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Colombo G, Aloisio E, Panteghini M. Laboratory investigation of peritoneal fluids: an updated practical approach based on the available evidence. J Clin Pathol 2024; 77:579-585. [PMID: 38538073 DOI: 10.1136/jcp-2023-209282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 03/10/2024] [Indexed: 04/11/2024]
Abstract
Even though analysis of peritoneal fluids (PF) is often requested to medical laboratories for biochemical and morphological tests, there is still no mutual agreement on what the most appropriate way is to manage PF samples and which tests should be appropriately executed. In this update, we tried to identify the most useful tests for PF analysis to establish best practice indications. We performed a literature review and examined available guidelines to select the most appropriate tests by an evidence-based approach. Accordingly, the basic PF profile should include (1) serum to effusion albumin gradient and (2) automated cell counts with differential analysis. This profile allows to determine the PF nature, differentiating between 'high-albumin gradient' and 'low-albumin gradient' effusions, which helps to identify the pathophysiological process causing the ascites formation. Restricted to specific clinical situations, additional tests can be requested as follows: PF lactate dehydrogenase (LDH) and glucose, to exclude (LDH) or confirm (glucose) secondary bacterial peritonitis; PF total protein, to differentiate ascites of cardiac origin from other causes; PF (pancreatic) amylase, for the identification of pancreatic ascites; PF bilirubin, when a choleperitoneum is suspected; PF triglycerides, in differentiating chylous from pseudochylous ascites and PF creatinine, to detect intraperitoneal urinary leakage.
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Affiliation(s)
- Giulia Colombo
- Clinical Pathology Unit, ASST Fatebenefratelli-Sacco, Milano, Italy
| | - Elena Aloisio
- Clinical Pathology Unit, ASST Fatebenefratelli-Sacco, Milano, Italy
| | - Mauro Panteghini
- Clinical Pathology Unit, ASST Fatebenefratelli-Sacco, Milano, Italy
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2
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Seghezzi M, Previtali G, Moioli V, Alessio MG, Guerra G, Buoro S. Performance evaluation of automated cell counts compared with reference methods for body fluid analysis. Diagnosis (Berl) 2021; 9:369-378. [PMID: 34599561 DOI: 10.1515/dx-2021-0088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 09/10/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Cellular analysis of body fluids (BFs) can assist clinicians for the diagnosis of many medical conditions. The aim of this work is the evaluation of the analytical performance of the UF-5000 body fluid mode (UF-BF) analyzer compared to the gold standard method (optical microscopy, OM) and to XN-1000 (XN-BF), another analyzer produced by the same manufacturer (Sysmex) and with a similar technology for BF analysis. METHODS One hundred BF samples collected in K3EDTA tubes were analyzed by UF-BF, XN-BF and OM. The agreement was evaluated using Passing and Bablok regression and Bland-Altman plot analysis. The receiver operating characteristic (ROC) curves were selected for evaluating the diagnostic agreement between OM classification and UF-BF parameters. RESULTS Comparison between UF-BF and OM, in all BF types, showed Passing and Bablok's slope comprised between 0.99 (polymorphonuclear cells count, PMN-BF) and 1.39 (mononuclear cells count, MN-BF), the intercepts ranged between 26.47 (PMN-BF parameter) and 226.80 (white blood cell count). Bland-Altman bias was comprised between 7.3% (total cell count, TC-BF) and 52.9% (MN-BF). Comparison between UF-BF and XN-BF in all BF showed slopes ranged between 1.07 (TC-BF and PMN-BF) and 1.16 (MN-BF), intercepts ranged between 8.30 (PMN) and 64.78 (WBC-BF). Bland-Altman bias ranged between 5.8 (TC-BF) and 21.1% (MN-BF). The ROC curve analysis showed an area under the curve ranged between 0.9664 and 1.000. CONCLUSIONS UF-BF shows very good performance for the differential counts of cells in ascitic, pleural and synovial fluids and therefore it is useful to screen and count cells in this type of BF.
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Affiliation(s)
- Michela Seghezzi
- Clinical Chemistry Laboratory, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - Giulia Previtali
- Clinical Chemistry Laboratory, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - Valentina Moioli
- Clinical Chemistry Laboratory, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | | | - Giovanni Guerra
- Clinical Chemistry Laboratory, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - Sabrina Buoro
- Regional Reference Center for the Quality of Laboratory Medicine Services, Milan, Italy
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3
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Alcaide Martín MJ, Altimira Queral L, Sahuquillo Frías L, Valiña Amado L, Merino A, García de Guadiana-Romualdo L. Automated cell count in body fluids: a review. ADVANCES IN LABORATORY MEDICINE 2021; 2:149-177. [PMID: 37363326 PMCID: PMC10197423 DOI: 10.1515/almed-2021-0011] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Accepted: 12/21/2020] [Indexed: 06/28/2023]
Abstract
Body fluid cell counting provides valuable information for the diagnosis and treatment of a variety of conditions. Chamber cell count and cellularity analysis by optical microscopy are considered the gold-standard method for cell counting. However, this method has a long turnaround time and limited reproducibility, and requires highly-trained personnel. In the recent decades, specific modes have been developed for the analysis of body fluids. These modes, which perform automated cell counting, are incorporated into hemocytometers and urine analyzers. These innovations have been rapidly incorporated into routine laboratory practice. At present, a variety of analyzers are available that enable automated cell counting for body fluids. Nevertheless, these analyzers have some limitations and can only be operated by highly-qualified laboratory professionals. In this review, we provide an overview of the most relevant automated cell counters currently available for body fluids, the interpretation of the parameters measured by these analyzers, their main analytical features, and the role of optical microscopy as automated cell counters gain ground.
