title: Optimization of Cellular analysis of Synovial Fluids by optical microscopy and automated count using the Sysmex XN Body Fluid Mode.
abstract: BACKGROUND
  This study was planned to assess the impact of pre-treating synovial fluid (SF) samples with hyaluronidase (HY), defining the best procedure for optical microscopy (OM) analysis and evaluating the performance of Sysmex XN-9000 Body Fluid module (XN-BF).
  
  
  METHODS
  The cell count by OM was carried out both with and without HY pre-treatment, and using 3 different types of staining reagents. The evaluation of XN-BF included data comparison with OM (100 SFs), carryover, Limit of Blank (LoB), Limit of Detection (LoD), Limit of Quantitation (LoQ) and linearity.
  
  
  RESULTS
  Unlike cell count in Burker's chamber and staining with Stromatol, pre-treatment with HY and staining with Methylene Blue and Turk's promoted cell clustering. The SF samples pre-treated with HY displayed excellent morphological quality, contrary to samples without HY pre-treatment. Excellent correlation was found between total cells counting with both OM and XN-BF. Satisfactory agreement was also observed between polymorphonuclear neutrophils compared to XN-BF parameter, whereas mononuclear cell count on XN-BF had suboptimal agreement with OM. The carryover was negligible. The LoB, LoD, LoQ and linearity were excellent.
  
  
  CONCLUSIONS
  XN-BF displays excellent performance, which makes it a reliable and practical alternative to OM for SF samples analysis in clinical laboratories.
authors: Clinical Chemistry Laboratory, Papa Giovanni XXIII Hospital, Bergamo, Italy.
authors: Michela
authors: M
authors: Seghezzi
authors: Clinical Chemistry Laboratory, Papa Giovanni XXIII Hospital, Bergamo, Italy. Electronic address: sbuoro@asst-pg23.it.
authors: Sabrina
authors: S
authors: Buoro
authors: Clinical Chemistry Laboratory, Papa Giovanni XXIII Hospital, Bergamo, Italy.
authors: Barbara
authors: B
authors: Manenti
authors: Clinical Chemistry Laboratory, Papa Giovanni XXIII Hospital, Bergamo, Italy.
authors: Tommaso
authors: T
authors: Mecca
authors: Orthopedics and Traumatology Unit. Hospital Papa Giovanni XXIII, Bergamo, Italy.
authors: Roberto
authors: R
authors: Ferrari
authors: Orthopedics and Traumatology Unit. Hospital Papa Giovanni XXIII, Bergamo, Italy.
authors: Giorgio
authors: G
authors: Zappalà
authors: Orthopedics and Traumatology Unit. Hospital Papa Giovanni XXIII, Bergamo, Italy.
authors: Claudio Carlo
authors: CC
authors: Castelli
authors: Clinical Chemistry Laboratory, Istituto Fiorentino di Cura e Assistenza (IFCA), Firenze, Italy.
authors: Fiamma
authors: F
authors: Balboni
authors: Clinical Chemistry Laboratory Hospital Careggi Firenze, , University of Firenze, Italy.
authors: Paola
authors: P
authors: Pezzati
authors: Synlab, Monza, Italy.
authors: Cosimo
authors: C
authors: Ottomano
authors: Section of Clinical Biochemistry, University of Verona, Verona, Italy.
authors: Giuseppe
authors: G
authors: Lippi
mesh_terms: D057205:Automation, Laboratory / Q000295:instrumentation*; D002452:Cell Count / Q000295:instrumentation*; D002454:Cell Differentiation; D005434:Flow Cytometry / Q000295:instrumentation*; D006801:Humans; D008853:Microscopy; D055620:Optical Phenomena; D013582:Synovial Fluid / Q000166:cytology*
keywords: Body Fluids; Optical Microscopy; Synovial fluid; Sysmex; XN