Evaluation of the Sysmex XN-20 Complete Blood Count Analyser

Lee, Eun Jin; Lee, Kwongu; Kim, Miyoung; Kim, Han Sung; Kang, Hee Jung; Lee, Young Kyung

Abstract

BACKGROUND
The XN-20 (Sysmex, Japan) is a recently developed hematology analyser, which adopts new technologies to improve the accuracy of complete blood count (CBC) and white blood cell (WBC) differentials and the efficiency of the flag system. In this study, we evaluated the performance of the XN-20 for CBC, WBC differentials, and reticulocyte counts. We also analysed the efficiency of its flag system.
METHODS
We evaluated the precision and linearity of CBC and reticulocyte counts. In the correlation study, the results of XN-20 were compared with those obtained using ADVIA 2120 (Siemens, USA). The performance was also evaluated in the 'low WBC mode.' We analysed the efficiency of the flag system in detecting abnormal blood cells using 43 abnormal samples.
RESULTS
The CVs for precision were <2% for most of the CBC parameters. Linearity was good for WBC, red blood cell (RBC), Hb, Hct, and platelet. The results of XN-20 were well correlated with those of ADVIA 2120. The correlation coefficients (r) was >0.9800 for all CBC parameters except for erythrocyte indices, and it was >0.9500 for WBC differentials except for monocyte and basophil. In the 'low WBC mode,' XN-20 could reliably analyse the WBC differentials in samples with low WBC count. The efficiencies of the flag systems were 95.3% for blasts, 83.7% for left-shifted neutrophils, 97.7% for atypical lymphocytes, and 86.0% for nucleated RBCs.
CONCLUSIONS
The XN-20 showed good precision and its results were well correlated with those obtained using ADVIA 2120. In particular, in the 'low WBC mode,' it could provide reliable WBC differentials for samples with low WBC counts, and the flag systems detected abnormal blood cells with high efficiency.