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Introduction: The Sysmex® XE-2100D is a multiparameter hematology analyzer designed for hematology testing in samples with ethylenediamine tetraacetic acid (EDTA). Objectives: Considering the importance of this hematology analyzer for clinical and laboratory practice, the objective of this study was to evaluate its analytical performance, comparing the obtained results with quality specifications described in literature. Material and method: In the evaluation of analytical performance, according to recommendations of the document H26-A2 of the Clinical and Laboratory Standards Institute (CLSI), intra-run imprecision, inter-run imprecision, linearity, carryover, autosampler evaluation, clinical sensitivity of the atypical lymphocytes flag (n = 400 samples) were included, as well as the comparison between automated and manual leukocyte differential count (n = 400 samples), based on an adaptation of the document H20-A2 of CLSI. Results: Repeatability, reproducibility, linearity and carryover were satisfactory according to the manufacturer's specifications. The clinical sensitivity of the atypical lymphocytes flag showed efficiency, sensitivity and specificity of 92.5%, 65.2% and 94.1% respectively. The correlation coefficients between the automated and manual differential counts of neutrophils, lymphocytes, monocytes, eosinophils and basophils were 0.991, 0.99, 0.872, 0.974 and 0.557, respectively. Conclusions: The results were in accordance with quality specifications described in literature, indicating reliability in Sysmex® XE-2100D. This fact ensures certainty to both laboratory professionals and medical staff. We conclude that the Sysmex® XE-2100D showed excellent analytical performance, and is useful to provide reliable hematology data...
Introdução: O Sysmex® XE-2100D é um analisador hematológico multiparamétrico destinado à realização de testes hematológicos em sangue anticoagulado com ácido etilenodiamino tetra-acético (EDTA). Objetivos: Considerando a sua importância na prática clínica e laboratorial, o objetivo deste estudo foi avaliar seu desempenho analítico, comparando os resultados obtidos com especificações de qualidade descritas na literatura. Material e método: Na avaliação de desempenho analítico, conforme recomendações do documento H26-A2 do Clinical and Laboratory Standards Institute (CLSI), foram incluídos ensaios de verificação da imprecisão intraensaio ou repetitividade, imprecisão entre ensaios ou reprodutibilidade, linearidade, carryover (arraste), avaliação do mecanismo homogeneizador de amostras, sensibilidade clínica do alerta morfológico (flag) de linfócitos atípicos (n = 400 amostras) e a comparação entre a contagem diferencial de leucócitos automatizada e a manual (n = 400 amostras), baseada em uma adaptação do documento H20-A2 do CLSI. Resultados: Os ensaios de verificação da repetitividade, reprodutibilidade, linearidade, carryover (arraste) foram satisfatórios conforme especificações do fabricante. O ensaio de sensibilidade clínica do alerta morfológico (flag) de linfócitos atípicos mostrou eficiência, sensibilidade e especificidade de 92,5%; 65,2% e 94,1% respectivamente. Os coeficientes de correlação entre as contagens diferenciais automatizadas e manuais de neutrófilos, linfócitos, monócitos, eosinófilos e basófilos foram de 0,991; 0,99; 0,872; 0,974 e 0,557 respectivamente...
Subject(s)
Humans , Automation, Laboratory/methods , Automation, Laboratory/standards , Quality Control , Hematologic Tests/methods , Hematologic Tests/standardsABSTRACT
Objective To investigate the application of lymphocyte parameters in screening the lymphocyte proliferation and re-active hyperplasia disease.Methods 128 cases as the healthy control,100 cases of lymphoma,35 cases of multiple myeloma(MM), 34 cases of lymphocytes reactive hyperplasia(RL)and 5 cases of chronic lymphocytic leukemia(CLL)were selected and performed the peripheral blood cells analysis by the Sysmex XE-2100 hematology analyzer.The relevant lymphocyte parameter values were re-corded and the comparative analysis in the difference between the disease groups and the control group was performed.The role of each lymphocyte parameter in screening the lymphocyte proliferation and reactive hyperplasia diseases was evaluated by the receiver operating characteristic curve(ROC curve).Results The high fluorescence lymphocytes(HFL),in the control group was 0.008 ± 0.008,in the lymphoma group was 0.016±0.058,in the MM group was 0.019 ±0.063,in the RL group was 0.040 ±0.070,and CLL group was 0.388±0.158.Compared with control group,the difference of RL and CLL group was statistically significant(P morphological changes of lymphocytes sensitively and contribute to screening the patients with lymphocyte proliferation and reactive hyperplasia disease.
