Department of Surgery, Division of Urology, University of Vermont Medical Center, Burlington, VT.
Department of Surgery, Division of Urology, University of Vermont Medical Center, Burlington, VT; Department of Surgery, King Abdulaziz University, Rabigh, Saudi Arabia.
Urology. 2021 Aug;154:24-27. doi: 10.1016/j.urology.2021.04.014. Epub 2021 Apr 23.
To explore how laboratories in the United States (U.S.) report red blood cell per high powered field (RBC/HPF) counts on urinalysis and to evaluate whether this methodology permits effective risk stratification in accordance with the 2020 AUA/SUFU microhematuria guidelines.
Reporting methods for RBC/HPF counts (ranges, or actual counts) were collected by querying urologists in U.S. academic medical institutions or commercial laboratories. We explore whether (1) the reporting schemes were concordant with the risk strata in the new microhematuria guideline (3-10 [low risk], 11-25 [intermediate risk], and more than 25 [high risk]), and (2) evaluate the potential for risk group misclassification based on reporting methodology.
Data were available for 141 laboratories. Seventy-two (51%) use RBC/HPF ranges, while the remainder use actual counts (or counts to a threshold). Sixty (42%) report range cutoffs which are not concordant with the microhematuria guidelines risk groups. Furthermore, fifty-six (40%) do not include the cutoff of 25 RBC/HPF which could potentially misclassify intermediate and high risk groups. Finally, sixteen (11%) do not include the cut-off of 3 RBC/HPF that defines the presence of microhematuria.
A significant number of laboratories report RBC/HPF counts in ranges that differ from thresholds in the 2020 AUA/SUFU guideline. The implication is potential misclassification of microhematuria both at minimum threshold diagnosis (3 RBC/HPF), and additionally between intermediate and high risk groups. Standardization of reporting schemes to actual RBC/HPF counts may allow improved adherence to guidelines while providing data for future guideline development.
探索美国（U.S.）实验室如何报告尿液分析中的高倍镜视野红细胞（RBC/HPF）计数，并评估这种方法是否能够根据 2020 年 AUA/SUFU 微量血尿指南进行有效的风险分层。
通过向美国学术医疗机构或商业实验室的泌尿科医生查询，收集 RBC/HPF 计数（范围或实际计数）的报告方法。我们探讨了（1）报告方案是否与新微量血尿指南中的风险分层（3-10 [低风险]、11-25 [中风险]和超过 25 [高风险]）一致，以及（2）根据报告方法评估风险组分类错误的可能性。
获得了 141 个实验室的数据。72 个（51%）使用 RBC/HPF 范围，其余则使用实际计数（或计数到阈值）。60 个（42%）报告的范围截止值与微量血尿指南的风险组不一致。此外，56 个（40%）不包括 25 RBC/HPF 的截止值，这可能会错误分类中风险和高风险组。最后，16 个（11%）不包括定义微量血尿的 3 RBC/HPF 截止值。
相当数量的实验室报告的 RBC/HPF 计数范围与 2020 年 AUA/SUFU 指南中的阈值不同。这意味着在最低阈值诊断（3 RBC/HPF）以及中风险和高风险组之间都存在潜在的微量血尿分类错误。报告方案标准化为实际的 RBC/HPF 计数可能会提高对指南的遵循，同时为未来的指南制定提供数据。
