D Labaere1, N Boeckx2,3, I Geerts1, M Moens1, M Van den Driessche1. 1. Department of Laboratory Medicine, Imelda Hospital, Bonheiden, Belgium. 2. Department of Laboratory Medicine, University Hospitals Leuven, Leuven, Belgium. 3. Department of Oncology, Catholic University of Leuven, Leuven, Belgium.
Abstract
INTRODUCTION: The body fluid mode of the Sysmex XN-2000 hematology analyzer differentiates cells into mononuclear and polymorphonuclear white blood cells (WBC) and high-fluorescent cells (HFC). The aim of this study was to evaluate the performance of the HFC count for detecting malignant cells in serous body fluids. METHODS: Two-hundred and thirty serous fluids were analyzed on the Sysmex XN body fluid mode. HFC were measured as relative count (HFC/100 WBC) and absolute count (HFC/μL). All samples were microscopically screened on cytospin slides for the presence of malignant cells. RESULTS: Malignant cells were found by microscopic examination in 49 of 230 samples (21.3%). Malignant samples contained significantly higher percentages (10.2 vs. 2.6/100 WBC) and absolute numbers (65 vs. 10/μL) of HFC than nonmalignant samples (P < 0.001). Areas under the ROC curve for relative and absolute HFC count were 0.69 and 0.77, respectively. A cutoff level of ≥17 HFC/μL showed the best performance to predict malignancy, with 88% sensitivity and 61% specificity. CONCLUSION: As serous body fluids will be more analyzed on automated analyzers in the future, HFC count can be a useful tool to select samples for microscopic review. Microscopic evaluation should be performed if HFC values are above a certain threshold (e.g. ≥17 HFC/μL) or in case of clinical suspicion of malignancy.
INTRODUCTION: The body fluid mode of the Sysmex XN-2000 hematology analyzer differentiates cells into mononuclear and polymorphonuclear white blood cells (WBC) and high-fluorescent cells (HFC). The aim of this study was to evaluate the performance of the HFC count for detecting malignant cells in serous body fluids. METHODS: Two-hundred and thirty serous fluids were analyzed on the Sysmex XN body fluid mode. HFC were measured as relative count (HFC/100 WBC) and absolute count (HFC/μL). All samples were microscopically screened on cytospin slides for the presence of malignant cells. RESULTS: Malignant cells were found by microscopic examination in 49 of 230 samples (21.3%). Malignant samples contained significantly higher percentages (10.2 vs. 2.6/100 WBC) and absolute numbers (65 vs. 10/μL) of HFC than nonmalignant samples (P < 0.001). Areas under the ROC curve for relative and absolute HFC count were 0.69 and 0.77, respectively. A cutoff level of ≥17 HFC/μL showed the best performance to predict malignancy, with 88% sensitivity and 61% specificity. CONCLUSION: As serous body fluids will be more analyzed on automated analyzers in the future, HFC count can be a useful tool to select samples for microscopic review. Microscopic evaluation should be performed if HFC values are above a certain threshold (e.g. ≥17 HFC/μL) or in case of clinical suspicion of malignancy.