Ranzi Alana Durayski, Prolla João Carlos, Keitel Elizete, Brackmann Rosicler, Kist Roger, dos Santos Giovana Tavares, Bica Claudia Giuliano
Federal University of Health Sciences of Porto Alegre, Porto Alegre, Brazil.
Acta Cytol. 2012;56(5):543-7. doi: 10.1159/000341425. Epub 2012 Sep 27.
To determine the role of urine cytology for 'decoy cells' as a screening tool for polyomavirus type BK (BKV) infection in renal transplant recipients.
This was a prospective cohort study of patients undergoing renal transplantation between 2006 and 2010.
A total of 442 patients underwent urine cytology for decoy cells, 27.8% underwent 1 examination only and 72.2% more than one. Of the 1,713 examinations reviewed, 426 (24.9%) were positive and 785 (45.8%) were negative for 'decoy' cells, 380 (22.2%) showed degenerated tubular cells and 122 (7.1%) were unsatisfactory for analysis. Urine cytology was found to have a specificity of 68.5%, a sensitivity of 84.6%, a positive predictive value of 21.2%, a negative predictive value of 97.8% and an overall accuracy of 69.9%. The incidence of polyomavirus nephropathy among the patients investigated was 11.8%. Of the 442 patients, 32 (7.2%) had graft loss, which was attributed to BKV nephropathy in 2 (6.2% of the 32).
Urine cytology is an effective screening method for monitoring renal transplant patients, with high sensitivity and a high negative predictive value, and can therefore be used routinely in the follow-up of renal transplant patients.
确定尿细胞学检查中“诱饵细胞”作为肾移植受者多瘤病毒BK（BKV）感染筛查工具的作用。
这是一项对2006年至2010年间接受肾移植患者的前瞻性队列研究。
共有442例患者接受了针对诱饵细胞的尿细胞学检查，其中27.8%仅接受了1次检查，72.2%接受了不止1次检查。在审查的1713次检查中，426次（24.9%）“诱饵”细胞检查呈阳性，785次（45.8%）呈阴性，380次（22.2%）显示肾小管细胞退变，122次（7.1%）检查结果不适合分析。尿细胞学检查的特异性为68.5%，敏感性为84.6%，阳性预测值为21.2%，阴性预测值为97.8%，总体准确率为69.9%。所调查患者中多瘤病毒肾病的发生率为11.8%。在442例患者中，32例（7.2%）出现移植肾丢失，其中2例（占32例的6.2%）归因于BKV肾病。
尿细胞学检查是监测肾移植患者的有效筛查方法，具有高敏感性和高阴性预测值，因此可常规用于肾移植患者的随访。
