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Haslacher H, Rappel R, Thalhammer R, Demyanets S, Simbrunner B, Reiberger T, Eberhard S, Schwarzinger I. Adequate scattergram interpretation increases the reliability of automated polymorphonuclear (pmn) cell counts from ascitic fluid of patients with liver cirrhosis. Int J Lab Hematol 2021; 43:O176-O180. [PMID: 33605534 PMCID: PMC8451782 DOI: 10.1111/ijlh.13488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 01/15/2021] [Accepted: 01/28/2021] [Indexed: 11/28/2022]
Affiliation(s)
- Helmuth Haslacher
- Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria
| | | | - Renate Thalhammer
- Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria
| | - Svitlana Demyanets
- Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria
| | - Benedikt Simbrunner
- Division of Gastroenterology and Hepatology, Department of Medicine III, Medical University of Vienna, Vienna, Austria.,Vienna Hepatic Hemodynamic Lab, Medical University of Vienna, Vienna, Austria
| | - Thomas Reiberger
- Division of Gastroenterology and Hepatology, Department of Medicine III, Medical University of Vienna, Vienna, Austria.,Vienna Hepatic Hemodynamic Lab, Medical University of Vienna, Vienna, Austria
| | - Simone Eberhard
- Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria
| | - Ilse Schwarzinger
- Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria
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Mlinarić A, Vogrinc Ž, Drenšek Z. Effect of sample processing and time delay on cell count and chemistry tests in cerebrospinal fluid collected from drainage systems. Biochem Med (Zagreb) 2019; 28:030705. [PMID: 30429673 PMCID: PMC6214696 DOI: 10.11613/bm.2018.030705] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Accepted: 06/12/2018] [Indexed: 12/02/2022] Open
Abstract
Introduction Cerebrospinal fluid (CSF) from extra-ventricular drainage (EVD) systems is routinely analysed to diagnose EVD–related bacterial meningitis. We investigated the effect of time delay and sample processing on cell count and basic biochemistry results in EVD CSF to define optimal turnaround time and whether manual and automated cell counting are comparable in such samples. Materials and methods In total, 32 EVD CSF samples were analysed. Baseline testing included cell counting (Fuchs-Rosenthal chamber and Sysmex XE5000) and biochemistry analyses (glucose, lactate, proteins). Manual cell counting was also performed at intervals of 61-90 and 91-150 minutes from baseline in the residual sample. Biochemistry analyses were performed in samples before and after centrifugation at baseline and at 91-150 minutes interval. Results At 91-150 minutes total cell count (P < 0.001), large lymphocytes (P = 0.007), neutrophils (P < 0.001) and phagocytes (P = 0.006) obtained by manual counting decreased and the number of disintegrated cells count increased (P = 0.016) compared to the baseline values. Considering method comparison, proportional difference between methods for all cell (sub)groups was obtained, whereas polymorphonuclears also showed the constant difference (y = 11.21 + 1.22x). Compared to centrifuged CSF, lower concentration of glucose and lactates were obtained in uncentrifuged samples (P < 0.001) at baseline. Conclusions Manual cell counting should be performed within 60 minutes as any delay can alter results. The same counting technique should be used to obtain longitudinally assessable results. Biochemistry tests are stable in uncentrifuged CSF up to 2.5 hours.
