Comparison Evaluation of Automated Nucleated Red Blood Cell Enumeration by Sysmex XN 1000 in Comparison With Microscopic Reference in Children Under 1 Year

IF 2.6 4区医学 Q2 MEDICAL LABORATORY TECHNOLOGY Journal of Clinical Laboratory Analysis Pub Date : 2024-04-15 DOI:10.1002/jcla.25037

Sophie Brunner-Ziegler, Bernd Jilma, Gabriele Grimm, Petra Jilma-Stohlawetz

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Abstract

Background

In newborns, elevated nucleated red blood cell (NRBC) levels can be associated with enhanced erythropoietic stress and might be predictive for adverse outcome. Also, the presence of NRBC in peripheral blood might lead to erroneous enumeration results of white blood cells in automated hematology analyzers. We aimed to assess the comparability of the Sysmex XN 1000 to manual slide reviews and correlation of NRBC with inflammation markers.

Methods

Specimens of 3397 children under 1 year were compared by automated and microscopic NRBC enumeration. Additionally, potential correlations between NRBC and age and inflammation markers were examined.

Results

Overall, there was good correlation (r = 0.97) between automated (range: 0%–3883%) and microscopic enumeration (range: 0%–3694%) of NRBC with high comparability up to a NRBC value of 200% and an increase in the variation between the two methods with increasing NRBC numbers. When 94 samples with ≤ 200% NRBC and ≥ 30% divergence between methods were separately reanalyzed with respect to overlapping cell populations in their scattergrams, Sysmex would have generated unrecognized incorrect automated results in 47 samples, corresponding to 1.4% of total study samples. NRBC counts were negatively correlated to age, but not to inflammation markers.

Conclusion

Sysmex XN 1000 is highly precise in the enumeration of NRBC in children under 1 year up to counts of 200% and might replace time-intense manual counting in routine diagnostics. In the setting of neonatal and intensive care diagnostics, microscopic control and supervision of scattergrams are highly recommended for any automated NRBC enumeration processes.

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用 Sysmex XN 1000 对一岁以下儿童进行有核红细胞自动计数与显微镜参照的比较评估

背景在新生儿中，有核红细胞（NRBC）水平升高可能与红细胞生成压力增加有关，并可能预示着不良预后。此外，外周血中 NRBC 的存在可能会导致自动血液分析仪中白细胞计数结果的错误。我们的目的是评估 Sysmex XN 1000 与手动玻片审查的可比性以及 NRBC 与炎症标记物的相关性。结果总体而言，NRBC 的自动计数（范围：0%-3883%）与显微镜计数（范围：0%-3694%）之间具有良好的相关性（r = 0.97），在 NRBC 值达到 200% 时具有很高的可比性，并且随着 NRBC 数量的增加，两种方法之间的差异也在增加。如果对 NRBC 值≤ 200% 且两种方法之间差异≥ 30% 的 94 个样本分别重新分析其散点图中重叠的细胞群，Sysmex 会在 47 个样本中生成无法识别的错误自动结果，相当于研究样本总数的 1.4%。NRBC 计数与年龄呈负相关，但与炎症标志物无相关性。在新生儿和重症监护诊断中，强烈建议对任何自动 NRBC计数流程进行显微镜控制和散点图监督。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Clinical Laboratory Analysis 医学-医学实验技术

CiteScore

5.60

自引率

7.40%

发文量

584

审稿时长

6-12 weeks

期刊介绍： Journal of Clinical Laboratory Analysis publishes original articles on newly developing modes of technology and laboratory assays, with emphasis on their application in current and future clinical laboratory testing. This includes reports from the following fields: immunochemistry and toxicology, hematology and hematopathology, immunopathology, molecular diagnostics, microbiology, genetic testing, immunohematology, and clinical chemistry.