title: Efficiency of Leukocyte Differential Using Flow Cytometry with CytoDiff in Different Workflows.
abstract: BACKGROUND
  To set up the review criteria for flow cytometry with CytoDiff (FCC) and evaluate the efficiency of different workflows using combinations of FCC with a hematology analyzer and microscopy.
  
  
  METHODS
  Leucocyte differentials of the samples from 995 clinical specimens and 278 specimens from healthy donors were analyzed using a hematology analyzer, FCC, and microscopy.
  
  
  RESULTS
  The correlations between the hematology analyzer, FCC, and microscopy were good for neutrophils, lymphocytes, and monocytes, but not in the case of basophils (r = 0.464, 0.358, 0.33) and eosinophils (r = 0.69, 0.67, 0.621). As a reference method of WBC differential using microscopy, the threshold of blasts for FCC was defined by a ROC curve at 1% (specificity 97.9%, sensitivity 97.5%, AUC 0.989). The optimal cutoff of immature granulocytes for FCC was 1% (specificity 85.8%, sensitivity 76.5%, AUC 0.866). The optimal cutoff of lymphocytes, neutrophils, and monocytes were 50%, 85% and 12%, respectively. According to the review criteria, the workflow of CBC after FCC and then microscopy had the highest sensitivity (97.07%), lower false negative rate (2.93%), and higher accuracy (80.3%) compared with others.
  
  
  CONCLUSIONS
  Our study integrated FCC into a WBC differential workflow in a routine laboratory and, for the first time, demonstrates the efficiency of different workflows. It can be used for reference in the selection of different hematology workflows.
authors.forename: Chenxue
authors.initials: C
authors.lastname: Qu
authors.forename: Jianzhong
authors.initials: J
authors.lastname: Wang
authors.forename: Chengwei
authors.initials: C
authors.lastname: Pu
authors.forename: Ying
authors.initials: Y
authors.lastname: Xing
authors.forename: Ke
authors.initials: K
authors.lastname: Shang
authors.forename: Ning
authors.initials: N
authors.lastname: Dong
authors.forename: Xiufeng
authors.initials: X
authors.lastname: Li
mesh_terms: D002454:Cell Differentiation; D005434:Flow Cytometry; D006801:Humans; D007958:Leukocyte Count; D007962:Leukocytes; D015203:Reproducibility of Results; D057188:Workflow