Body fluid cellular analysis using the Sysmex XN-2000 automatic hematology analyzer: focusing on malignant samples

Area of Science:

• Hematology
• Clinical Chemistry
• Flow Cytometry

Background:

• Previous body fluid (BF) studies primarily used nonmalignant samples.
• The Sysmex XN analyzer's BF mode is recently launched.
• Evaluation focused on counting blood cells in malignant samples.

Purpose of the Study:

• To evaluate the Sysmex XN analyzer's body fluid (BF) mode for cell counting.
• To assess its performance with malignant body fluid samples.
• To compare automated counts with manual microscopy.

Main Methods:

• Analyzed 405 BF specimens, including 125 malignant samples.
• Compared automated analysis with manual microscopy.
• Utilized receiver operating characteristic (ROC) curve analysis for HF-BF cells.

Main Results:

• High agreement (R² > 0.88) for WBC, RBC, and differential counts in non-CSF samples.
• CSF samples showed slightly lower correlations.
• High fluorescence-BF (HF-BF) cells were significantly more frequent in malignant samples (17.8 vs. 4.15/100 WBC; P < 0.001).
• HF-BF cell analysis yielded an AUC of 0.791 for detecting malignancy.

Conclusions:

• Sysmex XN BF mode offers an alternative to manual counting with minor limitations.
• Microscopic examination is recommended if HF-BF cell concentration exceeds a threshold.
• Automated analysis aids in detecting malignant cells in body fluids.