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Affiliation(s)
- Ana Mlinarić
- Department of Laboratory Diagnostics, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Željka Vogrinc
- Department of Laboratory Diagnostics, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Zrinka Drenšek
- Faculty of Pharmacy and Biochemistry, University of Zagreb, Zagreb, Croatia
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Zelazowska-Rutkowska B, Zak J, Wojtkowska M, Zaworonek J, Cylwik B. Use of the Sysmex XT-4000i hematology analyzer in the differentiation of cerebrospinal fluid cells in children. J Clin Lab Anal 2018; 33:e22822. [PMID: 30485541 DOI: 10.1002/jcla.22822] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Revised: 10/11/2018] [Accepted: 11/04/2018] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Routine analysis of pleocytosis and cellular composition of cerebrospinal fluid (CSF) is carried out with a phase-contrast microscope. The use of hematological analyzers seems to be an alternative to the manual method. The aim of the study was to assess the usefulness of the automated technique for counting and differentiating CSF cells in children. METHODS The study group consisted of 59 children (28 girls and 31 boys) aged from 4 to 17 years suffering from viral and bacterial meningitis. Children were divided into three subgroups according to CSF cell count: 1st group had a pleocytosis of 6-50 cells/µL, 2nd group-51-100 cells/µL, and 3rd group->100 cells/µL. A reference group involved 32 children (17 girls and 15 boys) aged from 2 to 18 years with a normal range of 0-5 cells/µL. Examination of CSF was performed in parallel by two different method, manual and automated. RESULTS The analysis of pleocytosis revealed that the values obtained by the manual method were statistically significantly lower in relation to the values obtained by automated technique in subgroups I and II. The number of mononuclear and polymorphonuclear cells in subgroups I, II, and III determined by both manual and automated methods was comparable. CONCLUSION We conclude that automated method cannot fully replace the previously used manual method and some of the dubious cases, such as samples with low pleocytosis rates or abnormal cells indicated by the analyzer, will still require microscopic examination.
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Affiliation(s)
| | - Janusz Zak
- Department of Pediatric Laboratory Diagnostics, Medical University of Bialystok, Bialystok, Poland
| | - Malgorzata Wojtkowska
- Department of Pediatric Laboratory Diagnostics, Medical University of Bialystok, Bialystok, Poland
| | - Justyna Zaworonek
- Department of Pediatric Laboratory Diagnostics, Medical University of Bialystok, Bialystok, Poland
| | - Bogdan Cylwik
- Department of Pediatric Laboratory Diagnostics, Medical University of Bialystok, Bialystok, Poland
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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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Sandhaus LM, Dillman CA, Hinkle WP, MacKenzie JM, Hong G. A New Automated Technology for Cerebrospinal Fluid Cell Counts: Comparison of Accuracy and Clinical Impact of GloCyte, Sysmex XN, and Manual Methods. Am J Clin Pathol 2017; 147:507-514. [PMID: 28419185 DOI: 10.1093/ajcp/aqx026] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES The purpose of the study was to compare the performance of GloCyte (Advanced Instruments, Norwood, MA), a new semiautomated instrument for cerebrospinal fluid cell counting, with the manual hemocytometer method and the automated Sysmex XN (Sysmex, Kobe, Japan) body fluid mode. The clinical impact of replacing the manual method with either automated method was determined. METHODS Fifty-seven samples from 38 patients were analyzed by all three methods. Pearson correlation and Passing-Bablok regression were used to compare methods. Cytospin smears were reviewed on all samples, and clinical histories were obtained. RESULTS There was a strong linear relationship between the manual and automated methods for WBC counts ( R = 0.988 for GloCyte; R = 0.980 for Sysmex XN). Positive bias was absent or negligible for WBC counts less than 30/μL. GloCyte and manual RBC counts were equivalent. There were no samples for which replacement of manual WBC counts by automated counts would have changed the diagnosis. Both automated methods showed improved precision for WBC counts compared with the manual method. CONCLUSIONS Replacing manual WBC counts by GloCyte or Sysmex XN WBC counts would improve consistency of results without compromising diagnostic accuracy.
