Abstract
Background For CSF analysis, exact knowledge of the type and amount of cells is essential, especially
for detection of infection or bleeding. The chamber count has been the current reference
method to date, yet it is problematic due to its subjectivity depending on the examiner’s
skill and experience. Therefore, as a reference method, we used an impulse cytophotometric
measurement with Epics XL owing to its improved objectify ability and compared this
method to the measurement of CSF samples performed with the ADVIA 2120 and XE-5000.
Material and Methods 101 CSF samples were measured with the ADVIA 2120, XE-5000, and Epics XL. For impulse
cytophotometric measurement, CD235a was used for identification of erythrocytes; CD45
for the entire leukocyte population; CD56, CD16 and CD14 for monocytes; CD3, CD4 and
CD19 for lymphocytes;and CD13, CD15 and CD33 for neutrophile granulocytes.
Results Regarding leukocyte measurements, a strong correlation was obtained between Epics
XL and XE-5000 (r = 0.990), with the correlation between Epics XL and ADVIA 2120 not
as strong (r = 0.538). This finding is due to the fact that with blood-stained CSF
samples (erythrocytes >1 500/µl), no valid results were produced by the ADVIA 2120.
In measurements of blood-free CSF samples, correlations between Epics XL, XE-5000,
and ADVIA 2120 were almost identical (r = 0.985 and r = 0.964). The same applies to
the correlation between polymorphonuclear and mononuclear cells (range 0.920–0.972).
In erythrocyte measurements, the correlation between XE-5000 and ADVIA 2120 was excellent
(r = 0.945). Impulse cytophotometric measurement of erythrocytes with CD 238 antibodies
did not appear to be functional.
Conclusion In the measurement of leukocytes in CSF with the ADVIA 2120, no valid results could
be obtained in blood-stained CSF samples (erythrocytes >1 500/µl). In blood-free CSF
samples (erythrocytes <1 500/µl), measurements of leukocytes, and polymorphonuclear
and mononuclear cells performed with the ADVIA 2120 and XE-5000 produced almost identical
good results. Determination of CSF cells with the XE-5000 is presently the best automated
method for counting leukocytes of blood-stained CSF.
Keywords
CSF - blood cells - cell counts - flow cytometry - XE 5000
