Eggensperger D, Schweitzer S, Ferriol E, O'Dowd G, Light J A
Department of Pathology, Washington Hospital Center, Washington, DC 20010.
Am J Nephrol. 1988;8(1):27-34. doi: 10.1159/000167549.
Cytodiagnostic urinalysis was tested to determine its utility in the evaluation of allograft dysfunction in renal transplant patients. Specimens were prepared using the Papanicolaou stain on cytocentrifuge preparations of standardized quantities of urine. Differential counts of blood cells (neutrophils, lymphocytes, red cells), renal tubule cells (convoluted, collecting duct, necrotic), and casts (i.e. hemoglobin, renal tubule cell) were included in the sediment evaluation. Receiver operating characteristic curves demonstrated collecting duct cell exfoliation at 20 per 10 hpf to be a more sensitive and specific reflector of acute rejection than lymphocytes at their optimum decision point of 13 per 10 hpf. Sixty-four percent of cytodiagnostic urinalysis diagnoses preceded the clinical diagnoses. Ciclosporin nephrotoxicity was differentiated by the exfoliation of renal tubule convoluted cells in excess of collecting duct cells. The advantages of this technique over membrane-filter or phase-microscopic techniques for examining urine sediment of both transplant and nephrology patients include improved sensitivity and specificity in identification of sediment elements and reliable quantitative data for use in detecting renal disease and for monitoring therapy.
进行了细胞诊断尿液分析，以确定其在评估肾移植患者同种异体移植功能障碍中的效用。使用巴氏染色法对标准化尿量的细胞离心涂片进行标本制备。沉淀物评估包括血细胞（中性粒细胞、淋巴细胞、红细胞）、肾小管细胞（曲管、集合管、坏死细胞）和管型（即血红蛋白、肾小管细胞管型）的分类计数。受试者工作特征曲线表明，每10个高倍视野中集合管细胞脱落20个比每10个高倍视野中淋巴细胞最佳判定点13个更能敏感且特异地反映急性排斥反应。64%的细胞诊断尿液分析诊断先于临床诊断。环孢素肾毒性可通过曲管肾小管细胞脱落超过集合管细胞来鉴别。与膜过滤或相差显微镜技术相比，该技术在检查移植患者和肾脏病患者尿液沉淀物方面的优势包括在识别沉淀物成分方面提高了敏感性和特异性，以及用于检测肾脏疾病和监测治疗的可靠定量数据。
