Abstract
Body fluid cell counting provides valuable information for the diagnosis and treatment of a variety of conditions. Chamber cell count and cellularity analysis by optical microscopy are considered the gold-standard method for cell counting. However, this method has a long turnaround time and limited reproducibility, and requires highly-trained personnel. In the recent decades, specific modes have been developed for the analysis of body fluids. These modes, which perform automated cell counting, are incorporated into hemocytometers and urine analyzers. These innovations have been rapidly incorporated into routine laboratory practice. At present, a variety of analyzers are available that enable automated cell counting for body fluids. Nevertheless, these analyzers have some limitations and can only be operated by highly-qualified laboratory professionals. In this review, we provide an overview of the most relevant automated cell counters currently available for body fluids, the interpretation of the parameters measured by these analyzers, their main analytical features, and the role of optical microscopy as automated cell counters gain ground.
Highlights
Body fluid testing is an important part of the workload in clinical laboratories [1]
We provide an overview of the most relevant automated cell counters currently available for body fluids, the interpretation of the parameters measured by these analyzers, their main analytical features, and the role of optical microscopy as automated cell counters gain ground
These counters provide determination of the following analytes: – Total nucleated cell count (TNC-BF), term recommended by the Clinical and Laboratory Standards Institute (CLSI) [7]. – Total white blood cell count (WBC-BF). – Red blood cell count (RBC-BF). – Polymorphonuclear cell count (PMN-BF) and mononuclear cell count (MN-BF), expressed as percentages and absolute values. – For research purposes, some analyzers measure other leukocyte populations or report the presence of other types of cells
Summary
Body fluid testing is an important part of the workload in clinical laboratories [1]. The gold-standard for the cytologic analysis of body fluids is manual cell counting by expert laboratory professionals using a count chamber and evaluation of the differential count by optical microscopy after cytocentrifugation and staining of the specimen [2]. This method has some limitations, namely: staining conditions vary across laboratories, which affects quality. This technique is timeconsuming, which increases intra-laboratory turnaround time; inter- and intra-observer variability results in high imprecision, and the equipment requires operation by highlyqualified personnel. Potential sources of error require that the results obtained by microscopy are interpreted with caution [4]
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