Sysmex XN-9000 Hematology Analyzer Can Provide Reference for the Classification of Nucleated Cells in Body Fluid and Detect Malignant Serous Effusion.

Objective: The purpose of this study is to evaluate the accuracy of Sysmex XN-9000 hematology analyzer (XN-9000) in detecting nucleated cell classifications in serous effusion and to further evaluate whether it can be used for screening malignant serous effusion.

Methods: The consistency between XN-9000 and manual microscopy in the classification of nucleated cells was evaluated using Passing-Bablok regression and Bland-Altman plot. ROC analysis was applied to evaluate the value of HF-BF% in screening malignant specimens.

Results: In the serous effusion of the group with nucleated cell count of (0-150) ×10⁶/μL, high consistency between XN-9000 and manual microscopy was found in detecting NE-BF% and LY-BF%. In the group with nucleated cell count >150×10⁶/μL, there was high consistency in detecting NE-BF%, LY-BF%, and HF-BF%. ROC analysis showed that HF-BF% can be used for screening malignant serous effusion, with an area under the curve (AUC) of 0.572 (95%CI=0.504~0.639).

Conclusion: If XN-9000 detection results are mainly NE-BF% and LY-BF%, the classification can be effectively referred to and reported regardless of the number of nucleated cells in the serous effusion. HF-BF% has certain value in screening malignant serous effusion with a nuclear cell count >150×10⁶/μL. The optimal cut-off value is 13.15%.