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Comparison between optical microscopy and automation for cytometric analysis of pericardial fluids in a cohort of adult subjects undergoing cardiac surgery
  1. Sabrina Buoro1,
  2. Michela Seghezzi1,
  3. Maria del Carmen Baigorria Vaca1,
  4. Barbara Manenti1,
  5. Valentina Moioli1,
  6. Giulia Previtali1,
  7. Caterina Simon2,
  8. Diego Cugola2,
  9. Antonio Brucato3,
  10. Cosimo Ottomano4,
  11. Giuseppe Lippi5
  1. 1 Clinical Chemistry Laboratory, ASST Papa Giovanni XXIII, Bergamo, Italy
  2. 2 Cardiac Surgery, ASST Papa Giovanni XXIII, Bergamo, Italy
  3. 3 Internal Medicine Division, ASST Fatebenefratelli-Sacco, Milano, Italy
  4. 4 Clinical Chemistry Laboratory, SYNLAB Castenedolo, Castenedolo, Italy
  5. 5 Section of Clinical Biochemistry, University of Verona, Verona, Italy
  1. Correspondence to Dr Michela Seghezzi, ASST Papa Giovanni XXIII, Bergamo, Clinical Chemistry Laboratory, Bergamo 24128, Italy; m.seghezzi89{at}


Aims Limited information is available on number and type of cells present in the pericardial fluid (PF). Current evidence and has been garnered with inaccurate application of guidelines for analysis of body fluids. This study was aimed at investigating the performance of automate cytometric analysis of PF in adult subjects.

Methods Seventy-four consecutive PF samples were analysed with Sysmex XN with a module for body fluid analysis (XN-BF) and optical microscopy (OM). The study also encompassed the assessment of limit of blank, limit of detection and limit of quantitation (LoQ), imprecision, carryover and linearity of XN-BF module.

Results XN-BF parameters were compared with OM for the following cell classes: total cells (TC), leucocytes (white blood cell [WBC]), polymorphonuclear (PMN) and mononuclear (MN) cells. The relative bias were −4.5%, 71.2%, 108.2% and −47.7%, respectively. Passing and Bablok regression yielded slope comprised between 0.06 for MN and 5.8 for PMN, and intercept between 0.7 for PMN and 220.3 for MN. LoQ was comprised between 3.8×106 and 6.0×106 cells/L for WBC and PMN. Linearity was acceptable and carryover negligible.

Conclusions PF has a specific cellular composition. Overall, automated cell counting can only be suggested for total number of cells, whereas OM seems still the most reliable option for cell differentiation.

  • cell counting
  • automation
  • differentiation

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  • Handling editor Professor Mary Frances McMullin.

  • Contributors All authors confirmed they have contributed to the intellectual content of this paper and have met the following three requirements: (1) significant contributions to the conception and design, acquisition of data, or analysis and interpretation of data; (2) drafting or revising the article for intellectual content; (3) final approval of the published article.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval This study was approved by the Ethics Committee of ASST Papa Giovanni XXIII.

  • Provenance and peer review Not commissioned; externally peer reviewed.