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Affiliation(s)
- María José Alcaide Martín
- Committee of Laboratory Tests, Spanish Society of Laboratory Medicine (SEQC-ML), Barcelona, Spain
- Hematologic Biology Committee, Spanish Society of Laboratory Medicine (SEQC-ML), Barcelona, Spain
| | - Laura Altimira Queral
- Committee of Laboratory Tests, Spanish Society of Laboratory Medicine (SEQC-ML), Barcelona, Spain
| | - Laura Sahuquillo Frías
- Committee of Laboratory Tests, Spanish Society of Laboratory Medicine (SEQC-ML), Barcelona, Spain
| | - Laura Valiña Amado
- Committee of Laboratory Tests, Spanish Society of Laboratory Medicine (SEQC-ML), Barcelona, Spain
| | - Anna Merino
- Hematologic Biology Committee, Spanish Society of Laboratory Medicine (SEQC-ML), Barcelona, Spain
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Lee J, Cho Y, Kim HS, Kang HJ, Kim M, Lee YK. A comparison of the analysis of 3 types of body fluids using the XN-350 hematology analyzer versus light microscopy assessment. Medicine (Baltimore) 2021; 100:e24852. [PMID: 33725957 PMCID: PMC7982217 DOI: 10.1097/md.0000000000024852] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 01/26/2021] [Indexed: 01/05/2023] Open
Abstract
We evaluated the capacity of the XN-350 instrument to analyze 3 different types of body fluid samples under "body fluid mode."The performance of XN-350 was evaluated in terms of precision, carryover, limit of blank, limit of detection, limit of quantification, and linearity. Cell enumeration and differential data produced by the XN-350 were compared to manual chamber counting results in 63 cerebrospinal fluid (CSF), 51 ascitic fluid, and 51 pleural fluid (PF) samples. Comparisons between XN-350 versus Cytospin data were also performed in PF samples.The precision, carry-over, limit of blank, and linearity of the XN-350 were acceptable. The limits of detection for white blood cells (WBCs) and red blood cells were 1.0/μL, and 1,000.0/μL, respectively; the corresponding limits of quantitation (LOQs) were 5.0/μL and 2,000.0/μL, respectively. The XN-350's cell enumeration and differential counting correlated well with those of manual chamber counting for all 3 sample types (except for differential counting in CSF samples), particularly parameters involving monocytes (r = 0.33) and mononuclear cells (MO- body fluid [BF]; r = 0.26), as well as total cell (TC-BF) enumeration (r = 0.50) and WBC-BF (r = 0.50) in PF samples. The MO-BF in CSF samples differed significantly from manual chamber counting results, but neither TC-BF nor WBC-BF in PF samples did. The XN-350 also showed good correlations with Cytospin analyses for differential counting of neutrophils, lymphocytes, and monocytes in PF samples. The differential counting of eosinophils via the XN-350 and Cytospin were not significantly correlated, but the difference between them was not significant.The XN-350 is an acceptable alternative to manual fluid analysis. Samples with low cellularity around the LOQ should be checked manually. Moreover, manual differential counting should be performed on CSF samples, particularity those with low cell numbers.
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5
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Lei X, Wang J, Yang Z. Diagnostic Accuracy of Pleural Effusion Mononuclear Cells/Leukocyte Ratio in Tuberculous Pleurisy. Front Med (Lausanne) 2021; 8:639061. [PMID: 33816527 PMCID: PMC8012480 DOI: 10.3389/fmed.2021.639061] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 02/24/2021] [Indexed: 01/15/2023] Open
Abstract
Background: Tuberculous pleurisy (TBP) is a common clinical type of tuberculosis (TB) in China. TBP is difficult to diagnose. Whether the mononuclear cell/leukocyte (MNC/LEU) ratio in pleural effusion can contribute to accurate TBP diagnosis remains yet unclear. Objective: To explore the diagnostic value of MNC/LEU ratio in pleural effusion for TBP in China. Methods: This study was a retrospective case-control study involving 406 patients with pleural effusion of unknown cause who were hospitalized at the Henan Provincial People's Hospital. Using histopathological examination of thoracoscopic pleural biopsy as the gold standard for TBP diagnosis, a final total of 215 subjects were included in this study including 91 cases of TBP and 124 cases of non-TBP. The receiver operating characteristic (ROC) curve of pleural effusion MNC/LEU ratio for TBP diagnosis was plotted and the area under curve (AUC) and the optimal cutoff value were determined. In addition, the sensitivity, specificity and accuracy of the MNC/LEU ratio at the optimal cutoff value for TBP diagnosis were also evaluated. Results: The MNC/LEU ratio was significantly higher in TB pleural effusion [95.9% (89.7–98.0%)] than in non-TB pleural effusion [77.8% (39.3–93.2%)] (P < 0.001). The AUC was 0.776 (95% CI, 0.714–0.830), and the sensitivity, specificity and accuracy for TBP diagnosis at the 93.7% cutoff value were 64.83%, 79.03%, and 0.730, respectively. Conclusion: The pleural effusion MNC/LEU ratio may be a new and valuable laboratory indicator for the diagnosis of tuberculous pleurisy in China.
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Affiliation(s)
- Xiaoli Lei
- Department of Pulmonary and Critical Care Medicine, Henan Provincial People's Hospital, Zhengzhou, China
| | - Junli Wang
- Department of Cardiopulmonary Function, Fuwai Central China Cardiovascular Hospital, Zhengzhou, China
| | - Zhigang Yang
- Department of Pulmonary and Critical Care Medicine, Henan Provincial People's Hospital, Zhengzhou, China
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Saadalla A, Jara Aguirre J, Wockenfus AM, Kelley BR, Swanson RL, Howard MT, Karon BS. Evaluation of automated synovial fluid total cell count and percent polymorphonuclear leukocytes on a Sysmex XN-1000 analyzer for identifying patients at risk of septic arthritis. Clin Chim Acta 2020; 510:416-420. [PMID: 32763227 DOI: 10.1016/j.cca.2020.07.058] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 06/23/2020] [Accepted: 07/31/2020] [Indexed: 11/25/2022]
Abstract
BACKGROUND Total cell counts (TC-BF) and percent polymorphonuclear cells (%PMN) of synovial fluid (SF) aspirates provide important cues for the timely diagnosis and management of septic arthritis. To facilitate faster turnaround time, we compared automated to manual TC-BF and differential counts in order to identify reporting cut-offs for automated TC-BF and %PMN that would allow release of automated results concordant with manual counts and differentials. METHODS Automated TC-BF and %PMN counts of a non-validated analyzer (Analyzer-B in STAT laboratory) were compared to a validated analyzer (Analyzer-A) and manual TC-BF counts and cytospin differentials. Concordance and %differences of Analyzer-B versus Analyzer-A and manual counts were assessed by linear regression analysis and Bland-Altman comparison. RESULTS Overall, automated and manual counts displayed good correlation. A majority of samples demonstrated unacceptable (>20%) differences between automated and manual counts at lower TC-BF (<10,000 cells/μl) and %PMN (<60%). CONCLUSIONS Based on good overall correlation and fewer samples with unacceptable (>20%) differences between automated and manual counts, we adopted TC-BF > 10,000 cells/μl and %PMN > 60% as cutoffs for reporting automated counts. These cutoffs minimize differences between automated and manual cell counts and differentials and would allow rapid automated reporting in the vast majority of septic arthritis cases.
