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Monocyte counting: discrepancies in results obtained with different automated instruments
W Goossens1, L Van Hove, R L Verwilghen
1Department of Haematology, University Hospital, Gasthuisberg, Leuven, Belgium.
Journal of Clinical Pathology
|March 1, 1991
Summary
Automated cell counters show significant discrepancies in monocyte counts. Dual staining with CD45 and CD14 antibodies offers the closest agreement to visual counts, suggesting it as a reliable alternative for accurate monocyte enumeration.
Area of Science:
- Hematology
- Clinical Chemistry
- Immunology
Background:
- Accurate monocyte counting is crucial for diagnosing and monitoring various medical conditions.
- Existing automated cell counters exhibit considerable discrepancies in monocyte enumeration.
- A reliable reference method is essential for evaluating the accuracy of automated systems.
Purpose of the Study:
- To assess the accuracy of different automated cell counting methods for monocyte measurement.
- To compare automated monocyte counts against a visual reference method.
- To identify the most reliable automated technique for monocyte enumeration.
Main Methods:
- Analysis of monocyte counts from multiple automated cell counters.
- Comparison with a reference method using visual counting of 800 leukocytes.
- Evaluation of dual staining with monoclonal antibodies (CD45 and CD14) for monocyte identification.
- Assessment of six other automated counting systems, including those measuring a 'third population'.
Main Results:
- Significant discrepancies were observed among automated counters for normal blood monocyte counts.
- Dual staining with CD45 and CD14 antibodies showed the closest agreement with the visual reference method.
- Some automated systems underestimated monocytosis but correlated well, while others provided unreliable or overestimated counts.
- Systems measuring a 'third population' (monocytes plus other leukocytes) showed variable correlation with the reference method.
Conclusions:
- Problems exist in evaluating automated instruments for monocyte counting.
- The visual method, while accurate, is too cumbersome for routine use.
- Dual staining with fluorescence-labelled monoclonal antibodies (CD45 and CD14) is a viable and acceptable alternative reference method for accurate monocyte counting.