Nguyen Gia-Khanh
Department of Laboratory Medicine and Pathology, University of Alberta Hospitals, Edmonton, Alberta, Canada.
Diagn Cytopathol. 2003 Aug;29(2):67-73. doi: 10.1002/dc.10320.
The objectives of the present study were to evaluate the cytology of urine sediments in patients with glomerular diseases, as well as the value of G1 dysmorphic erythrocytes (G1DE) or G1 cells in the detection of renal glomerular hematuria. Freshly voided urine samples from 174 patients with glomerular diseases were processed according to the method used for semiquantitative cytologic urinalysis. G1DEs (distorted erythrocytes with doughnut-like shape, target configuration with or without membranous protrusions or blebs), non-G1DEs (distorted erythrocytes without the above-mentioned morphologic changes), normal erythrocytes (NEs), and renal tubular cells (RTCs) were evaluated. Erythrocytic casts (ECs) were counted and graded as abundant (>1 per high-power field) or rare (1 per 5 high-power fields). G1DE/total erythrocyte ratios were calculated by counting 200 erythrocytes including G1DEs, non-G1DEs, and NEs. Only abundant NEs were found in 13 cases; abundant G1DEs, non-G1DEs, NEs, and no ECs in 95 cases; abundant NEs, non-G1DEs, and ECs and no G1DEs in 31 cases; and abundant NEs, G1DEs and non-G1DEs, and rare ECs in 35 cases. In 130 cases in which G1DEs were present, the G1DE/total erythrocyte ratios varied from 10% to 100%. This parameter was greater or equal to 80%, 50%, 20%, and 10% in 58 (44.6%), 29 (22.3%), 28 (21.5%), and 15 (11.5%) patients, respectively. In all cases, the number of RTCs was within normal limits or slightly increased, and a variable number of non-G1DEs were present in 161 cases. Thus, abundant ECs and/or G1DEs with a G1DE/total erythrocyte ratio of 10-100% proved to be specific urinary markers for renal glomerular diseases.
本研究的目的是评估肾小球疾病患者尿沉渣的细胞学特征，以及G1异形红细胞（G1DE）或G1细胞在检测肾小球性血尿中的价值。对174例肾小球疾病患者的新鲜晨尿样本按照半定量细胞学尿分析方法进行处理。评估G1DE（呈甜甜圈样形状、有或无膜状突起或泡状的变形红细胞）、非G1DE（无上述形态学改变的变形红细胞）、正常红细胞（NE）和肾小管上皮细胞（RTC）。对红细胞管型（EC）进行计数并分级为丰富（每高倍视野>1个）或稀少（每5个高倍视野1个）。通过计数包括G1DE、非G1DE和NE在内的200个红细胞来计算G1DE/总红细胞比率。仅在13例中发现丰富的NE；95例中有丰富的G1DE、非G1DE、NE且无EC；31例中有丰富的NE、非G1DE和EC且无G1DE；35例中有丰富的NE、G1DE和非G1DE且有稀少的EC。在存在G1DE的130例中，G1DE/总红细胞比率在10%至100%之间变化。该参数在58例（44.6%）、29例（22.3%）、28例（21.5%）和15例（11.5%）患者中分别≥80%、50%、20%和10%。在所有病例中，RTC数量在正常范围内或略有增加，161例中存在数量不等的非G1DE。因此，丰富的EC和/或G1DE且G1DE/总红细胞比率为10 - 100%被证明是肾小球疾病的特异性尿液标志物。