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Affiliation(s)
- Abdulrahman Saadalla
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, United States
| | - Jose Jara Aguirre
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, United States
| | - Amy M Wockenfus
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, United States
| | - Brandon R Kelley
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, United States
| | - Rebecca L Swanson
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, United States
| | - Matthew T Howard
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, United States
| | - Brad S Karon
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, United States.
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Favresse J, Boland L, Schellen M, Fervaille C, Wuestenberghs F, Camboni A, Chatelain B, Mullier F, Defour JP, Jacqmin H. Two-site evaluation of a new workflow for the detection of malignant cells on the Sysmex XN-1000 body fluid analyzer. Int J Lab Hematol 2020; 42:544-551. [PMID: 32163671 DOI: 10.1111/ijlh.13187] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2019] [Revised: 02/12/2020] [Accepted: 02/23/2020] [Indexed: 12/16/2022]
Abstract
INTRODUCTION The presence of high fluorescent cells (HF-BF) on the Sysmex XN-1000 hematology analyzers has gained interest regarding the prediction of malignant cells in body fluids, but lacks sensitivity. We aimed to increase this sensitivity by combining HF-BF value, automated results, and clinical information. METHODS We evaluated a new workflow for the management of body fluids in the hematology laboratory, including the HF-BF criterion and clinical information. In two laboratories, 1623 serous fluids were retrospectively analyzed on the XN-1000 BF mode. All samples were morphologically screened for malignant cells. Optimal HF-BF cutoffs were determined to predict their presence. Thereafter, the added value of clinical information was evaluated. Other reflex testing rules (eosinophilic count >5% and presence of the WBC Abnormal Scattergram flag) were also used to refine our workflow. RESULTS Optimal HF-BF cutoffs in the two hematology centers were 108 and 45 cells/µL, yielding a sensitivity/specificity of 66.7/93.6% and 86.8/66.6% for malignant cell detection. When adding clinical information, sensitivity/specificity evolved to 100.0/68.9% and 100.0%/not determined. Of 104 samples containing malignant cells, 97 had positive clinical information; the remainder had a HF-BF > cutoff. CONCLUSION Combining clinical information and HF-BF reached 100% sensitivity for malignant cell detection in body fluid analysis. Lack of robustness of the optimal HF-BF cutoff deserves the use of local cutoffs. Rapid automated results reporting from the XN-1000 BF mode are also feasible in clinical practice. Prospective evaluation of the workflow is needed before its implementation in clinical practice.
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Affiliation(s)
- Julien Favresse
- CHU UCL Namur, Namur Thrombosis and Hemostasis Center, Hematology Laboratory, Université catholique de Louvain, Yvoir, Belgium
| | - Lidvine Boland
- Hematology Laboratory, Department of Laboratory Medicine, St-Luc University Hospital and catholic University of Louvain, Brussels, Belgium
| | - Marie Schellen
- Hematology Laboratory, Department of Laboratory Medicine, St-Luc University Hospital and catholic University of Louvain, Brussels, Belgium
| | - Caroline Fervaille
- Pathology Department, CHU UCL Namur, Université catholique de Louvain, Yvoir, Belgium
| | - Fabien Wuestenberghs
- Department of Gastroenterology and Hepatology, CHU UCL Namur, Godinne University Hospital, UCLouvain, Yvoir, Belgium
| | - Alessandra Camboni
- Pathology Department, St-Luc University Hospital and catholic University of Louvain, Brussels, Belgium
| | - Bernard Chatelain
- CHU UCL Namur, Namur Thrombosis and Hemostasis Center, Hematology Laboratory, Université catholique de Louvain, Yvoir, Belgium
| | - François Mullier
- CHU UCL Namur, Namur Thrombosis and Hemostasis Center, Hematology Laboratory, Université catholique de Louvain, Yvoir, Belgium
| | - Jean-Philippe Defour
- Hematology Laboratory, Department of Laboratory Medicine, St-Luc University Hospital and catholic University of Louvain, Brussels, Belgium.,Ludwig Cancer Research and de Duve Institute, Université catholique de Louvain, Brussels, Belgium
| | - Hugues Jacqmin
- CHU UCL Namur, Namur Thrombosis and Hemostasis Center, Hematology Laboratory, Université catholique de Louvain, Yvoir, Belgium
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8
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Lei X, Wang J, Yang Z, Zhou S, Xu Z. Diagnostic Value of Pleural Effusion Mononuclear Cells Count and Adenosine Deaminase for Tuberculous Pleurisy Patients in China: A Case-Control Study. Front Med (Lausanne) 2019; 6:301. [PMID: 31921874 PMCID: PMC6927933 DOI: 10.3389/fmed.2019.00301] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Accepted: 11/29/2019] [Indexed: 01/14/2023] Open
Abstract
Background: The diagnostic value of pleural effusion mononuclear cells count for tuberculous pleurisy (TBP) is unclear. We aimed to evaluate the diagnostic value of pleural effusion mononuclear cells count and its combination with adenosine deaminase (ADA) in TBP patients. Methods: We initially analyzed 296 patients with unknown pleural effusion from the Department of Respiratory Medicine at Provincial People's Hospital during January 2014 to February 2018. Ultimately, 100 tuberculous pleurisy (TBP) patients and 105 non-tuberculous pleurisy (non-TBP) patients with pleural effusion were investigated in the current study. Meanwhile, pleural effusion mononuclear cells count and ADA test were performed to evaluate the diagnostic value for TBP. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), positive likelihood ratio (LR+), negative likelihood ratio (LR-), accuracy and area under the receiver operating characteristic (ROC) curve (AUC) of pleural effusion mononuclear cells count only and its combination with ADA for TBP diagnosis were investigated. Results: (i) The best cut-off value of pleural effusion mononuclear cells count for TBP diagnosis was 969.6 × 106/L, with the sensitivity, specificity and accuracy of 76, 57, and 66%, respectively. (ii) Combination of pleural effusion mononuclear cells count and ADA test suggested diagnostic value for TBP. Specifically, serial test showed the sensitivity, specificity, accuracy of 65, 90, 78%, respectively, whereas parallel test revealed the sensitivity, specificity, accuracy of 92, 45, 68%, respectively. The sensitivity of parallel test (92%) was significantly higher than pleural effusion mononuclear cells count alone (76%) (X2 = 23.19, p < 0.001). (iii) The area under the ROC of pleural effusion mononuclear cells count and it combined with ADA were 0.66 (95% CI, 0.59-0.72) and 0.83 (95% CI, 0.78-0.89), respectively, with statistically significant difference (Z = 3.46, p < 0.001). Conclusion: This retrospective case-control study demonstrated that pleural effusion mononuclear cells count is relatively useful for TBP diagnosis. Furthermore, the pleural effusion mononuclear cells count in combination with ADA can further improve the diagnostic accuracy of TBP.
