Department of Medical Biophysics, Kobe University Graduate School of Health Sciences, Kobe, Japan.
Department of Clinical Laboratory Science, Faculty of Health Care, Tenri University, Tenri, Japan.
Cytopathology. 2024 Sep;35(5):642-647. doi: 10.1111/cyt.13397. Epub 2024 May 28.
Recently, the nuclear area has attracted attention as a morphological parameter to differentiate high-grade urothelial carcinoma (HGUC) cells from benign reactive cells. The nuclear long diameter (NLD) strongly correlates with the nuclear area and is easy to subjectively estimate. Therefore, this study examined the usefulness of the NLD-to-neutrophil diameter ratio for detecting HGUC cells in urine cytology.
This study included 29, 26 and 18 patients with HGUC, glomerular disease and urolithiasis respectively. An image analysis system was used to measure the NLD of HGUC and benign reactive cells (reactive renal tubular cells and reactive urothelial cells) and the neutrophil diameter that appeared in the voided urine in these cases. The NLD index was calculated using the NLD-to-neutrophil diameter ratio. We subsequently compared HGUC and benign reactive cells with respect to NLD and NLD indices. In addition, the HGUC cell group and benign reactive cell group were compared by selecting the five cells with the largest NLD and NLD index on each slide.
The NLD and NLD indices of HGUC cells were significantly higher than those of benign reactive cells in all cells and in the five cells with the largest NLD and NLD indices. The cut-off value of the NLD index for detecting HGUC cells was 1.25 in all cells and 1.80 in the five cells with the largest NLD index.
The NLD index is a useful parameter that can be introduced into routine microscopic examinations to differentiate HGUC cells from benign reactive cells.
最近，核区作为一种形态学参数引起了人们的关注，可用于区分高级尿路上皮癌（HGUC）细胞与良性反应性细胞。核长径（NLD）与核面积强烈相关，且易于主观估计。因此，本研究探讨了 NLD 与中性粒细胞直径比在尿细胞学检测 HGUC 细胞中的应用价值。
本研究纳入了 29 例 HGUC 患者、26 例肾小球疾病患者和 18 例尿路结石患者。使用图像分析系统测量 HGUC 及良性反应性细胞（反应性肾小管细胞和反应性尿路上皮细胞）的 NLD 和这些患者尿液中出现的中性粒细胞直径。采用 NLD 与中性粒细胞直径比计算 NLD 指数。随后，我们比较了 HGUC 和良性反应性细胞的 NLD 和 NLD 指数。此外，通过选择每张载玻片上 NLD 和 NLD 指数最大的 5 个细胞，对 HGUC 细胞组和良性反应性细胞组进行了比较。
在所有细胞和 NLD 及 NLD 指数最大的 5 个细胞中，HGUC 细胞的 NLD 和 NLD 指数明显高于良性反应性细胞。在所有细胞和 NLD 指数最大的 5 个细胞中，用于检测 HGUC 细胞的 NLD 指数的截断值分别为 1.25 和 1.80。
NLD 指数是一种有用的参数，可以引入常规显微镜检查，以区分 HGUC 细胞与良性反应性细胞。
