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Background <p>Cerebrospinal fluid (CSF) cytology is essential for diagnosing neurological disorders. Automated analysers offer faster results, but their accuracy in cell differentiation remains debated. This study compares CSF cytology using the Sysmex XN–1000 analyser with manual counting in the Fuchs–Rosenthal (F–R) chamber.</p> Methods <p>A total of 89 CSF samples from patients aged 10&#xa0;days to 80&#xa0;years were analysed. Manual counting was performed using the F–R chamber, while the Sysmex XN–1000 measured cell counts in body fluid mode. Statistical comparisons in Medcalc software included the Shapiro–Wilk test, Wilcoxon test, Bland–Altman plots, Mann–Whitney test, and Cohen’s kappa coefficient.</p> Results <p>There were no statistically significant differences between the F–R chamber compared to Sysmex in mononuclear cells (MNc). Statistical significance was defined as <i>P</i> &lt; 0.05. Data presented as median [min–max]): 10 [1–724]/µl vs. 9 [0–670]/µl resp. (<i>P</i> = 0.1286); and in red blood cells (RBC): 36 [0–18,091]/µl –&#xa0;vs. 0 [0–34,000]/µl resp. (<i>P</i> = 0.5412). However, there were statistically significant changes in polymorphonuclear cells (PMNc) (<i>P</i> = 0.0002) using the F–R chamber – 0 [0–1,428]/µl in comparison with Sysmex – 1 [0–1,008]/µl. Cohen’s kappa analysis demonstrated a very good strength agreement (<i>K</i> = 0.89) in the classification of oligocytosis and pleocytosis.</p> Conclusions <p>The Sysmex XN–1000 is a fast and efficient tool for CSF cytology but it has limitations, especially in differentiating PMNc in siderophage–rich neonatal samples. Although it improves workflow, manual verification remains crucial for diagnostic accuracy.</p>

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Comparison of Quantitative Cerebrospinal Fluid Cytology Using Manual Counting and the Sysmex XN–1000

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年11月25日

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  • Simona Kukrálová,
  • Pavel Brož,
  • Jana Černá,
  • Klára Koldušková,
  • Eliška Naušová,
  • Jana Ženková,
  • Daniel Rajdl,
  • Jaroslav Racek

摘要

Background

Cerebrospinal fluid (CSF) cytology is essential for diagnosing neurological disorders. Automated analysers offer faster results, but their accuracy in cell differentiation remains debated. This study compares CSF cytology using the Sysmex XN–1000 analyser with manual counting in the Fuchs–Rosenthal (F–R) chamber.

Methods

A total of 89 CSF samples from patients aged 10 days to 80 years were analysed. Manual counting was performed using the F–R chamber, while the Sysmex XN–1000 measured cell counts in body fluid mode. Statistical comparisons in Medcalc software included the Shapiro–Wilk test, Wilcoxon test, Bland–Altman plots, Mann–Whitney test, and Cohen’s kappa coefficient.

Results

There were no statistically significant differences between the F–R chamber compared to Sysmex in mononuclear cells (MNc). Statistical significance was defined as P < 0.05. Data presented as median [min–max]): 10 [1–724]/µl vs. 9 [0–670]/µl resp. (P = 0.1286); and in red blood cells (RBC): 36 [0–18,091]/µl – vs. 0 [0–34,000]/µl resp. (P = 0.5412). However, there were statistically significant changes in polymorphonuclear cells (PMNc) (P = 0.0002) using the F–R chamber – 0 [0–1,428]/µl in comparison with Sysmex – 1 [0–1,008]/µl. Cohen’s kappa analysis demonstrated a very good strength agreement (K = 0.89) in the classification of oligocytosis and pleocytosis.

Conclusions

The Sysmex XN–1000 is a fast and efficient tool for CSF cytology but it has limitations, especially in differentiating PMNc in siderophage–rich neonatal samples. Although it improves workflow, manual verification remains crucial for diagnostic accuracy.