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Affiliation(s)
- Xiaoli Lei
- Department of Respiratory Medicine, Henan Provincial People's Hospital, Henan University People's Hospital, Zhengzhou, China
| | - Junli Wang
- Henan University People's Hospital, Henan Provincial People's Hospital, Zhengzhou, China
| | - Zhigang Yang
- Department of Respiratory Medicine, Henan Provincial People's Hospital, Henan University People's Hospital, Zhengzhou, China
| | - Shengli Zhou
- Department of Pathology, Henan Provincial People's Hospital, Henan University People's Hospital, Zhengzhou, China
| | - Zhiwei Xu
- Department of Clinical-Research Service Center, Henan Provincial People's Hospital, Henan University People's Hospital, Zhengzhou, China
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Milevoj Kopcinovic L, Culej J, Jokic A, Bozovic M, Kocijan I. Laboratory testing of extravascular body fluids: National recommendations on behalf of the Croatian Society of Medical Biochemistry and Laboratory Medicine. Part I - Serous fluids. Biochem Med (Zagreb) 2019; 30:010502. [PMID: 31839720 PMCID: PMC6904973 DOI: 10.11613/bm.2020.010502] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Accepted: 05/20/2019] [Indexed: 12/16/2022] Open
Abstract
Extravascular body fluids (EBF) analysis can provide useful information in the differential diagnosis of conditions that caused their accumulation. Their unique nature and particular requirements accompanying EBF analysis need to be recognized in order to minimize possible negative implications on patient safety. This recommendation was prepared by the members of the Working group for extravascular body fluid samples (WG EBFS). It is designed to address the total testing process and clinical significance of tests used in EBF analysis. The recommendation begins with a chapter addressing validation of methods used in EBF analysis, and continues with specific recommendations for serous fluids analysis. It is organized in sections referring to the preanalytical, analytical and postanalytical phase with specific recommendations presented in boxes. Its main goal is to assist in the attainment of national harmonization of serous fluid analysis and ultimately improve patient safety and healthcare outcomes. This recommendation is intended to all laboratory professionals performing EBF analysis and healthcare professionals involved in EBF collection and processing. Cytological and microbiological evaluations of EBF are beyond the scope of this document.
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Affiliation(s)
- Lara Milevoj Kopcinovic
- Croatian Society of Medical Biochemistry and Laboratory Medicine, Working group for extravascular body fluid samples.,Department of Clinical Chemistry, Sestre milosrdnice University Hospital Center, Zagreb, Croatia
| | - Jelena Culej
- Croatian Society of Medical Biochemistry and Laboratory Medicine, Working group for extravascular body fluid samples.,Department of Clinical Chemistry, Sestre milosrdnice University Hospital Center, Zagreb, Croatia
| | - Anja Jokic
- Croatian Society of Medical Biochemistry and Laboratory Medicine, Working group for extravascular body fluid samples.,Department of Medical Biochemistry, Haematology and Coagulation with Cytology, University Hospital for Infectious Diseases "Dr. Fran Mihaljević", Zagreb, Croatia
| | - Marija Bozovic
- Croatian Society of Medical Biochemistry and Laboratory Medicine, Working group for extravascular body fluid samples.,Department of Clinical Chemistry, Sestre milosrdnice University Hospital Center, Zagreb, Croatia
| | - Irena Kocijan
- Croatian Society of Medical Biochemistry and Laboratory Medicine, Working group for extravascular body fluid samples.,Medical Biochemistry Laboratory, General hospital Varaždin, Varaždin, Croatia
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10
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Favresse J, Fervaille C, Wuestenberghs F, Chatelain B, Mullier F, Jacqmin H. Utility of the XN‐1000 research mode for leukocytes counting in ascitic and pleural fluids. Int J Lab Hematol 2019; 42:e92-e95. [DOI: 10.1111/ijlh.13128] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Revised: 10/29/2019] [Accepted: 11/04/2019] [Indexed: 01/30/2023]
Affiliation(s)
- Julien Favresse
- Hematology Laboratory Namur Thrombosis and Hemostasis Center Université catholique de Louvain CHU UCL Namur Yvoir Belgium
| | - Caroline Fervaille
- Pathology Department Université catholique de Louvain CHU UCL Namur Yvoir Belgium
| | - Fabien Wuestenberghs
- Department of Gastroenterology and Hepatology Université catholique de Louvain CHU UCL Namur Yvoir Belgium
| | - Bernard Chatelain
- Hematology Laboratory Namur Thrombosis and Hemostasis Center Université catholique de Louvain CHU UCL Namur Yvoir Belgium
| | - François Mullier
- Hematology Laboratory Namur Thrombosis and Hemostasis Center Université catholique de Louvain CHU UCL Namur Yvoir Belgium
| | - Hugues Jacqmin
- Hematology Laboratory Namur Thrombosis and Hemostasis Center Université catholique de Louvain CHU UCL Namur Yvoir Belgium
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11
