Sysmex XN-9000 Hematology Analyzer Can Provide Reference for the Classification of Nucleated Cells in Body Fluid and Detect Malignant Serous Effusion.

OBJECTIVE

The purpose of this study is to evaluate the accuracy of Sysmex XN-9000 hematology analyzer (XN-9000) in detecting nucleated cell classifications in serous effusion and to further evaluate whether it can be used for screening malignant serous effusion.

METHODS

The consistency between XN-9000 and manual microscopy in the classification of nucleated cells was evaluated using Passing-Bablok regression and Bland-Altman plot. ROC analysis was applied to evaluate the value of HF-BF% in screening malignant specimens.

RESULTS

In the serous effusion of the group with nucleated cell count of (0-150) ×106/μL, high consistency between XN-9000 and manual microscopy was found in detecting NE-BF% and LY-BF%. In the group with nucleated cell count >150×106/μL, there was high consistency in detecting NE-BF%, LY-BF%, and HF-BF%. ROC analysis showed that HF-BF% can be used for screening malignant serous effusion, with an area under the curve (AUC) of 0.572 (95%CI=0.504~0.639).

CONCLUSION

If XN-9000 detection results are mainly NE-BF% and LY-BF%, the classification can be effectively referred to and reported regardless of the number of nucleated cells in the serous effusion. HF-BF% has certain value in screening malignant serous effusion with a nuclear cell count >150×106/μL. The optimal cut-off value is 13.15%.