Automated Analysis of Cerebrospinal Fluid Cells Using Commercially Available Blood Cell Analysis Devices-A Critical Appraisal.
Automated Analysis of Cerebrospinal Fluid Cells Using Commercially Available Blood Cell Analysis Devices-A Critical Appraisal.
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DOI：
10.3390/cells10051232
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发表时间：
2021-05-18
期刊：
影响因子：
6
通讯作者：
On Behalf Of The German Society Of Csf Diagnostics And Clinical Neurochemistry Dgln E V
中科院分区：
文献类型：
--
作者：
Wick M;Gross CC;Tumani H;Wildemann B;Stangel M;On Behalf Of The German Society Of Csf Diagnostics And Clinical Neurochemistry Dgln E V
脑脊液（CSF）中细胞的分析是一种常规程序，通常使用Fuchs-Rosenthal室和细胞显微镜进行细胞计数和分化。为了减少对人工评估的需求，主要用于血细胞分析的设备的自动分析也已用于CSF样本。在这里，我们总结了使用这些自动化设备的调查现状，并严格审查其局限性。尽管进行了技术改进，但CSF中可靠白细胞计数的下限仍约为20个细胞/µL，有待根据器械进行验证。由于临床决策的临界范围为5-30个细胞/微升，这意味着细胞数< 30个/微升需要手动确认。此外，自动化设备可靠的红细胞检测下限约为1000/µL。然而，即使是低红细胞数量也可能具有临床重要性。相比之下，来自神经外科的严重出血样本可以更快地以可接受的精度自动计数。最后，通过自动化装置进行的细胞分化仅提供淋巴细胞、粒细胞和单核细胞的粗略定向。其他诊断上重要的细胞类型，如肿瘤细胞、噬铁细胞、母细胞等不能可靠地检测。因此，尽管自动化可以给出足够用于急诊室情况的粗略估计，但是每个CSF需要手动显微镜检查以用于最终报告的细胞学评价。总之，尽管CSF细胞的自动化分析可以提供单个样本中细胞谱的第一方向，但仍然需要额外的手动细胞计数和显微镜细胞学检查，并且代表金标准。
The analysis of cells in the cerebrospinal fluid (CSF) is a routine procedure that is usually performed manually using the Fuchs–Rosenthal chamber and cell microscopy for cell counting and differentiation. In order to reduce the requirement for manual assessment, automated analyses by devices mainly used for blood cell analysis have been also used for CSF samples. Here, we summarize the current state of investigations using these automated devices and critically review their limitations. Despite technical improvements, the lower limit for reliable leukocyte counts in the CSF is still at approximately 20 cells/µL, to be validated depending on the device. Since the critical range for clinical decisions is in the range of 5–30 cells/µL this implies that cell numbers < 30/µL require a manual confirmation. Moreover, the lower limit of reliable erythrocyte detection by automated devices is at approximately 1000/µL. However, even low erythrocyte numbers may be of clinical importance. In contrast, heavily hemorrhagic samples from neurosurgery may be counted automatically at an acceptable precision more quickly. Finally, cell differentiation by automated devices provides only a rough orientation for lymphocytes, granulocytes and monocytes. Other diagnostically important cell types such as tumor cells, siderophages, blasts and others are not reliably detected. Thus, although the automation may give a gross estimate sufficient for the emergency room situation, each CSF requires a manual microscopy for cytological evaluation for the final report. In conclusion, although automated analysis of CSF cells may provide a first orientation of the cell profile in an individual sample, an additional manual cell count and a microscopic cytology are still required and represent the gold standard.
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影响因子：
3
作者：
Hod, E. A.;Brugnara, C.;Kratz, A.
通讯作者：
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影响因子：
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影响因子：
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作者：
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