title: Body fluid cellular analysis using the Sysmex XN-2000 automatic hematology analyzer: focusing on malignant samples.
abstract: BACKGROUND
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Laboratory Medicine, University of Ulsan College of Medicine and Asan Medical Center, Seoul, South Korea.
authors.forename: Y-U
authors.initials: YU
authors.lastname: Cho
authors.forename: H-S
authors.initials: HS
authors.lastname: Chi
authors.forename: S H
authors.initials: SH
authors.lastname: Park
authors.forename: S
authors.initials: S
authors.lastname: Jang
authors.forename: Y-J
authors.initials: YJ
authors.lastname: Kim
authors.forename: C-J
authors.initials: CJ
authors.lastname: Park
mesh_terms: D057205:Automation, Laboratory; D001826:Body Fluids / Q000166:cytology*; D002452:Cell Count / Q000295:instrumentation* / Q000379:methods*; D006801:Humans; D008853:Microscopy; D009369:Neoplasms / Q000175:diagnosis / Q000473:pathology; D012372:ROC Curve; D015203:Reproducibility of Results
keywords: Body fluid; HF-body fluid cells; Sysmex XN; automatic hematology analyzer; malignant sample; manual microscopy