Improved Identification of White Blood Cells and Renal Tubular Epithelial Cells in Urine Using Cytology

Abstract:

Objectives: Conventional automatic identification system to differentiate white blood cells from renal tubular epithelial cells was limited by overlapping parameters and investigation of clear classification of these two cells could be critical to diagnosis and prognosis. Methods: Urine samples from 120 individuals (30 bladder cystitis, 30 glomerular nephritis, 30 pyelonephritis and 30 nephrotic syndrome) were collected. Urine sediments were stained by Sternheimer method and examined by TJYDSXG-1 microscopic cell analysis system including cell size, degree of cytoplasmic staining and nuclear coefficient of variation (CV). Peroxidase chemical staining was also employed to differentiate white blood cells (WBC) and renal tubular epithelial cells (RTEC) in sediments. Results: WBC in urine sediment was (8-13) μm, while (10-16) μm for RTEC, with 36% overlapping of nuclear CV. Peroxidase chemical staining intensity index is 0-4 for WBC and 0-1 for RTEC. Conclusions: Percentage of overlap between WBC and RTEC can be reduced to 7%-13% when Sternheimer staining was combined with peroxidase staining.

• Periodical: Applied Mechanics and Materials (Volume 140)
• Pages: 152-156
• DOI: https://doi.org/10.4028/www.scientific.net/AMM.140.152
• Online since: November 2011
• Authors: Xu Guo Sun, Dian Jun Wei, Xiao Chun Liu, Yu Zhu Ma, Xin Fan, Ke Sheng Hu
• Keywords: Identification, Renal Tubular Epithelial Cells, Urine, White Blood Cells

References

[1] Budak YU, Huysal K. Comparison of three automated systems for urine chemistry and sediment analysis in routine laboratory practice.Clin Lab. 2011;57(1-2):47-52.

[2] Zaman Z, Fogazzi GB, Garigali G, Croci MD, Bayer G, Kránicz T. Urine sediment analysis: Analytical and diagnostic performance of sediMAX - a new automated microscopy image-based urine sediment analyser. Clin Chim Acta. 2010;411(3-4):147-154.

DOI: 10.1016/j.cca.2009.10.018

[3] Raisi O, Magnani C, Bigiani N, Cianciavicchia E, D'Amico R, Muscatello U, Ghirardini C, The diagnostic reliability of urinary cytology: A retrospective study. Diagn Cytopathol. 2011；00：1-7.

DOI: 10.1002/dc.21716

[4] Jiang T, Chen P, Ouyang J, Zhang S, Cai D. Urine particles analysis: performance evaluation of Sysmex UF-1000i and comparison among urine flow cytometer, dipstick, and visual microscopic examination. Scand J Clin Lab Invest. 2011;71(1):30-37.

DOI: 10.3109/00365513.2010.535011

[5] Pellet H, Minaire E, Cavailles C, Thonnerieux M. Advantage of phase contrast for the identification of the cellular constituents of urinary sediment. Bull Assoc Anat (Nancy). 1979;63(182):323-334.

[6] Decavele AS, Dhondt L, De Buyzere ML, Delanghe JR. Increased urinary neutrophil gelatinase associated lipocalin in urinary tract infections and leukocyturia. Clin Chem Lab Med. 2011;49(6):999-1003.

DOI: 10.1515/cclm.2011.156

[7] Jolkkonen S, Paattiniemi EL, Kärpänoja P, Sarkkinen H. Screening of urine samples by flow cytometry reduces the need for culture. J Clin Microbiol. 2010;48(9):3117-3121.

DOI: 10.1128/jcm.00617-10

[8] Chien TI, Kao JT, Liu HL, Lin PC, Hong JS, Hsieh HP, Chien MJ. Urine sediment examination: a comparison of automated urinalysis systems and manual microscopy. Clin Chim Acta. 2007;384(1-2):28-34.

DOI: 10.1016/j.cca.2007.05.012