title: Extent of agreement between the body fluid model of Sysmex XN-20 and the manual microscopy method.
abstract: BACKGROUND
  Although the correlations concerning cellular component analysis between the Sysmex XN-20 body fluid (BF) model and manual microscopy have been investigated by several studies, the extent of agreement between these two methods has not been investigated.
  
  
  METHODS
  A total of 90 BF samples were prospectively collected and analyzed using the Sysmex XN-20 BF model and microscopy. The extent of agreement between these two methods was evaluated using the Bland-Altman approach. Receiver operating characteristic (ROC) curve analysis was employed to evaluate the diagnostic accuracy of high-fluorescence (HF) BF cells for malignant diseases.
  
  
  RESULTS
  The agreements of white blood cell (WBC), red blood cell (RBC), and percentages of neutrophils, lymphocytes, and monocytes between the Sysmex XN-20 BF model and manual microscopy were imperfect. The areas under the ROC curves for absolute and relative HF cells were 0.67 (95% confidence interval [CI]: 0.56-0.78) and 0.60 (95% CI: 0.48-0.72), respectively.
  
  
  CONCLUSIONS
  Due to the Sysmex XN-20 BF model's imperfect agreement with manual microscopy and its weak diagnostic accuracy for malignant diseases, the current evidence does not support replacing manual microscopy with this model in clinical practice.
authors.affiliation: Department of Laboratory Medicine, Changhai Hospital, The Second Military Medical University, Shanghai, China.
authors.forename: Wei-Hua
authors.initials: WH
authors.lastname: Huang
authors.affiliation: Department of Laboratory Medicine, Seventh People's Hospital of Shanghai University of TCM, Shanghai, China.
authors.forename: Lin-Peng
authors.initials: LP
authors.lastname: Lu
authors.affiliation: Department of Laboratory Medicine, Changhai Hospital, The Second Military Medical University, Shanghai, China.
authors.forename: Kang
authors.initials: K
authors.lastname: Wu
authors.affiliation: Department of Laboratory Medicine, Changhai Hospital, The Second Military Medical University, Shanghai, China.
authors.forename: Fang-Yu
authors.initials: FY
authors.lastname: Guo
authors.affiliation: Department of Laboratory Medicine, Changhai Hospital, The Second Military Medical University, Shanghai, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Guo
authors.affiliation: Department of Laboratory Medicine, Changhai Hospital, The Second Military Medical University, Shanghai, China.
authors.forename: Jing-Long
authors.initials: JL
authors.lastname: Yu
authors.affiliation: Department of Laboratory Medicine, Changhai Hospital, The Second Military Medical University, Shanghai, China.
authors.forename: Dao-Yin
authors.initials: DY
authors.lastname: Zhou
authors.affiliation: Department of Laboratory Medicine, Changhai Hospital, The Second Military Medical University, Shanghai, China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Sun
authors.affiliation: Clinical Research Center, Changhai Hospital, The Second Military Medical University, Shanghai, China.
authors.forename: An-Mei
authors.identifier: http://orcid.org/0000-0002-5055-8382
authors.initials: AM
authors.lastname: Deng
mesh_terms: D001331:Automation; D001826:Body Fluids / Q000166:cytology*; D003584:Cytological Techniques / Q000379:methods / Q000592:standards; D006801:Humans; D008853:Microscopy / Q000379:methods / Q000592:standards; D008954:Models, Biological; D012372:ROC Curve; D015203:Reproducibility of Results
keywords: Bland-Altman approach; SysmexXN-20; agreement; cellular component analysis; high-fluorescence cell