title: Evaluation of 2 hematology analyzers in body fluid mode versus flow cytometry immunophenotyping of mainly neurosurgical cerebrospinal fluid samples.
abstract: BACKGROUND
  For CSF analysis, exact knowledge of the type and amount of cells is essential, especially for detection of infection or bleeding. The chamber count has been the current reference method to date, yet it is problematic due to its subjectivity depending on the examiner's skill and experience. Therefore, as a reference method, we used an impulse cytophotometric measurement with Epics XL owing to its improved objectify ability and compared this method to the measurement of CSF samples performed with the ADVIA 2120 and XE-5000.
  
  
  METHODS
  101 CSF samples were measured with the ADVIA 2120, XE-5000, and Epics XL. For impulse cytophotometric measurement, CD235a was used for identification of erythrocytes; CD45 for the entire leukocyte population; CD56, CD16 and CD14 for monocytes; CD3, CD4 and CD19 for lymphocytes;and CD13, CD15 and CD33 for neutrophile granulocytes.
  
  
  RESULTS
  Regarding leukocyte measurements, a strong correlation was obtained between Epics XL and XE-5000 (r = 0.990), with the correlation between Epics XL and ADVIA 2120 not as strong (r = 0.538). This finding is due to the fact that with blood-stained CSF samples (erythrocytes >1,500/µl), no valid results were produced by the ADVIA 2120. In measurements of blood-free CSF samples, correlations between Epics XL, XE-5000, and ADVIA 2120 were almost identical (r = 0.985 and r = 0.964). The same applies to the correlation between polymorphonuclear and mononuclear cells (range 0.920-0.972). In erythrocyte measurements, the correlation between XE-5000 and ADVIA 2120 was excellent (r = 0.945). Impulse cytophotometric measurement of erythrocytes with CD 238 antibodies did not appear to be functional.
  
  
  CONCLUSIONS
  In the measurement of leukocytes in CSF with the ADVIA 2120, no valid results could be obtained in blood-stained CSF samples (erythrocytes >1,500/µl). In blood-free CSF samples (erythrocytes <1,500/µl), measurements of leukocytes, and polymorphonuclear and mononuclear cells performed with the ADVIA 2120 and XE-5000 produced almost identical good results. Determination of CSF cells with the XE-5000 is presently the best automated method for counting leukocytes of blood-stained CSF.
authors.affiliation: Universitätsklinik Bonn, Institut für Klinische Chemie und Klinische Pharmakologie, Bonn, Germany. berndt.zur@ukb.uni-bonn.de
authors.forename: B
authors.initials: B
authors.lastname: Zur
authors.forename: L
authors.initials: L
authors.lastname: Eichhorn
authors.forename: E
authors.initials: E
authors.lastname: Albers
authors.forename: B
authors.initials: B
authors.lastname: Stoffel-Wagner
mesh_terms: D001826:Body Fluids / Q000737:chemistry / Q000166:cytology; D002494:Central Nervous System Infections / Q000134:cerebrospinal fluid* / Q000175:diagnosis / Q000601:surgery; D002555:Cerebrospinal Fluid / Q000737:chemistry / Q000166:cytology*; D005434:Flow Cytometry / Q000295:instrumentation / Q000379:methods*; D006405:Hematology / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D016130:Immunophenotyping / Q000295:instrumentation / Q000379:methods*; D020300:Intracranial Hemorrhages / Q000134:cerebrospinal fluid* / Q000175:diagnosis / Q000601:surgery