nrbc NRBC综述.docVIP

nrbc NRBC综述 Sysmex Journal International Vol.10 No.2 (2000) The pattern across laboratory medicine during the past thirty years has been one of increasing demand for testscombined with a need for cost containment. The latterhas now become an over-riding consideration. It is no longer more work for the same number of technologists but more work for fewer individuals since staff repre- sents the major expenditure in most clinical laboratories. Fortunately, incremental advances in instrumentation, particularly in the area of blood cell counting, have accompanied these increasing economic pressures and this has resulted in a reduction in the need for manual and semi-automated processing. The most recent addition is the ability, with some instruments, to enumerate nucleated red blood cells (NRBC) (Fig.1). This inevitably poses the question: is there clinical value in counting NRBC? At the moment examination of blood cell morphology by microscopy remains one of the major labour intensive non-automated procedures conducted in the haematology laboratory. It is a perpetual challenge to reduce the num- ber of peripheral blood films examined but at the same time not miss valuable diagnostic pointers. Some labora- tories cling to the hallowed tradition that examination of the peripheral blood is incomplete without a blood film report. This luxury becomes impossible in the high throughput laboratory where a film review rate greater than 10 – 15 % becomes impossible to manage. This low review rate does not appear to result in significant loss of screening or diagnostic capability1-3). The blood film is examined for a number of reasons: to explain an unex-leukocyte count or to undertake an extended differentialcount. For the last, the most frequently occurring find-ings are the presence of immature granulocytes andNRBC. It is therefore important to recognise the pres-Fig. 1Nucleated red blood cells on a conventional stained peripheral blood film ?59? Sysmex Jour