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Affiliation(s)
- Linda M Sandhaus
- Department of Pathology, University Hospitals Cleveland Medical Center, Cleveland, OH
| | - Christine A Dillman
- Department of Pathology, University Hospitals Cleveland Medical Center, Cleveland, OH
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Buoro S, Appassiti Esposito S, Vavassori M, Mecca T, Ottomano C, Dominoni P, Seghezzi M, Candiago E, Farina C, Gianatti A, Crippa A, Lippi G. Reflex Testing Rules for Cell Count and Differentiation of Nucleated Elements in Pleural and Ascitic Fluids on Sysmex XE-5000. ACTA ACUST UNITED AC 2016; 21:297-304. [DOI: 10.1177/2211068215593375] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2015] [Indexed: 12/29/2022]
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Fleming C, Russcher H, Brouwer R, Lindemans J, de Jonge R. Evaluation of Sysmex XN-1000 High-Sensitive Analysis (hsA) Research Mode for Counting and Differentiating Cells in Cerebrospinal Fluid. Am J Clin Pathol 2016; 145:299-307. [PMID: 27124911 DOI: 10.1093/ajcp/aqv093] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES Counting cells in cerebrospinal fluid (CSF) using automated analyzers is generally problematic due to low precision at low cell numbers. To overcome this limitation, Sysmex (Kobe, Japan) developed the high-sensitive analysis (hsA) research mode specifically for counting cells in fluids that contain low cell counts. We evaluated this mode by counting RBCs, WBCs, and differentiated WBCs in CSF samples. METHODS We analyzed 248 CSF samples using the hsA mode and compared these results with those obtained using the manual counting method. We also evaluated the linearity, detection limits, carryover, and precision of the hsA mode. RESULTS Using the hsA mode, the lower limit of quantification for RBCs and WBCs was 10 and 2 cells/μL, respectively. Comparing the two methods revealed good agreement with respect to WBCs (y = 1.08x + 0.52), RBCs (y = 1.07x + 0.00), lymphocytes (y = 1.00x + 0.00), neutrophils (y = 1.05x + 0.00), and monocytes (y = 0.88x + 0.07). Regression analysis for samples containing low WBCs (<10 cells/μL) and low RBCs (<50 cells/μL) also had good agreement, although a slight positive bias was found for RBCs. Linearity was good (r(2) ≥ 0.99) for all parameters evaluated. Carryover was negligible and never exceeded 0.04%. CONCLUSIONS The XN hsA research mode provides reliable cell counts in CSF samples, even in samples containing low numbers of WBCs and RBCs.
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Affiliation(s)
- Chérina Fleming
- From the Department of Clinical Chemistry, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Henk Russcher
- From the Department of Clinical Chemistry, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Rob Brouwer
- From the Department of Clinical Chemistry, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Jan Lindemans
- From the Department of Clinical Chemistry, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Robert de Jonge
- From the Department of Clinical Chemistry, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands.
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Buoro S, Apassiti Esposito S, Alessio M, Crippa A, Ottomano C, Lippi G. Automated Cerebrospinal Fluid Cell Counts Using the New Body Fluid Mode of Sysmex UF-1000i. J Clin Lab Anal 2015; 30:381-91. [PMID: 26302990 DOI: 10.1002/jcla.21866] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2015] [Accepted: 07/27/2015] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND We evaluated the new body fluid module on Sysmex UF1000-i (UF1000i-BF) for analysis of white blood cell (WBC) and red blood cell (RBC) in cerebrospinal fluid (CSF). METHODS WBC and RBC counting were compared between UF1000i-BF and Fuchs-Rosenthal counting chamber in 67 CSF samples. This study also included the evaluation of between-day precision, limit of blank (LoB), limit of detection (LoD), functional sensitivity (limit of quantitation, LoQ), carryover and linearity. Diagnostic agreement for differentiation between normal and increased WBC counts (≥5.0 × 10(6) /L) was also assessed. RESULTS The agreement between UF1000i-BF and manual WBC counts was otpiaml in all CSF samples (r = 0.99; y = 1.05x + 0.09). A modest overestimation was noticed in samples with WBC < 30 × 10(6) /L (r = 0.95; y = 1.21x - 0.15). A good agreement was observed for RBC counts (r = 0.98; y = 1.15x + 0.55), particularly in samples with RBC ≥ 18 × 10(6) /L (r = 0.98; y = 1.01x + 8.90). Between-day precision was good, with coefficient of variations (CVs) lower than 7.2% for both WBC and RBC. The LoBs were 0.1 × 10(6) WBC/L and 1.2 × 10(6) RBC/L, the LoDs were 0.7 × 10(6) WBC/L and 5.5 × 10(6) RBC/L, the LoQs were 2.4 × 10(6) WBC/L and 18.0 × 10(6) RBC/L, respectively. Linearity was excellent (r = 1.00 for both WBC and RBC). Carryover was negligible. Excellent diagnostic agreement was obtained at 4.5 × 10(6) WBC/L cut-off (sensitivity, 100%; specificity, 97.4%). CONCLUSION The UF1000i-BF provides rapid and accurate WBC and RBC counts in clinically relevant values of CSF cells. The use of UF1000i-BF may hence allow to replace routine optical counting, except for samples displaying abnormal WBC counts or abnormal scattergram distribution, for which differential cell counts may still be required.
