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Clinical Chemistry and Laboratory Medicine (CCLM)

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Validation of the body fluid module on the new Sysmex XN-1000 for counting blood cells in cerebrospinal fluid and other body fluids

Chérina Fleming1 / Rob Brouwer1 / Jan Lindemans1 / 1

1Department of Clinical Chemistry, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands

Corresponding author: Dr. Robert de Jonge, Department of Clinical Chemistry, L-137, Erasmus MC, University Medical Center Rotterdam, s-Gravendijkwal 230, 3015 CE Rotterdam, The Netherlands Phone: +31 10 7033473, Fax: +31 10 4367894

Citation Information: Clinical Chemistry and Laboratory Medicine. Volume 50, Issue 10, Pages 1791–1798, ISSN (Online) 1437-4331, ISSN (Print) 1434-6621, DOI: 10.1515/cclm-2011-0927, May 2012

Publication History

Received:
2011-12-15
Accepted:
2012-03-22
Published Online:
2012-05-07

Abstract

Background: We evaluated the body fluid (BF) module on the new Sysmex XN-1000 for counting blood cells.

Methods: One hundred and eighty-seven BF samples [73 cerebrospinal fluid (CSF), 48 continuous ambulatory peritoneal dialysis (CAPD), 46 ascites, and 20 pleural fluid] were used for method comparison between the XN-1000 and manual microscopy (Fuchs-Rosenthal chamber and stained cytospin slides) for counting red blood cells (RBCs) and white blood cells (WBCs) (differential).

Results: Good agreement was found for counting WBCs (y=1.06x+0.09, n=67, R2=0.96) and mononuclear cells (MNs) (y=1.04x–0.01, n=40, R2=0.93) in CSF. However, the XN-1000 systematically counted more polymorphonuclear cells (PMNs) (y=1.48x+0.18, n=40, R2=0.99) compared to manual microscopy. Excellent correlation for RBCs >1×109/L (y=0.99x+116.56, n=26, R2=0.99) in CSF was found. For other fluids (CAPD, ascites and pleural fluid) excellent agreement was found for counting WBCs (y=1.06x+0.26, n=109, R2=0.98), MNs (y=1.06x–0.41, n=93, R2=0.96), PMNs (y=1.06x+0.81, n=93, R2=0.98) and RBCs (y=1.04x+110.04, n=43, R2=0.98). By using BF XN-check, the lower limit of quantitation (LLoQ) for WBC was defined at 5×106/L. Linearity was excellent for both the WBCs (R2=0.99) and RBCs (R2=0.99) and carry-over never exceeded 0.05%.

Conclusions: The BF module on the XN-1000 is a suitable tool for fast and accurate quantification of WBC (differential) and RBC counts in CSF and other BFs in a diagnostic setting.

Keywords: body fluid; cerebrospinal fluid; counting chamber; hematology analyzer; leukocytes; Sysmex XN-1000

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