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Rastogi L, Dass J, Arya V, Kotwal J. Evaluation of high-fluorescence body fluid (HF-BF) parameter as a screening tool of malignancy in body fluids. INDIAN J PATHOL MICR 2019; 62:572-577. [PMID: 31611442 DOI: 10.4103/ijpm.ijpm_802_18] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Introduction Automated body fluid (BF) analysis is gradually replacing the traditional methods of cell counting in all BFs. This study was done to analyze the high-fluorescence (HF)-BF parameter generated on Sysmex XN-1000 and study its correlation with the presence of malignant cells in the body fluids. A correlation between manual and automated differential counts was also done. Materials and Methods A total of 1985 samples including 797 ascitic fluids (AF), 532 pleural fluids (PF), and 656 cerebrospinal fluids (CSF) were run on Sysmex XN-1000 in BF mode and cytopathology was available for 924 BFs including 389 AF, 379 PF, and 156 CSF. Both manual and automated methods were used for cell differential and cell morphology. Results Of the 924 samples with corresponding cytopathology, malignancy was found in 59 samples. The HF-BF%/100 WBCs (24.8 ± 72.5) and HF-BF#/μL (329.86 ± 932.35) for malignant BF samples were found to be significantly higher than the nonmalignant samples (4.41 ± 8.1) and (19.57 ± 61.91), respectively. Receiver-operator-characteristic curve cutoffs for all BF for percentage and absolute HF-BF were 2.85%/100 WBCs and >12/μL. A good correlation was found between the manual and automated WBC differential counts in all fluids except CSF with total count < 5/μL. Conclusions BFs can be reliably analyzed on automated analyzers. HF-BF parameter is helpful in identifying malignant samples but cannot be totally relied upon. If HF-BF%/# are above the lab-generated cutoffs, microscopy should be done. A complete validation study on HF-BF parameter in BF mode is desired to set the standards for the analysis of serious effusions.
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Affiliation(s)
- Loveena Rastogi
- Department of Hematology, Sir Ganga Ram Hospital, New Delhi, India
| | - Jasmita Dass
- Department of Hematology, Sir Ganga Ram Hospital, New Delhi, India
| | - Vandana Arya
- Department of Hematology, Sir Ganga Ram Hospital, New Delhi, India
| | - Jyoti Kotwal
- Department of Hematology, Sir Ganga Ram Hospital, New Delhi, India
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12
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Buoro S, Seghezzi M, Baigorria Vaca MDC, Manenti B, Moioli V, Previtali G, Simon C, Cugola D, Brucato A, Ottomano C, Lippi G. Comparison between optical microscopy and automation for cytometric analysis of pericardial fluids in a cohort of adult subjects undergoing cardiac surgery. J Clin Pathol 2019; 72:493-500. [DOI: 10.1136/jclinpath-2019-205788] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Revised: 03/28/2019] [Accepted: 03/28/2019] [Indexed: 01/04/2023]
Abstract
AimsLimited information is available on number and type of cells present in the pericardial fluid (PF). Current evidence and has been garnered with inaccurate application of guidelines for analysis of body fluids. This study was aimed at investigating the performance of automate cytometric analysis of PF in adult subjects.MethodsSeventy-four consecutive PF samples were analysed with Sysmex XN with a module for body fluid analysis (XN-BF) and optical microscopy (OM). The study also encompassed the assessment of limit of blank, limit of detection and limit of quantitation (LoQ), imprecision, carryover and linearity of XN-BF module.ResultsXN-BF parameters were compared with OM for the following cell classes: total cells (TC), leucocytes (white blood cell [WBC]), polymorphonuclear (PMN) and mononuclear (MN) cells. The relative bias were −4.5%, 71.2%, 108.2% and −47.7%, respectively. Passing and Bablok regression yielded slope comprised between 0.06 for MN and 5.8 for PMN, and intercept between 0.7 for PMN and 220.3 for MN. LoQ was comprised between 3.8×106 and 6.0×106 cells/L for WBC and PMN. Linearity was acceptable and carryover negligible.ConclusionsPF has a specific cellular composition. Overall, automated cell counting can only be suggested for total number of cells, whereas OM seems still the most reliable option for cell differentiation.
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Buoro S, Seghezzi M, Dominoni P, Moioli V, Manenti B, Previtali G, Ottomano C, Lippi G. Lack of harmonization in high fluorescent cell automated counts with body fluids mode in ascitic, pleural, synovial, and cerebrospinal fluids. Int J Lab Hematol 2019; 41:277-286. [PMID: 30758900 DOI: 10.1111/ijlh.12968] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Revised: 11/28/2018] [Accepted: 12/12/2018] [Indexed: 12/17/2022]
Abstract
INTRODUCTION Cellular analysis in body fluids (BFs) provides important diagnostic information in various pathological settings. This study was hence aimed at comparing automated cell count obtained with Mindray BC-6800 (BC-BF) vs Sysmex XN-series (XN-BF) and evaluating other quantitative and qualitative information provided by these analyzers in ascitic (AF), pleural (PF), synovial (SF), and cerebrospinal (CSF) fluids. METHODS Three hundred and fifty-one samples (99 AFs, 45 PFs, 75 SFs, and 132 CSFs) were analyzed in parallel with BC-BF, XN-BF, and optical microscopy (OM). The study also included the assessment of diagnostic agreement among BC-BF, XN-BF, and OM. RESULTS The comparison of BC-BF vs XN-BF yielded slopes of Passing and Bablok regression always comprised between 0.9 and 1.0 except for EO-BF and HF-BF, whilst the intercepts ranged from -0.4 for MN-BF and 12.0 for PMN-BF. The bias was comprised between -103.3% and 67.1% for HF-BF and EO-BF, respectively. A significant bias was found for TC-BF, WBC-BF, HF-BF (negative bias) and for PMN-BF and EO-BF (positive bias). The agreement (Cohen's kappa) between XN-BF and BC-BF was always ≥0.7, ranging between 0.87 in CSFs and 0.94 in AFs, and that with OM was similar (ie, 0.85 and 0.96). CONCLUSION The cytometric analysis of BF samples using BC-BF and XN-BF is clinically favorable when appropriately combined with OM. Quantitative and qualitative parameters displayed optimal agreement, whilst instrument-specific cut-offs should be defined and implemented for HF-BF and EO-BF. Further efforts should be made for achieving better harmonization in cytometric analysis of BF samples.