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Since the advent of automation in the fi eld of hematological cell counters there has been a constant refi nement of the technology and increase in the number of newer parameters available on CBC analysers. Many novel parameters are being put into routine clinical use and both clinical evaluation and monitoring critically depend on knowledge of laboratory reference ranges. Here, we present reference interval for the Sysmex XE-2100, with emphasis on the novel or newer research parameters. Blood samples from a total of 122 clinically asymptomatic and apparently healthy subjects were evaluated and a fi nal of 100 subjects (54-M, 46-F) were included in the study. A broad spectrum of parameters available with the analyser was assessed and reference ranges for the same evaluated.
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Background: There are several methods for counting platelets, of which the international fl ow reference method (IRM) is considered to be the gold standard. We compared the platelet count given by this method to the count given by automated analyzers using other methods, such as optical fl uorescence and impedance. Aims: The aim of this study is to compare the platelet counts obtained by Sysmex XE 2100 by Impedance (Sysmex-I), optical fl orescence (Sysmex-O) and reported (Sysmex-R) based on the switching algorithm and LH-750 by Impedance (LH-750) with the IRM in thrombocytopenic blood samples. To calculate the sensitivity, specifi city, positive predictive value (PPV) and negative predictive value (NPV) of various technologies at the clinically relevant transfusion thresholds of 10 × 109/l and 20 × 109/l. Materials and Methods: A total of 118 blood samples with platelet count of <50 × 109/l were selected for the study. Platelet counts of all samples were analyzed by all methods using the Sysmex analyzer, LH-750 and IRM in parallel within 6 h of collection. Statistical Analysis Used: Pearson correlation, bland Altman analysis, sensitivity and specifi city, PPV and NPV. Results and Conclusions: Sysmex-R had the least Bias and 95% limits of agreement (95%LA) range and thus correlated best with IRM values. LH-750 had a higher Bias compared to Sysmex-O and Sysmex-R, but a strikingly similar 95% LA ensures similar results in all three methods. In fact, in the oncology subset, it had the narrowest 95% LA, which made it the best performer in this subgroup. Of the three Sysmex results, Sysmex-I had the highest bias, widest 95% LA and highest potential risk of over transfusion. Hence, Sysmex-R and LH-750 were found to be reliable tools for estimation of platelet count in thrombocytopenic patients.
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Background: Diagnosis of malaria is usually made by microscopy [Giemsa, Acridine Orange (AO), and Quantitative Buffy Coat (QBC) assay], which requires expertise. Currently, automated haematology analyzers are being used for complete blood count (CBC), in all acute febrile and non-febrile illnesses which simultaneously detects malaria. The normal scattergram by the analyzer (Sysmex 2100) comprises of five parameters i.e. lymphocytes (pink), monocytes (green), neutrophils (blue), eosinophils (red) with a space between the neutrophil and eosinophil populations. Aims : We carried out a prospective study to compare the efficacy of Sysmex XE-2100 (Sysmex Corporation, Kobe) for detection of malaria in comparison to other conventional techniques. Materials and Methods : 430 cases were analyzed for malaria by microscopy (QBC, AO, Giemsa), ICT (Immunochromatography) and flowcytometric analyzer (Sysmex XE-2100). The abnormal scattergrams were observed as double neutrophil, double eosinophil, grey zone, extended neutrophil zone with a decrease space between eosinophil and neutrophil, and a combination of above patterns. Results : Out of 70 positive cases [49/70 (70%) P. vivax, 18/70 (25.7%) P. falciparum, and 3/70 (4.2%) both P. vivax and P. falciparum], 52 showed abnormal scattergrams by the analyzer. The sensitivity and specificity of hematology analyzer found to be 74.2% and 88%, respectively. Conclusion : Flowcytometric analyzer is a rapid, high throughput device which needs less expertization for the diagnosis of malaria. Hence, it can be used in the diagnostic laboratories as an early modality for diagnosis of malaria in suspected as well as clinically in apparent cases.
