Kridsada Sirisabhabhorn1 Anurak Choeymang2 Supaporn Pumpa1 Naiyana poottasane1 and Palakorn Puttaruk1 1Department of Medical Technology Laboratory, Thammasat University hospital, Pathumthani, Thailand 2Pharmacology and Toxicology Unit, Faculty of Allied Health Sciences, Thammasat University, Pathumthani, Thailand

1. Comparison of reticulocyte count by VCS technology; Beckman Coulter
Hematology LH785 & fluorescent flow cytometry; XT4000i automate
hematology analyzers
Kridsada Sirisabhabhorn1 Anurak Choeymang2 Supaporn Pumpa1 Naiyana poottasane1 and Palakorn Puttaruk1
1Department of Medical Technology Laboratory, Thammasat University hospital, Pathumthani, Thailand
2Pharmacology and Toxicology Unit, Faculty of Allied Health Sciences, Thammasat University, Pathumthani, Thailand
Reticulocyte count is significant for indication a new erythrocyte synthesis. Especially, usually applied for diagnosis and monitor in new born blood and anemia
diseases. The traditional method for investigation of reticulocyte count with 1% brilliant cresyl blue stain have been long time practice, it not suitable for work load unit
and rapid diagnosis requirement today. The new principle of reticulocyte detection was applied with 2 automate hematology analyzers which Coulter®LH785; VCS
(volume, conductivity and light scatter) technology and Sysmex®XT-4000i; fluorescent flow cytometry for improve reticulocyte count diagnosis. This study propose for
evaluate VCS technology by two automate hematology analyzers, compared with traditional method. All 105 cases were investigated by comparison among
Coulter®LH785, Sysmex® XT-4000i and traditional method approved percentage reticulocyte count by 3 professional medical technologists. Pearson correlation was used
for consider correlation. The results demonstrated that Coulter®LH785 and Sysmex® XT-4000i correlation coefficients (r) as 0.889, p-values < 0.05 and 0.936, p-values
< 0.05 respectively. Moreover, the comparisons between Coulter®LH785 and Sysmex® XT-4000i illustrated correlation coefficients (r) as 0.902. The traditional method of
human reticulocyte countable was not different significantly statistic analysis by ANOVAs test. Conclusion, 3 methods of Coulter®LH785, Sysmex® XT-4000i automate
hematology analyzers and traditional reticulocyte counts are good correlation within p-values < 0.05. Moreover, it is helpful for work flow management than traditional
method and reduce turn around time (TAT) of reticulocyte investigation.
Abstract
Key words: reticulocyte, fluorescent flow cytometry, VCS technology
Manual LH785 XT4000i
Manual Pearson Correlation 1 .889(**) .936(**)
Sig. (2-tailed) .000 .000
N 105 105 105
LH785 Pearson Correlation .889(**) 1 .902(**)
Sig. (2-tailed) .000 .000
N 105 105 105
XT4000i Pearson Correlation .936(**) .902(**) 1
Sig. (2-tailed) .000 .000
N 105 105 105
Methods & Correlations
** Correlation is significant at the 0.01 level (2-tailed).
0
1
2
3
4
5
6
7
8
9
0 2 4 6 8 10
XT400i
Manual
0
1
2
3
4
5
6
7
8
0 2 4 6 8 10
LH785
Manual
0
1
2
3
4
5
6
7
8
0 2 4 6 8 10
XT400i
LH785
Introduction
Materials and Methods
Complication of conventional method used for investigation % reticulocyte increase job workload and leads to long TAT (Turn Around Time) and costumer
dissatisfaction. Moreover manual method needs microscope specialist for % reticulocyte counting. Today the principle of fluorescent flow cytometry, Sysmex®XT-4000i and
VCS technology, Coulter®LH785 can reduce work flow of conventional method for % reticulocyte count analysis. However measuring accuracy of each method is
significant for reliable report. The objective in this study was to evaluated comparative both two principle of automate analyzer above with conventional or manual method
, 1% brilliant cresyl blue stain using Pearson Correlation. The study was shown benefit that confidence reliable % reticulocyte count values and provided short procedure
of analysis which suitable each analytical department.
Conventional method with 1% brilliant cresyl blue stain
Fluorescent flow cytometry, Sysmex®XT-4000i
VCS technology, Coulter®LH785
Results
Conclusion and discussion
In this study conclude that two automate analyzers which composed principle of fluorescent flow cytometry, Sysmex®XT-4000i and VCS technology, Coulter®LH785
were presented good correlation for investigated % reticulocyte counting by correlation coefficients (r) values as 0.936 and 0.889 within p-values < 0.05 when compared
with conventional method. Additionally two automate analyzers were demonstrated correlation coefficients (r) as 0.902 within p-values < 0.05 thus also good correlation
each other. The performance ensuring in conventional method by three special medical technologists were shown no different significantly statistic analysis by ANOVAs
test. The automated analyzers can provide helpful in % reticulocyte investigation and improve diagnosis approach to standard, reduced individual human errors and
eliminated process of crysel blue staining and slide preparation. Lastly, quality assurance necessary should monitoring update always by medical technologist. This study
declared no conflict of interest.
References
R=0.902R=0.889R=0.936
Conventional method
Sysmex®XT-4000i
Coulter®LH785
Graph 1. Illustrated correlation curve of % reticulocyte count between
Sysmex®XT-4000i and conventional method (manual method)
Graph 2. Illustrated correlation curve of % reticulocyte count between
Coulter®LH785 and conventional method (manual method)
Graph 3. Illustrated correlation curve of % reticulocyte count between
Coulter®LH785 and Sysmex®XT-4000i
Pearson Correlations
Table 1. Illustrated
correlation results 3 method
for investigated percent of
reticulocyte count which
compared using Pearson
correlation, p-values < 0.05
All 105 cases were investigated % reticulocyte count with 3 principles mention above. All methods were investigated their relationships using Pearson correlation,
which explored correlation coefficients (r) p-values < 0.05. Using 3 medical technologists who were ensued not different significantly statistic analysis by ANOVAs test in
conventional method evaluated mean values of % reticulocyte count
Sysmex. Reticulocytes and their significance. Sysmex Xtra Online, 2010: 1-12.
PCL Holding Co., Ltd. Standard Operating Procedure ( SOP ) For Coulter ReticPakTM