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Clinical Chemistry and Laboratory Medicine (CCLM)

Published in Association with the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM)

Editor-in-Chief: Plebani, Mario

Ed. by Gillery, Philippe / Lackner, Karl J. / Lippi, Giuseppe / Melichar, Bohuslav / Payne, Deborah A. / Schlattmann, Peter / Tate, Jillian R.

IMPACT FACTOR increased in 2015: 3.017
Rank 5 out of 30 in category Medical Laboratory Technology in the 2014 Thomson Reuters Journal Citation Report/Science Edition

SCImago Journal Rank (SJR) 2015: 0.873
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Performance evaluation of the digital cell imaging analyzer DI-60 integrated into the fully automated Sysmex XN hematology analyzer system

1 / Takemasa Yamamoto2 / Imiko Maenou2 / Rie Nakai3 / Mayumi Idei1 / Takashi Horii2 / Takashi Miida1 / Akimichi Ohsaka2

1Department of Clinical Laboratory Medicine, Juntendo University School of Medicine, Bunkyo-ku, Tokyo, Japan

2Division of Clinical Laboratory, Juntendo University Hospital, Bunkyo-ku, Tokyo, Japan

3Scientific Affairs, Sysmex Corporation, Kobe, Hyogo, Japan

Corresponding author: Yoko Tabe, MD, PhD, Department of Clinical Laboratory Medicine, Juntendo University School of Medicine, Hongo 2-1-1, Bunkyo-ku, Tokyo 113-8421, Japan, Phone: +81-3-3813-3111 ext. 5187, Fax: +81-3-5804-8637, E-mail:

Citation Information: Clinical Chemistry and Laboratory Medicine (CCLM). Volume 53, Issue 2, Pages 281–289, ISSN (Online) 1437-4331, ISSN (Print) 1434-6621, DOI: 10.1515/cclm-2014-0445, August 2014

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Background: The XN-Series (Sysmex, Kobe, Japan) have been equipped with the automated digital cell imaging analyzer DI-60, which provides complete automation of the sample processing with automated complete blood counts (CBC), slide making/staining, and digital scanning with cell pre-classification. The aim of this study was to evaluate the efficacy of the XN-Series as an integrated blood cell analysis system.

Methods: White blood cell (WBC) morphological analysis by the DI-60 was evaluated using 232 blood samples from patients. Routine analysis of a total of 2000 blood samples has been performed to evaluate the processing ability of the XN-Series connected to the DI-60.

Results: The overall analysis accuracy of pre-classification of WBC by the DI-60 was 88.4%. Good correlation was observed between final results of the DI-60 analysis and manual differentiation with high sensitivity and specificity for blasts and immature granulocytes. The sample processing time of the XN-Series, from automated CBC to cell pre-classification, was 38±1 min/single run and 165±12 min/500 CBC samples run (slide preparation rate 15.6%) with no sample hold-up at the DI-60.

Conclusions: The automated morphological analysis capability of the DI-60 has potential usefulness in the integrated automated hematology analysis system of XN-Series.

Keywords: automated digital imaging; DI-60; hematology analyzer; integrated slide processing system; white blood cell differential; XN-Series

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