Manual microscopic differentiation of leukocytes is the primary tool for the diagnosis and monitoring of various diseases. Recently, digital optical microscopy has become a more common method, being an alternative to the conventional one, and therefore, there is a need to investigate its compatibility in more detail. The objective is to compare the results of digital and manual microscopy in the analysis of different leukocyte types and to assess the linearity, systemic and proportional differences between the methods. 109 samples were analyzed by manual and digital microscopy (Sysmex DI-60), and the comparison of the obtained results was performed by Passing-Bablok and Bland-Altman analysis. The linearity of the methods is satisfactory in all cells, except basophils and blasts. A statistically significant systemic difference was detected in segmented neutrophils, immature granulocytes, and lymphocytes, and correlations between the methods range from very strong to moderate, depending on the type of cells. Significant deviations were observed in leukocytosis and leukopenia. The results of the conducted analysis indicate a good correlation between digital and manual microscopy, but the identified systemic and proportional differences indicate the significance of the reclassification offered by the analyzer. In cases of severe leukopenia and leukocytosis, it is recommended to use manual microscopy as an additional check.

Background: Differentiation of leukocytes is one of the key diagnostic procedures in clinical medicine and their correct identification in a blood smear is of essential importance. Light microscopy is the reference method for leukocyte differentiation, however, it is time-consuming, and it must be performed by a highly qualified specialist. For this reason, automatic analyzers capable of precise and accurate differentiation of blood cells in the examined sample are increasingly present in hematology laboratories. The aim of this paper is to evaluate the performance of Sysmex XN-3100 analyzer, manufactured by SYSMEX CORPORATION, Kobe, Japan., with focus on the advantages and disadvantages of its digital microscopy in the differentiation of leukocytes. Methods: Digital optical microscopy on 253 samples was performed with primary data (preclassification) collected after the completion of the autoanalysis. Before validating the obtained results, the data were reviewed by a medical biochemistry specialist who confirmed or corrected it. This generated secondary data (reclassification). The two groups of data were statistically analyzed using Passing-Bablok regression analysis, Bland-Altman analysis and Spearman correlation. Results: The obtained results showed strong correlations between the primary and secondary analysis in all cells (highest in lymphocyte group (r=0.986), lowest in eosinophil group (r=0.870)) except immature granulocytes and blasts (significant deviation from linearity, p<0.01). Conclusions: Hematology analyzer Sysmex XN-3100 shows high performance in leukocyte analysis and differentiation using digital microscopy, but samples containing blasts and immature granulocytes must be additionally analyzed by light microscopy.

Abstract Background: Low-grade chronic inflammation is an important feature of chronic kidney disease (CKD). Aim: To determine the values of C-reactive protein (CRP), neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) in patients with different stages of CKD and to examine how they change depending on the progression of renal damage. Materials and methods: A cross-sectional descriptive comparative study included 157 subjects at different stages of CKD which was assessed based on glomerular filtration rate (GFR) calculated according to the MDRD equation. CRP was analyzed by an immunoturbidimetric method. NLR and PLR were calculated by a mathematical calculation after a blood count was performed. Results: The present study showed an increase in serum creatinine, CRP, and NLR values with progression of renal failure. There was a statistically significant difference in the creatinine and CRP concentrations between groups with different stages of CKD (p <0.001 for all comparisons). A significant positive correlation was found between NLR and CRP, while negative, significant correlations were observed between NLR and eGFR as well as between PLR and eGFR. There was a slight increase in PLR value with the progression of renal impairment, but the correlation between PLR and CRP was not significant. Conclusion: These results suggest that NLR, together with CRP, may serve as an indicator of systemic low-grade inflammation progression in patients with CKD. Larger prospective studies are required to observe the possibility of using NLR as a surrogate marker for CRP in patients with CKD.