Flow-cytochemical Differential Leukocyte Analysis with Quantitation of Neutrophil Left Shift:<i>An Evaluation of the Cobas-Helios Analyzer</i>

Bentley, Stuart; Johnson, Terrence S.; Sohier, Catherina H.; Bishop, Connie A.

doi:10.1093/ajcp/102.2.223

Cited by 13 publications

(8 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Based on the coefficient of variation as a measure of basophil reproducibility, hematology analyzers usually appeared exceptionally imprecise (1,3,5,7), which is consistent with our findings. However, we found the number of theoretically differentiated leukocytes to be in the same range as for other leukocyte classes (12), which indicated that to a great extent this high imprecision is due to the smallness of the basophil population rather than only to differentiation-related problems.…”

Section: Discussion Precisionsupporting

confidence: 91%

“…Basophil count results frequently showed a high imprecision and poor results in regression analysis against the manual differential, the presently accepted reference method (1)(2)(3)(4)(5). Some investigators conceded that, due to the inadequacies of this reference method (5)(6)(7) and the shortcomings of least-squares linear regression (3), the validity of these results was doubtful.This situation, however, is far from satisfying considering the time and money manufacturers have spent on implementing basophil counting on their hematology analyzers.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Evaluation of automated basophil counting by using fluorescence-labelled monoclonal antibodies

Hübl

Andert

Erath

et al. 1996

J. Clin. Lab. Anal.

View full text Add to dashboard Cite

Section: Discussion Precisionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

Evaluation of automated basophil counting by using fluorescence-labelled monoclonal antibodies

Hübl

Andert

Erath

et al. 1996

J. Clin. Lab. Anal.

View full text Add to dashboard Cite

“…1), our correlation results of the STKS were better than in most other studies (3,8,9,22,23). The mean negative bias against the manual dif- •Inc., Branchburg, NJ, USA), which is very similar to the Argos, and found a positive mean bias (24), probably due to a different setting of discriminators in the Argos scattergramme. Such an.…”

Section: Precisionmentioning

confidence: 67%

Peripheral Blood Monocyte Counting: Towards a New Reference Method

Hübl

Andert²,

Erath³

et al. 1995

CCLM

View full text Add to dashboard Cite

Flow cytometric enumeration of monocytes stained with fluorescence-labelled monoclonal antibodies has been proposed as a possible reference method for monocyte counting. We compared precision and accuracy of monocyte counting of the Coulter STKS, the Cobas Argos 5 Diff, the 800-cell manual differential, and the Coulter Epics Profile II flow cytometer using double-staining with fluorescence-labelled monoclonal antibodies (CD45-F1TC and CD14-PE).Precision: STKS, Argos and Profile II achieved a precision analogous to a 3423-, 1298-, and 11089-cell differential, respectively, confirming the superiority of automated methods. Accuracy (136 normal and abnormal samples): Correlation of automated methods with the manual differential was good (STKS: r = 0.934, Argos 5 Diff: r = 0.808, Profile : r = 0.924; Spearman's rank correlation coefficient). The mean relative STKS monocyte result was 0.52 ± 1.63% (mean i SD) higher than the manual differential, whereas the Argos 5 Diff results were 1.22 ± 2.51% lower (p < 0.001). Profile II results showed a small bias against the manual differential (-0.18 ± 1.44%, p < 0.05).Analysing 135 healthy adult subjects on the Profile II, males were found to have a higher mean monocyte count (relative count: 6.95 ± 1.43% vs. 5.86 ± 0.98%; absolute count: 0.48 ± 0.15 X 10 9 /1 vs. 0.39 ± 0.11 X 10 9 /1, p < 0.001) and a higher and wider normal range than females (relative count: 4.97 to 9.78% vs. 4.26 to 7.81%, absolute count: 0.30 to 0.84 X 10 9 /1 vs. 0.25 to 0.65 X 10 9 /1).Flow cytometry based on fluorescence-labelled monoclonal antibodies for monocyte enumeration seems an efficient tool to evaluate the monocyte counting performance of haematology analysers and an ideal successor to the manual differential as reference method for monocyte counting. IntroductionEvaluations of the differential leukocyte count of haem-cannot be the main reason for this, as the less frequent atology analysers have often yielded satisfactory results eosinophils usually showed good results (1-8, 11). The for neutrophils, lymphocytes, and eosinophils, whereas morphological variety of monocytes definitely poses the performance of monocyte counting has been disap-problems for automated differentiating techniques, anpointing (1^8), even when studying only normal sam-other serious problem being lack of an appropriate referples (9, 10). The correlation with the reference method ence method. The value of the manual 400-cell difwas frequently poor and both accuracy and precision ferential, which is still used as reference in monocyte worse than for other leukocyte classes. Although mono-counting (12), is diminished by subjectivity of the examcytes represent a relatively small leukocyte class, this iner (13) and a low precision for smaller cell populations Eur J Clin Chem Clin Biochem 1995; 33 (No 11) Brought to you by | University of Arizona Authenticated Download Date | 7/20/15 8:35 PM

