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High Fluorescent Cells on Automated Body Fluid Analysis as Discriminator for Malignant Cell Detection.

Ankita Saini1, Rateesh Sareen1, G N Gupta1

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Automated analysis of body fluids (BF) using high fluorescence cells (HFC) effectively screens for malignancy. The Sysmex XN-1000 provides reliable cutoff values for detecting malignant cells in BF samples.

Keywords:
Sysmex XN-1000automationbody fluidhigh fluorescent cellsmalignant cells screening

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Area of Science:

  • Clinical diagnostics
  • Hematology
  • Cytopathology

Background:

  • Automated examination of body fluids (BF) is crucial for detecting malignant cells.
  • High fluorescence cells (HFC) identified by the Sysmex XN-1000 analyzer are potential indicators of malignancy.
  • Establishing reliable cutoff values for HFC is necessary due to limited literature.

Purpose of the Study:

  • To correlate HFC counts from automated analyzers with manual cytology for malignant cell detection in BF.
  • To establish specific cutoff values for HFC to screen BF samples for malignancy.

Main Methods:

  • A comparative study analyzed 120 BF samples (ascitic, pleural, CSF) from January 2019 to May 2020.
  • Samples underwent both automated analysis (Sysmex XN-1000) for HFC counts and manual cytopathological examination.
  • Receiver operating characteristic (ROC) curve analysis was used to determine cutoff values and assess diagnostic performance.

Main Results:

  • Malignant cells were detected in 50 (41.67%) of the BF samples.
  • Automated analyzers showed significantly higher white blood cell and median HFC counts in malignant samples compared to nonmalignant ones.
  • ROC analysis demonstrated that HF-BF parameters effectively distinguished benign from malignant fluids, with specific AUC, sensitivity, and specificity values for HF# and HF%.

Conclusions:

  • HFC counts in BF mode of Sysmex XN-1000 are valuable for predicting malignancy in serous fluids.
  • Recommended cutoff values of 15.70/µL for absolute HFC count and 5.05% for relative HFC count offer good sensitivity and specificity for screening BF samples.
  • Automated HFC analysis can aid in selecting samples for further microscopic examination, improving diagnostic efficiency.