Subject(s)
Autoanalysis/instrumentation , Blood Cell Count/instrumentation , Flow Cytometry/instrumentation , Hematologic Tests/instrumentation , Humans , Malaria/diagnosis , Malaria, Falciparum/diagnosis , Malaria, Vivax/diagnosis , Plasmodium falciparum/analysis , Plasmodium vivax/analysis , Sensitivity and SpecificityABSTRACT
BACKGROUND: Immature platelet fraction (IPF, %) is a measure of reticulated platelets (RPs), which represents the state of thrombopoiesis. The IPF is obtained from an automated hematology analyzer as one of the platelet parameters. This study was performed to establish reference intervals of IPF and its cut-off values for the differential diagnosis of thrombocytopenia. METHODS: Blood samples from 2,039 healthy individuals (1,161 males, 878 females) were obtained to establish reference intervals. The patient group included patients with idiopathic thrombocytopenic purpura (ITP) (N=150) and aplastic anemia (AA) (N=51) with platelet counts of less than 100x10(9)/L. We evaluated the reliability of the IPF measurements, the reference intervals, and cut-off value for the diagnosis of ITP. RESULTS: The reference intervals of IPF were 0.5-3.2% in males and 0.4-3.0% in females (95% confidence interval). The median IPF% of ITP and AA were 7.7% (range, 1.0-33.8%) and 3.5% (range, 0.6-12.9%), respectively. Statistical analysis revealed a significant difference between the IPF% of ITP and AA (P<0.0001). The cut-off value of IPF for differentiating ITP from AA was 7.3% with a sensitivity and specificity of 54.0% and 92.2%, respectively. CONCLUSIONS: A rapid and inexpensive automated measurement of IPF can be integrated as a standard parameter to evaluate the thrombopoietic state of the bone marrow. This study determined the reference intervals of IPF from a large population of healthy individuals, including children. Further studies are needed to establish the clinical utility of IPF.
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BACKGROUND: The main causes of thrombocytopenia in cirrhosis are thought to be platelet destruction and the reduction of thrombopoietin (TPO) expression in the liver. Immature platelet fraction (IPF) has been measured by a fully automated analyzer (Sysmex XE-2100, Japan) as reticulated platelet (RP), which is reflected with thrombopoiesis in bone marrow. In this study, we tried to compare the percentage of IPF (IPF) with that of RP (RP) in patients with liver cirrhosis (LC) and controls. METHODS: We compared IPF to RP in 72 liver cirrhosis patients and 30 healthy normal controls. RP was stained with acridine orange, followed by FC500 (Beckman Coulter, USA) analysis and the IPF was identified by flow cytometry with the use of a nucleic acid specific dye in the reticulocyte channel on the Sysmex XE-2100 (TOA Medical Electronics Co., Ltd., Japan). RESULTS: IPF value in the healthy control was 2.2% (1.7-5.2). RP and IPF were significantly higher in the patients with liver cirrhosis (P<0.05). IPF appeared to be correlated with RP (y=0.19x+3.35, r=0.34, P<0.05). In ROC for diagnosis of LC, IPF was significantly more useful than RP. CONCLUSIONS: This results show that a rapid, inexpensive automated method for measuring the IPF is feasible and should become a standard parameter in evaluating reticulated platelets.
Subject(s)
Aged , Female , Humans , Male , Middle Aged , Liver Cirrhosis/complications , Platelet Count/methods , Stem Cells/cytology , Thrombocytopenia/diagnosisABSTRACT
Objective To evaluate the identification and counting effeciency of nucleated red blood cells by Sysmex XE-2100 Hematology Analyzer. Methods Accurancy: nucleated red blood cells were counted from 38 specimens by Sysmex XE-2100 Hematology Analyzer and compared with the number counted under microscopy. Precision: 3 specimens with different values were counted for the nucleated red blood cells 10 times by Sysmex XE-2100 Hematology Analyzer and compared with the number counted under microscopy. The CV(% ) value was estimated.Results There was insignificant difference between the results obtained from Sysmex XE-2100 Hematology Analyzer and those under microscopy. In the T-test, P >0.05, r=0.9893(P< 0.01).CV(% ) were 8.1% and 15.8% . It means that the Sysmex XE-2100 is more precise in analyzing the nucleated red blood cells than that under microscopy. Conclusion The nucleated red blood cells count by Sysmex XE-2100 is accurate and fast to obtain clinical data.
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Objective To evaluate the influence of the storing time of venous blood samples on the differential count of WBC by Sysmex XE-2100 hematology analyzer. Methods At room temperature, the precision of the differential count of WBC by Sysmex XE-2100 hematology analyzer were tested. 38 samples were taken the differential count of WBC by Sysmex XE-2100 hematology analyzer after stored for 0, 2, 4, 8, 24 and 48 h. Differential count of WBC was also taken under microscope for comparison. Results The precision of differential count of WBC by Sysmex XE-2100for all the samples was in the allowable range. The correlation coefficient of the differential count of WBC by two methods for neutrophils, lymphocytes, monocytes, eosinophils and basophils were 0.9859, 0.9775, 0.8053, 0.8695and 0.5243 (P<0.01). There was insignificant difference in the test at 8h, very significant difference of MONO and EOS at 48 h. Differences of EOS, MONO between two methods were significant increased at 8 h. Conclusion At room temperature, the differential count of WBC of venous blood samples by Sysmex XE-2100 hematology analyzer should finish within 8 h.