Fujita T, Sofue T, Moritoki M, Nishijima Y, Tokuhara Y, Wakisaka H, Kushida Y, Haba R, Ohsaki H
Department of Clinical Laboratory, Ehime General Health Care Association, Ehime, Japan.
Course of Medical Technology, Graduate School of Ehime Prefectural University of Health Sciences, Ehime, Japan.
Cytopathology. 2017 Dec;28(6):524-530. doi: 10.1111/cyt.12460. Epub 2017 Sep 15.
The purpose of this study was to assess the relationship between urinary WT1-positive cells (podocytes and active parietal epithelial cells) and WT1-positive cells in renal biopsy to investigate whether urinary WT1-positive cells are useful for detection of crescent formation.
Fifty-two patients with kidney disease were investigated (15 cases with crescentic lesions and 37 cases with non-crescentic lesions) for immunoenzyme staining using anti-WT1 antibody for urine cytology and renal biopsy. Numbers of WT1-positive cells in urine and renal biopsy were counted.
There was no correlation between urinary WT1-positive cells and WT1-positive cells in renal biopsy. However, the number of urinary WT1-positive cells in patients with crescentic lesions was significantly higher than in patients with non-crescentic lesions. In addition, the best cut-off value to detect patients with crescentic lesions using urinary was 5 cells/10-mL (area under the concentration-time curve=0.735).
The results of our study suggest urinary WT1-positive cells can be used to detect patients with crescent formation using 5 cells/10-mL cutoff value. WT1-positive glomerular podocytes and parietal epithelial cells may be shed into urine in active glomerular disease. This study, investigating the relationship between WT1-positive cells in urine and in the renal biopsy found no correlation; however, the results do suggest that, using a cutoff value of 5 cells/10 mL, WT1 positive urinary cells can be used to detect patients with crescent formation.
本研究旨在评估尿中WT1阳性细胞（足细胞和活跃的壁层上皮细胞）与肾活检中WT1阳性细胞之间的关系，以调查尿中WT1阳性细胞是否有助于新月体形成的检测。
对52例肾病患者（15例有新月体病变，37例无新月体病变）进行抗WT1抗体免疫酶染色，用于尿液细胞学检查和肾活检。计数尿液和肾活检中WT1阳性细胞的数量。
尿中WT1阳性细胞与肾活检中WT1阳性细胞之间无相关性。然而，有新月体病变患者的尿中WT1阳性细胞数量明显高于无新月体病变患者。此外，使用尿液检测有新月体病变患者的最佳临界值为5个细胞/10 mL（浓度-时间曲线下面积=0.735）。
我们的研究结果表明，尿中WT1阳性细胞可用于检测新月体形成的患者，临界值为5个细胞/10 mL。在活动性肾小球疾病中，WT1阳性的肾小球足细胞和壁层上皮细胞可能脱落至尿液中。本研究调查了尿中与肾活检中WT1阳性细胞之间的关系，未发现相关性；然而，结果确实表明，使用5个细胞/10 mL的临界值，WT1阳性尿细胞可用于检测新月体形成的患者。
