• Chérina Fleming, Henk Russcher, Rob Brouwer, Jan Lindemans, and Robert de Jonge.
• From the Department of Clinical Chemistry, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands.
• Am. J. Clin. Pathol. 2016 Mar 1; 145 (3): 299-307.

ObjectivesCounting cells in cerebrospinal fluid (CSF) using automated analyzers is generally problematic due to low precision at low cell numbers. To overcome this limitation, Sysmex (Kobe, Japan) developed the high-sensitive analysis (hsA) research mode specifically for counting cells in fluids that contain low cell counts. We evaluated this mode by counting RBCs, WBCs, and differentiated WBCs in CSF samples.MethodsWe analyzed 248 CSF samples using the hsA mode and compared these results with those obtained using the manual counting method. We also evaluated the linearity, detection limits, carryover, and precision of the hsA mode.ResultsUsing the hsA mode, the lower limit of quantification for RBCs and WBCs was 10 and 2 cells/μL, respectively. Comparing the two methods revealed good agreement with respect to WBCs (y = 1.08x + 0.52), RBCs (y = 1.07x + 0.00), lymphocytes (y = 1.00x + 0.00), neutrophils (y = 1.05x + 0.00), and monocytes (y = 0.88x + 0.07). Regression analysis for samples containing low WBCs (<10 cells/μL) and low RBCs (<50 cells/μL) also had good agreement, although a slight positive bias was found for RBCs. Linearity was good (r(2) ≥ 0.99) for all parameters evaluated. Carryover was negligible and never exceeded 0.04%.ConclusionsThe XN hsA research mode provides reliable cell counts in CSF samples, even in samples containing low numbers of WBCs and RBCs.© American Society for Clinical Pathology, 2016. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

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