Evidence map›Paper›PMID 40112826›Full record

ArticleInternational journal of laboratory hematology2025

Sysmex XN-Based Evaluation of the Diagnostic Performance of High-Fluorescent Cells From CSF as a Supportive Diagnostic Criterion in Neurological Diseases.

Benedict Schwarz, Christopher Hardt, Katharina Friedrich, Monika Prpic, Anja Osterloh, Frank L Heppner, Klemens Ruprecht, Kai Kappert, Amir Jahic

Abstract read
In one paragraph

Article in International journal of laboratory hematology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Benedict SchwarzInstitute of Diagnostic Laboratory Medicine, Clinical Chemistry and Pathobiochemistry, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität and Humboldt-Universität Zu Berlin, Berlin, Germany.
Christopher HardtInstitute of Diagnostic Laboratory Medicine, Clinical Chemistry and Pathobiochemistry, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität and Humboldt-Universität Zu Berlin, Berlin, Germany.ORCID https://orcid.org/0000-0002-8093-4131
Katharina FriedrichInstitute of Diagnostic Laboratory Medicine, Clinical Chemistry and Pathobiochemistry, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität and Humboldt-Universität Zu Berlin, Berlin, Germany.ORCID https://orcid.org/0009-0002-3566-9006
Monika PrpicInstitute of Diagnostic Laboratory Medicine, Clinical Chemistry and Pathobiochemistry, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität and Humboldt-Universität Zu Berlin, Berlin, Germany.ORCID https://orcid.org/0009-0006-3730-5037
Anja OsterlohInstitute of Pathology, Ulm University, Ulm, Germany.ORCID https://orcid.org/0000-0003-3554-8108
Frank L HeppnerDepartment of Neuropathology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität and Humboldt-Universität Zu Berlin, Berlin, Germany.ORCID https://orcid.org/0000-0001-9816-8917
Klemens RuprechtDepartment of Neurology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität and Humboldt-Universität Zu Berlin, Berlin, Germany.ORCID https://orcid.org/0000-0003-1962-6014
Kai KappertInstitute of Diagnostic Laboratory Medicine, Clinical Chemistry and Pathobiochemistry, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität and Humboldt-Universität Zu Berlin, Berlin, Germany.ORCID https://orcid.org/0000-0001-6976-0428
Amir JahicInstitute of Diagnostic Laboratory Medicine, Clinical Chemistry and Pathobiochemistry, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität and Humboldt-Universität Zu Berlin, Berlin, Germany.ORCID https://orcid.org/0000-0001-8318-0147

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionAutomatic cytological analysis of cerebrospinal fluid (CSF) by Sysmex XN-Series represents a convenient laboratory platform for quantitative examination of nucleated CSF cells (monomorphonuclear (MN), polymorphonuclear (PMN), high-fluorescent (HF)). HF cells (HFC), a research laboratory parameter so far, seem to be associated with certain clinical patterns. Hence, we aimed to determine the diagnostic HFC value for different clinical categories in neurological settings.

methodsMorphological classification of automatically detected HFC was carried out using manual light microscopy. Automatic method precision for cell differentiation was evaluated in comparison. In 284 cases, multiple correlation strategies and mathematical disease modellings enabled an explorative analysis of HFC suitability for case stratification into the categories Hemorrhage, Inflammation, Neoplasia, other, and unknown.

resultsManual microscopic reevaluation revealed plasma cells, macrophages, and malignant cells being HFC correlates in 80% of automatically detected HFC. Method correlation for automatic and manual CSF cell differentiation approaches was 95%, yielding a negative bias of 4.3% for MN and positive bias of 0.4% and 3.9% for PMN and HF, respectively. When HFC were used as a "stand-alone" predicting tool, diagnostic accuracy, specificity, and sensitivity depended on the clinical condition, ranging from > 0.5 up to > 0.7 for Hemorrhage, Inflammation, and Neoplasia. However, multiparametric correlation analyses combining laboratory CSF diagnostics and mathematical methods defined HFC as a relevant laboratory parameter for adequate clinical case stratification. With an expected random distribution of 25% for four clinical categories, almost 70% of cases were correctly classified when the HFC-based mathematical algorithm was applied.

conclusionHFC has significant diagnostic and/or predictive value for neurological diseases.

Indexed as

Cerebrospinal FluidNervous System DiseasesAdultFemaleHumansMaleMiddle Agedcerebrospinal fluidclinical patient stratificationhigh‐fluorescent cellsmathematical disease modellingSysmex XN hematology analyzer

Identifiers

PMID40112826
PMCPMC12239702

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.