘몄 옱솗씤 삉뒗 닔湲곕쾿쓣 넻븳 寃넗(review)媛 븘슂븯떎. 寃넗媛 븘슂븳 寃쎌슦 UF-1000i 옣鍮꾩뿉꽌뒗 썝떖遺꾨━, 뒳씪씠뱶 젣옉 벑쓽 踰덇굅濡쒖슫 寃泥 以鍮꾧낵젙씠 엳뼱빞 븯굹, PluScope쓽 寃쎌슦 誘몃텇瑜섎줈 遺꾨쪟맂 궗吏꾩씠 뵒吏꽭 씠誘몄濡 珥ъ쁺릺뼱 옣릺湲 븣臾몄뿉 遺덊븘슂븳 寃泥 以鍮꾧낵젙쓣 뵾븯怨 珥ъ쁺븳 씠誘몄瑜 솗씤븿쑝濡쒖뜥 吏곸젒 寃넗媛 媛뒫븯떎뒗 옣젏씠 엳떎.

썝二, 寃곗젙 벑 뱶臾쇨쾶 愿李곕릺뒗 蹂묒쟻씤 냼寃щ뱾씠 옄룞솕 옣鍮꾩뿉꽌 솗씤릺吏 븡쓣 닔 엳湲 븣臾몄뿉 寃넗 諛 솗씤寃궗濡쒖꽌 닔湲곕줈 떆뻾븯뒗 슂寃쎄寃궗媛 諛섎뱶떆 븘슂븯떎怨 뿬윭 끉臾몄뿉꽌 뼵湲됲븯쑝硫[6,8-12], 씪遺 뿰援ъ뿉꽌뒗 寃넗쑉(review rate)쓣 슂솕븰寃궗 슂移⑥궗寃궗쓽 鍮꾧탳(삁瑜 뱾뼱, 쟻삁援ъ 옞삁諛섏쓳, 諛깊삁援ъ leukocyte esterase, 諛뺥뀒由ъ븘 nitrite 벑)瑜 넻빐 以꾩씪 닔 엳떎怨 二쇱옣븯떎[8,10,11,22]. 엫긽寃궗떎뿉꽌 솚옄쓽 슂寃궗寃곌낵瑜 옄룞솕 옣鍮꾨줈 蹂닿퀬븷 븣, 蹂묒쟻씤 긽깭瑜 諛섏쁺븯뒗 썝二쇰굹 寃곗젙 벑쓽 寃쎌슦 섎몃텇瑜섃숇줈 蹂닿퀬릺뒗 빆紐⑸뱾쓽 쑀臾대 二쇱쓽 源딄쾶 솗씤븯怨 寃넗븯뿬빞 븳떎. 씠윴 씠쑀뱾濡 씤빐 닔湲곕쾿쓣 넻븳 쁽誘멸꼍 뙋룆 쁽옱濡쒖꽌뒗 븘吏 옄룞솕 湲곌린媛 셿쟾엳 泥댄븷 닔 뾾떎.

蹂 뿰援ъ쓽 젣븳젏 떎쓬怨 媛숇떎. 泥レ㎏, 옄룞솕 옣鍮꾩쓽 젙諛룄 룊媛뿉꽌 긽뭹솕맂 젙룄愿由щЪ吏 떊 pooled urine 寃泥대 궗슜븯떎. 洹 씠쑀뒗 몢 옣鍮 媛 鍮꾧탳룊媛 뿰援щ 쐞빐꽌뒗 怨듯넻臾쇱쭏쓣 넻빐 옣鍮꾩쓽 꽦뒫룊媛瑜 븯怨좎옄 븯뒗 寃껋씠 蹂 뿰援ъ쓽 紐⑹쟻씤뜲, 뿰援 以鍮꾧낵젙뿉꽌 媛 옣鍮꾩뿉꽌 蹂꾨룄濡 궗슜 媛뒫븳 젙룄愿由щЪ吏덉 援ы븷 닔 엳뿀쑝굹 怨듯넻쑝濡 궗슜 媛뒫븳 젙룄愿由щЪ吏덉 援ы븷 닔媛 뾾뿀湲 븣臾몄씠떎. 씠뿉 옄뱾 젙諛룄 룊媛瑜 쐞븳 젙룄愿由щЪ吏덈줈꽌 pooled urine쓣 씠슜븯쑝硫, CLSI뿉꽌 젣떆븳 吏移[23]뿉 留욊쾶 젙諛룄 룊媛瑜 닔뻾븯젮 뻽쑝굹 슂 寃泥댁쓽 듅꽦긽 寃泥댁쓽 遺덉븞젙꽦쑝濡 5씪媛 遺꾩꽍쓣 븯吏 紐삵븯怨 遺뱷씠븯寃 븯猷 5쉶 痢≪젙븳 寃곌낵濡 蹂씠怨꾩닔瑜 궛異쒗븯뿬 젙諛룄 룊媛뿉 遺議깊븳 遺遺꾩씠 엳뿀떎. 뼢썑 몢 옣鍮꾩뿉 怨듯넻쑝濡 궗슜 媛뒫븳 젙룄愿由щЪ吏덉쓣 씠슜븯뿬 젙諛룄瑜 룊媛븯硫 뜑 굹 寃곌낵瑜 뼸쓣 닔 엳쓣 寃껋쑝濡 湲곕맂떎. 몢踰덉㎏濡, 긽뵾꽭룷 諛 吏꾧퇏, 寃곗젙뿉 븳 씪移섎룄 鍮꾧탳뿉꽌 寃궗寃곌낵媛 遺遺 쓬꽦 삉뒗 궙 寃곌낵瑜 蹂댁뿬, 遺꾪룷媛 렪以묐릺怨 怨좊냽룄뿉꽌쓽 씪移섎룄뒗 룊媛릺吏 紐삵븯떎. 뼢썑 蹂묐━쟻 蹂솕媛 엳뒗 鍮꾨눊湲곌퀎 諛 떊옣궡怨 솚옄쓽 寃泥대 異붽븯뿬 遺꾩꽍븳떎硫 뜑 醫뗭 鍮꾧탳遺꾩꽍쓣 븷 닔 엳쓣 寃껋씠떎.

媛먯궗쓽 湲

씠 뿰援щ뒗 怨쇳븰湲곗닠젙蹂댄넻떊遺 븳援썝옄젰쓽븰썝 뿰援ъ슫쁺鍮꾩썝궗뾽쓽 吏썝쓣 諛쏆븘 닔뻾븯떎(50544-2018).

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