show abstract

“…[9][10][11] Despite the effort put into the development of analyzer flagging, its efficiency in the present study was not substantially superior to that of the absolute neutrophil count.…”

Section: Detection Of Left Shiftmentioning

confidence: 85%

Value of Neutrophil CD16 Expression for Detection of Left Shift and Acute-Phase Response

et al. 1997

View full text Add to dashboard Cite

Fey RIII (CD16) expression of neutrophil granulocytes was measured in 156 patients by means of fluorescence-labeled antibodies with a flow cytometer. Results were compared with (1) 400-cell manual differential count; (2) left shift flagging on hematology analyzers; (3) absolute neutrophil count; and (4) acute-phase protein levels. Asynchrony was noted between neutrophil CD16 expression and microscopically defined neutrophil stage, particularly in heavily left-shifted samples, which made it impossible to reliably enumerate immature neutrophils on the basis of CD16 expression. According to receiver operating characteristics, the absolute count of CD16-negative neutrophils was highly discriminatory for detection of left shift, with an area under the curve (AUC) of 0.842 ± 0.03 (SE) and maximum efficiency of 81% ± 3%, but absolute neutrophil count was not significantly inferior (0.821 ± 0.03 and 76% ± 3%).Some investigators question the clinical value of detection of left shift or band cells.1-5 ; others consider left shift a valuable sign for a neutrophil reaction, particularly in neonatal or pediatric patients, who may not demonstrate an increase in total neutrophil count or a humoral response of acute-phase proteins.6-8 However, both automated and manual methods of detecting left shift have serious shortcomings. Most hematology analyzers report flags designed to indicate left shift, but instrument evaluations have shown the efficiency of the flagging algorithms to be insufficient, 9,10 especially for detection of band cells.11 Lack of an adequate reference method for enumeration of band cells or immature granulocytes is one problem. Manual differential counting is characterized by high imprecision, subjectivity of the examiner, and varying definition of band cells.2,4 ' 5,12 Even after uniform band identification criteria were defined, band results remained poorly reproducible. 13 In an effort to find alternative methods toFrom the Central Laboratory, Wilhelminenspital, Vienna, Austria.M a n u s c r i p t submitted April 2, 1996; revision accepted September 4,1996.Address reprint requests to Dr Hubl: Central Laboratory, Wilhelminenspital, Montleartstrasse 37, A-1171 Vienna, Austria.STKS and SE9000 flagging demonstrated efficiency of 76% ± 3% and 81% ± 3%, respectively. For detection of acute-phase response, absolute neutrophil count (AUC, 0.836 ± 0.04; maximum efficiency, 80% ± 4%) outperformed both quantitative neutrophil CD16 expression (0.760 ± 0.05; 75% ± 4%) and absolute CD16-negative neutrophil count (0.757 ± 0.05; 71% ± 4%); absolute band count performed similarly (0.853 ± 0.04; 79% ± 4%) and showed high efficiency at high sensitivity and specificity. Efficiency of analyzer flagging for detection of acute-phase response was not superior to absolute neutrophil count (STKS, 77% ± 4%; SE9000, 78% ± 4%). In conclusion, the diagnostic value of measuring neutrophil CD16 expression was generally similar to that of less complicated analytes.

show abstract

Flow-cytochemical Differential Leukocyte Analysis with Quantitation of Neutrophil Left Shift:An Evaluation of the Cobas-Helios Analyzer

Cited by 13 publications

References 0 publications

Evaluation of automated basophil counting by using fluorescence-labelled monoclonal antibodies

Evaluation of automated basophil counting by using fluorescence-labelled monoclonal antibodies

Peripheral Blood Monocyte Counting: Towards a New Reference Method

Value of Neutrophil CD16 Expression for Detection of Left Shift and Acute-Phase Response

Contact Info

Product

Resources

About