Evaluation of Mindray BC-6800 body fluid mode for automated cerebrospinal fluid cell counting

Abstract

BC-6800-BF offers rapid and accurate counts in clinically relevant concentration ranges, replacing LM for most samples. However, in samples with abnormal cell counts or with abnormal white blood cell differential scattergrams the need to microscopic review for a correct clinical outcome remains.

Lack of harmonization in high fluorescent cell automated counts with body fluids mode in ascitic, pleural, synovial, and cerebrospinal fluids

“…The intercepts were comprised between −4.9 for MN‐BF and 12.0 for PMN‐BF using BC‐BF (Table ). The bias calculated with Bland‐Altman plots was then comprised between −97.0% for EO‐BF using the XN‐BF and 40.3% for PMN‐BF using BC‐BF …”

“…The statistical significance was set at P < 0.05 with a H0 hypothesis “the agreement beyond chance is greater than or equal to 0.6” by Z test. Cell counts in BF samples were then classified as negative or positive according to the following instrument‐specific cut‐offs AF: XN‐PMN‐ BF ≥190 × 10 6 /L and BC‐PMN‐BF ≥170 × 10 6 /L; PF: XN‐MN‐BF ≥72%, XN‐PMN‐BF ≥33% and BC‐MN‐BF ≥70%, BC‐PMN‐ BF≥30%; SF: TC ≥1700 × 10 6 /L with PMN ≥65% for both analyzers; CSF: XN‐WBC‐BF ≥5 × 10 6 /L and BC‐WBC‐BF ≥4 × 10 6 /L …”

“…Cell counting and classification in body fluids (BFs; ascitic [AF], pleural [PF], synovial [SF], and cerebrospinal [CSF]) has become very popular in recent times due to enhanced availability of new commercial instrumentation . Carried out using suitable analyzers, automated cell count can now be regarded as a useful screening, since is adequately precise, may substantially reduce the turnaround time (TAT), is available 24 hours a day, and allows better standardization of the analytical process …”

“…Although all hematological analyzers (also referred to as “hemocytometers”) equipped with the BF‐mode can generate both quantitative and qualitative measures, these parameters differ among the various commercial analyzers, being mostly instrument‐dependent. Quantitative parameters may include total cell count (TC), leukocyte count (WBC) and, sometimes, differential cell count capable to discriminate between polymorphonuclear (PMN) and mononuclear (MN) leukocytes . The two hematological analyzers of Sysmex XN series (Sysmex, Kobe Japan) and the Mindray BC‐6800 (Mindray, Shenzhen, China) are equipped with a BF‐mode channel dedicated to cell count and classification, which is based on optical fluorescence reading, selective lysis of red blood cells (RBCs), along with specific hardware and fluidics.…”

“…The XN‐module in BF mode (XN‐BF) provides the following diagnostic parameters: TC (XN‐TC‐BF), WBC (XN‐WBC‐BF), PMN (XN‐PMN‐BF), MN (XN‐MN‐BF), and high fluorescent cells (XN‐HF‐BF) counts, as well as additional research parameters such as neutrophil (XN‐NE‐BF), lymphocyte (XN‐LY‐BF), monocyte (XN‐MO‐BF), and eosinophil (XN‐EO‐BF) counts . The BC‐6800 in BF mode (BC‐BF) generate TC (BC‐TC‐BF), WBC (BC‐WBC‐BF), PMN (BC‐PMN‐BF), MN (BC‐MN‐BF), and high fluorescent cells (BC‐HF‐BF) counts, along with other research parameters such as neutrophil (BC‐NE‐BF) and eosinophil (BC‐EO‐BF) counts . For both XN‐BF and BC‐BF modes, the number of cells classified as HF‐BF is significantly correlated with the presence of mesothelial and/or various neoplastic cells .…”