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Affiliation(s)
- Sabrina Buoro
- Laboratory of Clinical Chemistry, Hospital Papa Giovanni XXIII, Bergamo, Italy.
| | | | - MariaGrazia Alessio
- Laboratory of Clinical Chemistry, Hospital Papa Giovanni XXIII, Bergamo, Italy
| | - Alberto Crippa
- Laboratory of Clinical Chemistry, Hospital Papa Giovanni XXIII, Bergamo, Italy
| | - Cosimo Ottomano
- Laboratory of Clinical Chemistry and Hematology, Academic Hospital of Parma, Parma, Italy
| | - Giuseppe Lippi
- Laboratory of Clinical Chemistry and Hematology, Academic Hospital of Parma, Parma, Italy
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Bignardi GE. Flow cytometry for the microscopy of body fluids in patients with suspected infection. J Clin Pathol 2015; 68:870-8. [PMID: 26188055 DOI: 10.1136/jclinpath-2015-203088] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2015] [Accepted: 06/23/2015] [Indexed: 11/03/2022]
Abstract
Automating the microscopy of body fluids is challenging, due to the wider range and lower concentrations of cells in these fluids, as opposed to blood, while the viscous nature of some of these fluids can also be problematic. This review shows that there have been major improvements and that newer flow cytometers can have remarkably low limits of quantitation for WBCs. Accurate counting of RBCs is still problematic with many flow cytometers, but this is of no clinical significance. Many flow cytometers can give reasonably accurate WBC differential counts, but detection of eosinophils and neoplastic or other nucleated cells which are not blood cells can still be problematic, hence fail-safe measures are recommended. Cerebrospinal fluid is the most challenging body fluid as it requires the ability to count and differentiate WBCs down to a 'normal range', which is much lower than the diagnostic cut-off values used for serous fluids; precision at or around the cerebrospinal fluid WBC normal range is reduced even with the best flow cytometers, but manual microscopy is even less precise.
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Affiliation(s)
- Giuseppe Enrico Bignardi
- South of Tyne and Wear Pathology, Queen Elizabeth Hospital, Tyne and Wear, UK NE9 6SX and Microbiology Department, Sunderland Royal Hospital, Sunderland, UK
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Piccinini F, Tesei A, Paganelli G, Zoli W, Bevilacqua A. Improving reliability of live/dead cell counting through automated image mosaicing. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2014; 117:448-463. [PMID: 25438936 DOI: 10.1016/j.cmpb.2014.09.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2014] [Revised: 09/18/2014] [Accepted: 09/19/2014] [Indexed: 06/04/2023]
Abstract
Cell counting is one of the basic needs of most biological experiments. Numerous methods and systems have been studied to improve the reliability of counting. However, at present, manual cell counting performed with a hemocytometer still represents the gold standard, despite several problems limiting reproducibility and repeatability of the counts and, at the end, jeopardizing their reliability in general. We present our own approach based on image processing techniques to improve counting reliability. It works in two stages: first building a high-resolution image of the hemocytometer's grid, then counting the live and dead cells by tagging the image with flags of different colours. In particular, we introduce GridMos (http://sourceforge.net/p/gridmos), a fully-automated mosaicing method to obtain a mosaic representing the whole hemocytometer's grid. In addition to offering more significant statistics, the mosaic "freezes" the culture status, thus permitting analysis by more than one operator. Finally, the mosaic achieved can thus be tagged by using an image editor, thus markedly improving counting reliability. The experiments performed confirm the improvements brought about by the proposed counting approach in terms of both reproducibility and repeatability, also suggesting the use of a mosaic of an entire hemocytometer's grid, then labelled trough an image editor, as the best likely candidate for the new gold standard method in cell counting.