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Affiliation(s)
- Sabrina Buoro
- Clinical Chemistry Laboratory, Hospital Papa Giovanni XXIII, Bergamo, Italy
| | - Michela Seghezzi
- Clinical Chemistry Laboratory, Hospital Papa Giovanni XXIII, Bergamo, Italy
| | - Paola Dominoni
- Clinical Chemistry Laboratory, Hospital Papa Giovanni XXIII, Bergamo, Italy
| | - Valentina Moioli
- Clinical Chemistry Laboratory, Hospital Papa Giovanni XXIII, Bergamo, Italy
| | - Barbara Manenti
- Clinical Chemistry Laboratory, Hospital Papa Giovanni XXIII, Bergamo, Italy
| | - Giulia Previtali
- Clinical Chemistry Laboratory, Hospital Papa Giovanni XXIII, Bergamo, Italy
| | | | - Giuseppe Lippi
- Section of Clinical Biochemistry, University of Verona, Verona, Italy
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Favresse J, van Dievoet MA, De Wolf H, Rodriguez-Villalobos H, Defour JP. Characterization of Candida
spp. interference on the Sysmex XN-1000 body fluid mode. Int J Lab Hematol 2018; 40:e28-e32. [DOI: 10.1111/ijlh.12780] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Accepted: 01/10/2018] [Indexed: 11/29/2022]
Affiliation(s)
- J. Favresse
- Department of Laboratory Hematology; Cliniques Universitaires Saint-Luc; Université catholique de Louvain; Brussels Belgium
| | - M.-A. van Dievoet
- Department of Laboratory Hematology; Cliniques Universitaires Saint-Luc; Université catholique de Louvain; Brussels Belgium
| | - H. De Wolf
- Department of Laboratory Hematology; Cliniques Universitaires Saint-Luc; Université catholique de Louvain; Brussels Belgium
| | - H. Rodriguez-Villalobos
- Department of Laboratory Hematology; Cliniques Universitaires Saint-Luc; Université catholique de Louvain; Brussels Belgium
- Department of Microbiology; Cliniques Universitaires Saint-Luc; Université catholique de Louvain; Brussels Belgium
| | - J.-P. Defour
- Department of Laboratory Hematology; Cliniques Universitaires Saint-Luc; Université catholique de Louvain; Brussels Belgium
- Ludwig Cancer Research and de Duve Institute; Université catholique de Louvain; Brussels Belgium
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15
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Cho YU, You E, Jang S, Park CJ. Validation of reflex testing rules and establishment of a new workflow for body fluid cell analysis using a Sysmex XN-550 automatic hematology analyzer. Int J Lab Hematol 2018; 40:258-267. [DOI: 10.1111/ijlh.12774] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Accepted: 10/17/2017] [Indexed: 11/28/2022]
Affiliation(s)
- Y.-U. Cho
- Department of Laboratory Medicine; University of Ulsan College of Medicine and Asan Medical Center; Seoul Korea
| | - E. You
- Department of Laboratory Medicine; University of Ulsan College of Medicine and Asan Medical Center; Seoul Korea
| | - S. Jang
- Department of Laboratory Medicine; University of Ulsan College of Medicine and Asan Medical Center; Seoul Korea
| | - C.-J. Park
- Department of Laboratory Medicine; University of Ulsan College of Medicine and Asan Medical Center; Seoul Korea
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Hod EA, Brugnara C, Pilichowska M, Sandhaus LM, Luu HS, Forest SK, Netterwald JC, Reynafarje GM, Kratz A. Automated cell counts on CSF samples: A multicenter performance evaluation of the GloCyte system. Int J Lab Hematol 2017; 40:56-65. [PMID: 28880455 DOI: 10.1111/ijlh.12728] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Accepted: 07/15/2017] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Automated cell counters have replaced manual enumeration of cells in blood and most body fluids. However, due to the unreliability of automated methods at very low cell counts, most laboratories continue to perform labor-intensive manual counts on many or all cerebrospinal fluid (CSF) samples. This multicenter clinical trial investigated if the GloCyte System (Advanced Instruments, Norwood, MA), a recently FDA-approved automated cell counter, which concentrates and enumerates red blood cells (RBCs) and total nucleated cells (TNCs), is sufficiently accurate and precise at very low cell counts to replace all manual CSF counts. METHODS The GloCyte System concentrates CSF and stains RBCs with fluorochrome-labeled antibodies and TNCs with nucleic acid dyes. RBCs and TNCs are then counted by digital image analysis. Residual adult and pediatric CSF samples obtained for clinical analysis at five different medical centers were used for the study. Cell counts were performed by the manual hemocytometer method and with the GloCyte System following the same protocol at all sites. The limits of the blank, detection, and quantitation, as well as precision and accuracy of the GloCyte, were determined. RESULTS The GloCyte detected as few as 1 TNC/μL and 1 RBC/μL, and reliably counted as low as 3 TNCs/μL and 2 RBCs/μL. The total coefficient of variation was less than 20%. Comparison with cell counts obtained with a hemocytometer showed good correlation (>97%) between the GloCyte and the hemocytometer, including at very low cell counts. CONCLUSIONS The GloCyte instrument is a precise, accurate, and stable system to obtain red cell and nucleated cell counts in CSF samples. It allows for the automated enumeration of even very low cell numbers, which is crucial for CSF analysis. These results suggest that GloCyte is an acceptable alternative to the manual method for all CSF samples, including those with normal cell counts.
