Evaluation of the WBC-differential flagging performances and accuracy of the HORIBA Yumizen H2500 cell counter in oncology patients from a single institution

Int J Lab Hematol. 2023 Feb;45(1):37-45. doi: 10.1111/ijlh.13983. Epub 2022 Nov 9.

Abstract

Introduction: The Yumizen H2500 (YH2500) cell analyser was compared to the Pentra DX Nexus (both from HORIBA Medical) to evaluate the efficiency of the new YH2500 technology for the WBC-differential in samples from oncology patients with WBC-diff abnormalities.

Material and methods: The 220 samples with slide review criteria on the Nexus were systematically analysed on the YH2500. The WBC-diff was compared to flow cytometry (FCM). The 100 additional samples with Monocyte/Neutrophil separation flags were evaluated. The flagging performance and the accuracy of the WBC-diff were analysed.

Results: The YH2500 generated fewer flags than the Nexus (47.73% vs 66.64%; p < .0001), except for Monocyte/Neutrophil flag (15.5% vs. 2.7%; p < 0.0001). Overall performances were higher on the YH2500 (Sensitivity, 100 vs. 89.6%; Specificity 81.0% vs. 50.9%; PPV, 74.3% vs. 62.9%; NPV, 100% vs. 69.5%; Efficiency, 87.7% vs. 69.5%). YH2500 showed a statistically significant better correlation with FCM for the 6-part differential than the Nexus. On 134 samples with Monocyte/Neutrophil separation flag, it was shown that, in samples with less than 10% monocytes on the YH2500, the results of monocyte and neutrophil counts were comparable to the manual count, and that these samples did not need a slide review if no other main criterion for review was present.

Conclusion: The YH2500 demonstrated better performance characteristics than the previous cell counter, the Nexus. Its implementation in our laboratory routine work significantly improved the practice workflow, decreased the number of manual cell counts and increased the pertinence of slide review and reporting of the microscopic count.

Keywords: WBC differential; flow cytometry; general hematology; laboratory automation; laboratory practice.

MeSH terms

  • Flow Cytometry / methods
  • Humans
  • Leukocyte Count
  • Monocytes
  • Neoplasms*
  • Neutrophils*