title: Performance evaluation of the automated nucleated red blood cell enumeration on Sysmex XN analyser.
abstract: BACKGROUND
  Presence of peripheral blood nucleated red blood cell (NRBC) is associated with pathological conditions and leads to the overestimation of white blood cell count in automated haematology analysers (HA). The authors evaluated NRBC enumeration by a new HA Sysmex XN (XN) to demonstrate the precision and comparability to manual count (MC) at the various NRBC values.
  
  
  METHODS
  Specimens with initially NRBC positive were included. For precision assessment, 8 levels of NRBCs were repeatedly analysed. For comparison study, 234 specimens were analysed by both XN and MC.
  
  
  RESULTS
  For precision study, the percentage of coefficient of variation ranged from 14% to 45.6% and 1.2% to 4.4% for MC and XN, respectively. For comparison study between XN and MC, NRBCs ranged from 0% to 612.5%. Regression analysis demonstrated an r(2) of 0.98. The mean bias of 14.1% with 95% limits of agreement between -48.76% and 76.95% was found. The NRBC counts from XN appeared to be more in accordance with MC when the NRBCs were lower than 200% with the concordance rate of 94.2%.
  
  
  CONCLUSIONS
  The automated NRBC enumeration by XN was precise and could replace the traditional MC, especially for the specimens with NRBCs lower than 200%.
authors.affiliation: Department of Clinical Pathology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
authors.forename: C
authors.initials: C
authors.lastname: Tantanate
authors.forename: C
authors.initials: C
authors.lastname: Klinbua
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D057205:Automation, Laboratory; D001772:Blood Cell Count / Q000295:instrumentation* / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D004900:Erythroblasts; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008853:Microscopy; D008875:Middle Aged; D015203:Reproducibility of Results; D055815:Young Adult
keywords: Nucleated red blood cell; Sysmex XN; automation; haematology analyser; normoblastemia