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Affiliation(s)
- E A Hod
- Department of Pathology and Cell Biology, Columbia University College of Physicians and Surgeons, New York, NY, USA.,NewYork-Presbyterian Hospital, New York, NY, USA
| | - C Brugnara
- Department of Laboratory Medicine, Boston Children's Hospital, and Harvard Medical School, Boston, MA, USA
| | | | - L M Sandhaus
- University Hospitals, Cleveland Medical Center, Cleveland, OH, USA
| | - H S Luu
- Children's Medical Center Dallas, Dallas, TX, USA
| | - S K Forest
- Department of Pathology and Cell Biology, Columbia University College of Physicians and Surgeons, New York, NY, USA.,NewYork-Presbyterian Hospital, New York, NY, USA
| | - J C Netterwald
- Department of Pathology and Cell Biology, Columbia University College of Physicians and Surgeons, New York, NY, USA
| | | | - A Kratz
- Department of Pathology and Cell Biology, Columbia University College of Physicians and Surgeons, New York, NY, USA.,NewYork-Presbyterian Hospital, New York, NY, USA
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Buoro S, Peruzzi B, Fanelli A, Seghezzi M, Manenti B, Lorubbio M, Biagioli T, Nannini S, Ottomano C, Lippi G. Two-site evaluation of the diagnostic performance of the Sysmex XN Body Fluid (BF) module for cell count and differential in Cerebrospinal Fluid. Int J Lab Hematol 2017; 40:26-33. [PMID: 28866874 DOI: 10.1111/ijlh.12723] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Accepted: 06/26/2017] [Indexed: 12/12/2022]
Abstract
INTRODUCTION Cellular analysis in cerebrospinal fluid (CSF) provides important diagnostic information in many pathological settings. The aim of this two-site study was to evaluate the Sysmex XN Body Fluid mode (XN-BF) for cell analysis of CSF compared to light microscopy (LM). METHODS Two hundred and seven consecutive CSF samples were analyzed in parallel with XN-BF and LM. The study also included the estimation of the limit of blank (LoB), limit of detection (LoD), limit of quantitation (LoQ), carry-over and linearity of XN-BF module. RESULTS LoQ of white blood cells (WBC) was 3×106 cells/L; linearity was good and carry-over negligible. XN-BF parameters were compared to LM for the following cell classes: total cells, WBC, polymorphonuclear (PMN), and mononuclear (MN) cells. The bias ranged from 1.3 to 15.2×106 cells/L. The receiver operating characteristics curve analysis for WBC showed an area under the curve of 0.98, and the global diagnostic agreement was 95% at a cutoff of 5×106 cells/L. CONCLUSIONS XN-BF provides rapid and accurate counts in clinically relevant ranges of CSF values, thus providing a valuable alternative to conventional LM analysis. However, microscopic review remains advisable in samples with abnormal cell counts or high fluorescent (HF-BF) cell parameter exceeding 5×106 cells/L.
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Affiliation(s)
- S Buoro
- Clinical Chemistry Laboratory, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - B Peruzzi
- Clinical Chemistry Laboratory Hospital Careggi Firenze, University of Firenze, Firenze, Italy
| | - A Fanelli
- Clinical Chemistry Laboratory Hospital Careggi Firenze, University of Firenze, Firenze, Italy
| | - M Seghezzi
- Clinical Chemistry Laboratory, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - B Manenti
- Clinical Chemistry Laboratory, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - M Lorubbio
- Clinical Chemistry Laboratory Hospital Careggi Firenze, University of Firenze, Firenze, Italy
| | - T Biagioli
- Clinical Chemistry Laboratory Hospital Careggi Firenze, University of Firenze, Firenze, Italy
| | - S Nannini
- Clinical Chemistry Laboratory Hospital Careggi Firenze, University of Firenze, Firenze, Italy
| | - C Ottomano
- Clinical Chemistry Laboratory, Synlab, Monza, Italy
| | - G Lippi
- Section of Clinical Biochemistry, University of Verona, Verona, Italy
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18
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Xu W, Yu Q, Xie L, Chen B, Zhang L. Evaluation of Sysmex XN-1000 hematology analyzer for cell count and screening of malignant cells of serous cavity effusion. Medicine (Baltimore) 2017; 96:e7433. [PMID: 28682907 PMCID: PMC5502180 DOI: 10.1097/md.0000000000007433] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Over the years, with the advancement in hematology analyzer technology, the use of fluid analysis method has seen a drastic increase in clinical examinations. Cell counting and classification in independent body fluid analysis method are conducted by semiconductor laser flow cytometry and nucleic acid fluorescence staining techniques. This study is to evaluate the efficacy of Sysmex XN-1000 hematology analyzer in cell counting and to screen malignant cells with serous cavity effusion. Specimens (N = 206) with serous cavity effusion from our hospital were included in this study. Manual and instrumental methods for cell counting, nucleated cell classification, and high-fluorescent cells (HFC) were used in this study. The correlation between RBC, nucleated cell count (NUC), the percentages of polymorphonuclear cell (PMN%), and mononuclear cells (MN%) was statistically analyzed using manual and instrumental methods. The regression equations of RBC, NUC, PMN%, and MN% in the manual and instrumental methods were RBC y = 0.88x + 426.4; NUC y = 0.85x + 33.4; PMN% y = 0.91x + 4.2; and MN% y = 0.91x + 5.1. Correlation coefficient R was 0.99, 0.98, 0.90, and 0.90 (P < .001). ROC curve analysis showed that when the cut-off value of HFC% was 4.4% and HFC# was 24.5/μL, area under curve (AUC), sensitivity, specificity, and 95% confidence interval were 0.707, 0.792, 0.558, 0.637-0.777; 0.708, 0.753, 0.550, 0.635-0.780, respectively. XN-1000 hematology analyzer body fluid method can accurately and rapidly count cell and nucleated cell classification with serous cavity effusion. HFC can indicate the possible existence of malignant cells; however, further investigations are required to validate its efficacy.
