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Automated cell counts on CSF samples: A multicenter performance evaluation of the GloCyte system
Author(s) -
Hod E. A.,
Brugnara C.,
Pilichowska M.,
Sandhaus L. M.,
Luu H. S.,
Forest S. K.,
Netterwald J. C.,
Reynafarje G. M.,
Kratz A.
Publication year - 2018
Publication title -
international journal of laboratory hematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.705
H-Index - 55
eISSN - 1751-553X
pISSN - 1751-5521
DOI - 10.1111/ijlh.12728
Subject(s) - hemocytometer , blood cell , cell counting , cell , cerebrospinal fluid , medicine , biology , immunology , pathology , biochemistry , cell cycle
Objectives Automated cell counters have replaced manual enumeration of cells in blood and most body fluids. However, due to the unreliability of automated methods at very low cell counts, most laboratories continue to perform labor‐intensive manual counts on many or all cerebrospinal fluid ( CSF ) samples. This multicenter clinical trial investigated if the GloCyte System (Advanced Instruments, Norwood, MA ), a recently FDA ‐approved automated cell counter, which concentrates and enumerates red blood cells ( RBC s) and total nucleated cells ( TNC s), is sufficiently accurate and precise at very low cell counts to replace all manual CSF counts. Methods The GloCyte System concentrates CSF and stains RBC s with fluorochrome‐labeled antibodies and TNC s with nucleic acid dyes. RBC s and TNC s are then counted by digital image analysis. Residual adult and pediatric CSF samples obtained for clinical analysis at five different medical centers were used for the study. Cell counts were performed by the manual hemocytometer method and with the GloCyte System following the same protocol at all sites. The limits of the blank, detection, and quantitation, as well as precision and accuracy of the GloCyte, were determined. Results The GloCyte detected as few as 1 TNC /μL and 1 RBC /μL, and reliably counted as low as 3 TNC s/μL and 2 RBC s/μL. The total coefficient of variation was less than 20%. Comparison with cell counts obtained with a hemocytometer showed good correlation (>97%) between the GloCyte and the hemocytometer, including at very low cell counts. Conclusions The GloCyte instrument is a precise, accurate, and stable system to obtain red cell and nucleated cell counts in CSF samples. It allows for the automated enumeration of even very low cell numbers, which is crucial for CSF analysis. These results suggest that GloCyte is an acceptable alternative to the manual method for all CSF samples, including those with normal cell counts.