Flow cytometric enumeration of monocytes stained with fluorescence-labelled monoclonal antibodies has been proposed as a possible reference method for monocyte counting. We compared precision and accuracy of monocyte counting of the Coulter STKS, the Cobas Argos 5 Diff, the 800-cell manual differential, and the Coulter Epics Profile II flow cytometer using double-staining with fluorescence-labelled monoclonal antibodies (CD45-F1TC and CD14-PE).Precision: STKS, Argos and Profile II achieved a precision analogous to a 3423-, 1298-, and 11089-cell differential, respectively, confirming the superiority of automated methods. Accuracy (136 normal and abnormal samples): Correlation of automated methods with the manual differential was good (STKS: r = 0.934, Argos 5 Diff: r = 0.808, Profile : r = 0.924; Spearman's rank correlation coefficient). The mean relative STKS monocyte result was 0.52 ± 1.63% (mean i SD) higher than the manual differential, whereas the Argos 5 Diff results were 1.22 ± 2.51% lower (p < 0.001). Profile II results showed a small bias against the manual differential (-0.18 ± 1.44%, p < 0.05).Analysing 135 healthy adult subjects on the Profile II, males were found to have a higher mean monocyte count (relative count: 6.95 ± 1.43% vs. 5.86 ± 0.98%; absolute count: 0.48 ± 0.15 X 10 9 /1 vs. 0.39 ± 0.11 X 10 9 /1, p < 0.001) and a higher and wider normal range than females (relative count: 4.97 to 9.78% vs. 4.26 to 7.81%, absolute count: 0.30 to 0.84 X 10 9 /1 vs. 0.25 to 0.65 X 10 9 /1).Flow cytometry based on fluorescence-labelled monoclonal antibodies for monocyte enumeration seems an efficient tool to evaluate the monocyte counting performance of haematology analysers and an ideal successor to the manual differential as reference method for monocyte counting.
IntroductionEvaluations of the differential leukocyte count of haem-cannot be the main reason for this, as the less frequent atology analysers have often yielded satisfactory results eosinophils usually showed good results (1-8, 11). The for neutrophils, lymphocytes, and eosinophils, whereas morphological variety of monocytes definitely poses the performance of monocyte counting has been disap-problems for automated differentiating techniques, anpointing (1^8), even when studying only normal sam-other serious problem being lack of an appropriate referples (9, 10). The correlation with the reference method ence method. The value of the manual 400-cell difwas frequently poor and both accuracy and precision ferential, which is still used as reference in monocyte worse than for other leukocyte classes. Although mono-counting (12), is diminished by subjectivity of the examcytes represent a relatively small leukocyte class, this iner (13) and a low precision for smaller cell populations Eur J Clin Chem Clin Biochem 1995; 33 (No 11) Brought to you by | University of Arizona Authenticated Download Date | 7/20/15 8:35 PM