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Affiliation(s)
- Filippo Piccinini
- Advanced Research Center on Electronic Systems (ARCES) for Information and Communication Technologies "E. De Castro", University of Bologna, Italy.
| | - Anna Tesei
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, FC, Italy.
| | - Giulia Paganelli
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, FC, Italy.
| | - Wainer Zoli
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, FC, Italy.
| | - Alessandro Bevilacqua
- Advanced Research Center on Electronic Systems (ARCES) for Information and Communication Technologies "E. De Castro", University of Bologna, Italy; Department of Computer Science and Engineering (DISI), University of Bologna, Italy.
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Cho YU, Chi HS, Park SH, Jang S, Kim YJ, Park CJ. Body fluid cellular analysis using the Sysmex XN-2000 automatic hematology analyzer: focusing on malignant samples. Int J Lab Hematol 2014; 37:346-56. [PMID: 25212101 DOI: 10.1111/ijlh.12292] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2014] [Accepted: 08/05/2014] [Indexed: 01/22/2023]
Abstract
INTRODUCTION The majority of previous studies on body fluid (BF) mode of automatic hematology analyzer used nonmalignant BF samples. Here, we evaluated the BF mode on the recently launched Sysmex XN for counting blood cells, especially for malignant samples. METHODS A total of 405 BF specimens including 125 malignant samples were analyzed using both the automated method and manual microscopy. RESULTS In non-cerebrospinal fluids (CSF) samples, there was an agreement between two methods for WBC, RBC, polymorphonuclear, and mononuclear cell counts (R(2) = 0.96, 0.94, 0.88, and 0.88, respectively). CSF samples showed slightly poorer correlations than other fluids. Exclusion of malignant samples significantly improved correlations in non-CSF samples, but not in CSF samples. High fluorescence-BF (HF-BF) cells were identified significantly more frequently in malignant samples compared to benign samples (17.8 and 4.15/100 WBC, respectively; P < 0.001). Receiver operating characteristic curve analysis demonstrated an HF-BF cell AUC of 0.791 using a cutoff value of 6.9/100 WBC for detecting malignant samples. CONCLUSION The BF mode on the Sysmex XN could be an alternative method for the manual counts in the BF analysis with a few drawbacks. However, if a concentration of HF-BF cells is greater than the given threshold, microscopic examination should be subsequently performed.
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Affiliation(s)
- Y-U Cho
- Department of Laboratory Medicine, University of Ulsan College of Medicine and Asan Medical Center, Seoul, South Korea
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Li A, Grönlund E, Brattsand G. Automated white blood cell counts in cerebrospinal fluid using the body fluid mode on the platform Sysmex XE-5000. Scandinavian Journal of Clinical and Laboratory Investigation 2014; 74:673-80. [PMID: 25180445 DOI: 10.3109/00365513.2014.939994] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND The Sysmex XE-5000 offers automated quantification of red blood cells and white blood cells (WBCs) in body fluids, with differentiation of polymorphonuclear cells (PMNs) and mononuclear cells (MNCs). METHODS We evaluated automated WBC counting in cerebrospinal fluid (CSF) using the body fluid mode on the Sysmex XE-5000, comparing it with flow cytometry as the reference method, and also with manual counting by microscopy. Experimental analysis for linearity and limit of detection was performed by diluting isolated WBCs in cell-free CSF. To study the ability to discriminate between PMNs and MNCs, samples were spiked using MNCs separated from peripheral blood. Comparison of WBC counts between a counting chamber and the XE-5000 was performed for 198 CSF samples. RESULTS In the experimental set-up, within-run (CV 19%) and between-day imprecision (CV 15.3%) in quantitating total number of WBC on XE-5000 was acceptable for WBC counts ≥ 25 × 10(6)/L. Compared with expected cell counts, mean bias was + 2.6% for flow cytometry, + 5.5% for XE-5000 and - 73.2% for manual counting. Differentiation between PMNs and MNCs was in concordance with flow cytometry. In comparisons of clinical CSF samples, overall agreement between the XE-5000 and manual counting was observed in 81% of the samples, but mean difference in WBC differentiation was higher for PMN (51.1 × 10(6)/L) than for MNC (7.95 × 10(6)/L). CONCLUSION Despite limited precision at low WBC counts, XE-5000 could be a favourable alternative to the labour-intensive, time-consuming and less reliable manual counting and cuts turnaround times in routine CSF-based diagnosis.
