Comparative Evaluation of Body Fluid Analysis by Sysmex XN Hematology Analyzers, CellaVision, Manual Microscopy and Multicolor Flow Cytometry.

OBJECTIVE:The aim of this study was to investigate the correlation between instrumental and morphological cell differential methods in body fluid (BF) samples.METHODS:Forty ascitic (AF) and forty cerebrospinal (CSF) fluid samples were measured with Sysmex XN1000 and XN2000 instruments in BF mode. Flow cytometry (FC) was carried out with FACS Canto II. From the centrifuged cytospin preparations mononuclear (MN%) and polymorphonuclear (PMN%) cell percentages were determined using optical microscopy (OM) and a digital cell morphology system CellaVision (CV).RESULTS:Both Passing-Bablok and Bland-Altman analysis showed strong correlation between the hematology analyzers for total cell count (TC), white blood cell count (WBC), MN%, and PMN% in BFs. With slightly inferior results, all other WBC differential methods showed acceptable correlation. Passing-Bablok regression analysis yielded a slope encompassing 1.0 in all method comparisons except for three scenarios in CSF. The bias calculated with Bland-Altman plots was comprised between -6.05% and 6.05%. Strong correlations were found when comparing XN1000, XN2000, and CV to OM and FC method with linear regression analysis (r values between 0.905 and 0.984).CONCLUSION:We found strong correlation between instrumental and manual morphological WBC differential methods when testing BF samples containing no tumor cells.