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Affiliation(s)
- Weiyi Xu
- Department of Laboratory Medicine,The First Affiliated Hospital, College of Medicine, Zhejiang University
- Key Laboratory of Clinical In Vitro Diagnostic Techniques of Zhejiang Province, Hangzhou
| | - Qian Yu
- Department of Laboratory Medicine,The First Affiliated Hospital, College of Medicine, Zhejiang University
- Key Laboratory of Clinical In Vitro Diagnostic Techniques of Zhejiang Province, Hangzhou
| | - Lixia Xie
- Department of Laboratory Medicine,The First Affiliated Hospital, College of Medicine, Zhejiang University
- Key Laboratory of Clinical In Vitro Diagnostic Techniques of Zhejiang Province, Hangzhou
| | - Baode Chen
- Department of Laboratory Medicine,The First Affiliated Hospital, College of Medicine, Zhejiang University
- Key Laboratory of Clinical In Vitro Diagnostic Techniques of Zhejiang Province, Hangzhou
| | - Ling Zhang
- Renji College, Wenzhou Medical University, Wenzhou, China
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Buoro S, Seghezzi M, Manenti B, Mecca T, Candiago E, Vidali M, Ottomano C, Castelli C, Ferrari R, Zappalà G, Lippi G. Reliability of automated synovial fluid cell counting with Mindray BC-6800 body fluid mode. Int J Lab Hematol 2017; 39:337-346. [DOI: 10.1111/ijlh.12632] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Accepted: 01/06/2017] [Indexed: 11/28/2022]
Affiliation(s)
- S. Buoro
- Clinical Chemistry Laboratory; Hospital Papa Giovanni XXIII; Bergamo Italy
| | - M. Seghezzi
- Clinical Chemistry Laboratory; Hospital Papa Giovanni XXIII; Bergamo Italy
| | - B. Manenti
- Clinical Chemistry Laboratory; Hospital Papa Giovanni XXIII; Bergamo Italy
| | - T. Mecca
- Clinical Chemistry Laboratory; Hospital Papa Giovanni XXIII; Bergamo Italy
| | - E. Candiago
- Pathology; Hospital Papa Giovanni XXIII; Bergamo Italy
| | - M. Vidali
- Immunohaematology and Transfusion Medicine Unit; SS Trinità Hospital; Borgomanero Italy
| | | | - C.C. Castelli
- Orthopedics and Traumatology Unit; Hospital Papa Giovanni XXIII; Bergamo Italy
| | - R. Ferrari
- Orthopedics and Traumatology Unit; Hospital Papa Giovanni XXIII; Bergamo Italy
| | - G. Zappalà
- Orthopedics and Traumatology Unit; Hospital Papa Giovanni XXIII; Bergamo Italy
| | - G. Lippi
- Section of Clinical Biochemistry; University of Verona; Verona Italy
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Seghezzi M, Buoro S, Manenti B, Mecca T, Ferrari R, Zappalà G, Castelli CC, Balboni F, Pezzati P, Ottomano C, Lippi G. Optimization of Cellular analysis of Synovial Fluids by optical microscopy and automated count using the Sysmex XN Body Fluid Mode. Clin Chim Acta 2016; 462:41-48. [PMID: 27581597 DOI: 10.1016/j.cca.2016.08.018] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2016] [Revised: 08/25/2016] [Accepted: 08/26/2016] [Indexed: 01/13/2023]
Abstract
BACKGROUND This study was planned to assess the impact of pre-treating synovial fluid (SF) samples with hyaluronidase (HY), defining the best procedure for optical microscopy (OM) analysis and evaluating the performance of Sysmex XN-9000 Body Fluid module (XN-BF). METHODS The cell count by OM was carried out both with and without HY pre-treatment, and using 3 different types of staining reagents. The evaluation of XN-BF included data comparison with OM (100 SFs), carryover, Limit of Blank (LoB), Limit of Detection (LoD), Limit of Quantitation (LoQ) and linearity. RESULTS Unlike cell count in Burker's chamber and staining with Stromatol, pre-treatment with HY and staining with Methylene Blue and Turk's promoted cell clustering. The SF samples pre-treated with HY displayed excellent morphological quality, contrary to samples without HY pre-treatment. Excellent correlation was found between total cells counting with both OM and XN-BF. Satisfactory agreement was also observed between polymorphonuclear neutrophils compared to XN-BF parameter, whereas mononuclear cell count on XN-BF had suboptimal agreement with OM. The carryover was negligible. The LoB, LoD, LoQ and linearity were excellent. CONCLUSION XN-BF displays excellent performance, which makes it a reliable and practical alternative to OM for SF samples analysis in clinical laboratories.
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Affiliation(s)
- Michela Seghezzi
- Clinical Chemistry Laboratory, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - Sabrina Buoro
- Clinical Chemistry Laboratory, Papa Giovanni XXIII Hospital, Bergamo, Italy.
| | - Barbara Manenti
- Clinical Chemistry Laboratory, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - Tommaso Mecca
- Clinical Chemistry Laboratory, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - Roberto Ferrari
- Orthopedics and Traumatology Unit. Hospital Papa Giovanni XXIII, Bergamo, Italy
| | - Giorgio Zappalà
- Orthopedics and Traumatology Unit. Hospital Papa Giovanni XXIII, Bergamo, Italy
| | | | - Fiamma Balboni
- Clinical Chemistry Laboratory, Istituto Fiorentino di Cura e Assistenza (IFCA), Firenze, Italy
| | - Paola Pezzati
- Clinical Chemistry Laboratory Hospital Careggi Firenze, , University of Firenze, Italy
| | | | - Giuseppe Lippi
- Section of Clinical Biochemistry, University of Verona, Verona, Italy
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Buoro S, Seghezzi M, Mecca T, Vavassori M, Crippa A, La Gioia A. Evaluation of Mindray BC-6800 body fluid mode for automated cerebrospinal fluid cell counting. ACTA ACUST UNITED AC 2016; 54:1799-1810. [DOI: 10.1515/cclm-2015-1092] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2015] [Accepted: 03/04/2016] [Indexed: 11/15/2022]
Abstract
AbstractBackground:Cellular analysis in cerebrospinal fluid (CSF) provides important diagnostic information in various medical conditions. The aim of this study was to evaluate the application of Mindray BC-6800 body fluid (BF) mode in cytometric analysis of CSF compared to light microscopy (LM).Methods:One hundred and twenty-nine consecutive CSF samples were analyzed by BC-6800-BF mode as well as by LM. The study also included limits of blank (LoB), limit of detection (LoD), limit of quantitation (LoQ), carryover and linearity.ResultsWhite blood cells LoQ was 4.0×10Conclusions:BC-6800-BF offers rapid and accurate counts in clinically relevant concentration ranges, replacing LM for most samples. However, in samples with abnormal cell counts or with abnormal white blood cell differential scattergrams the need to microscopic review for a correct clinical outcome remains.
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