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Affiliation(s)
- Aihong Li
- Department of Medical Biosciences, Clinical Chemistry, Umeå University Hospital, Umeå University , Umeå , Sweden
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Seo JY, Lee ST, Kim SH. Performance evaluation of the new hematology analyzer Sysmex XN-series. Int J Lab Hematol 2014; 37:155-64. [PMID: 24815300 DOI: 10.1111/ijlh.12254] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2013] [Accepted: 04/07/2014] [Indexed: 11/30/2022]
Abstract
INTRODUCTION The Sysmex XN-series is a new automated hematology analyzer designed to improve the accuracy of cell counts and the specificity of the flagging events. METHODS The basic characteristics and the performance of new measurement channels of the XN were evaluated and compared with the Sysmex XE-2100 and the manual method. Fluorescent platelet count (PLT-F) was compared with the flow cytometric method. The low WBC mode and body fluid mode were also evaluated. For workflow analysis, 1005 samples were analyzed on both the XN and the XE-2100, and manual review rates were compared. RESULTS All parameters measured by the XN correlated well with the XE-2100. PLT-F showed better correlation with the flow cytometric method (r(2) = 0.80) compared with optical platelet count (r(2) = 0.73) for platelet counts <70 × 10(9) /L. The low WBC mode reported accurate leukocyte differentials for samples with a WBC count <0.5 × 10(9) /L. Relatively good correlation was found for WBC counts between the manual method and the body fluid mode (r = 0.88). The XN made less flags than the XE-2100, while the sensitivities of both instruments were comparable. CONCLUSION The XN provided reliable results on low cell counts, as well as reduced manual blood film reviews, while maintaining a proper level of diagnostic sensitivity.
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Affiliation(s)
- J Y Seo
- Department of Laboratory Medicine, Gachon University Gil Medical Center, Incheon, Korea; Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Lehto TM, Leskinen P, Hedberg P, Vaskivuo TE. Evaluation of the Sysmex XT-4000ifor the automated body fluid analysis. Int J Lab Hematol 2013. [DOI: 10.1111/ijlh.12134] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- T. M. Lehto
- Department of Clinical Chemistry; Center of Medical Services; Päijät-Häme Social and Health Care Group; Lahti Finland
- Nordlab Oulu; Oulu University Hospital; Oulu Finland
- Department of Clinical Chemistry; Institute of Diagnostics; University of Oulu; Oulu Finland
| | - P. Leskinen
- Faculty of Health Care and Nursing; Helsinki Metropolia; University of Applied Sciences; Helsinki Finland
| | - P. Hedberg
- Nordlab Oulu; Oulu University Hospital; Oulu Finland
- Department of Clinical Chemistry; Institute of Diagnostics; University of Oulu; Oulu Finland
| | - T. E. Vaskivuo
- Department of Clinical Chemistry; Center of Medical Services; Päijät-Häme Social and Health Care Group; Lahti Finland
- Nordlab Oulu; Oulu University Hospital; Oulu Finland
- Department of Clinical Chemistry; Institute of Diagnostics; University of Oulu; Oulu Finland
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Performance evaluation and result comparison of the automated hematology analyzers Abbott CD 3700, Sysmex XE 2100 and Coulter LH 750 for cell counts in serous fluids. Clin Chim Acta 2013; 419:113-8. [DOI: 10.1016/j.cca.2013.01.022] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2012] [Revised: 01/19/2013] [Accepted: 01/29/2013] [Indexed: 11/22/2022]
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Lippi G, Cattabiani C, Benegiamo A, Gennari D, Pavesi F, Caleffi A, Pipitone S. Evaluation of the Fully Automated Hematological Analyzer Sysmex XE-5000 for Flow Cytometric Analysis of Peritoneal Fluid. ACTA ACUST UNITED AC 2013; 18:240-4. [DOI: 10.1177/2211068212471833] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
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Fleming C, Brouwer R, Lindemans J, de Jonge R. Improved software on the Sysmex XE-5000 BF mode for counting leukocytes in cerebrospinal fluid. Clin Chem Lab Med 2013; 51:e61-3. [DOI: 10.1515/cclm-2012-0461] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2012] [Accepted: 09/06/2012] [Indexed: 11/15/2022]
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