全自动尿沉渣分析仪检测“异型细胞”对尿路上皮癌筛查价值的初步探讨

Diagnostic value of "atypical cell" detected by automatic urine sediment analyzer for screening urothelial carcinoma

目的探讨全自动尿沉渣仪检测"异型细胞"对尿路上皮癌的筛查价值。方法纳入2014年9月至2015年8月天津医科大学第二医院54 852例门/急诊患者,用FUS2000/FUS200尿沉渣仪进行尿有形成分检测,用人工图像复核、人工显微镜、瑞氏染色3种方式对"异型细胞(肿瘤细胞)"进行形态学确认。跟踪随访"异型细胞"阳性患者的病理诊断结果。结果 54 852例患者中271例检测到"异型细胞",阳性率0.5%。271例"异型细胞"阳性患者中194例病理诊断为尿路上皮癌,全自动尿沉渣分析仪结合人工复核对"异型细胞"的判定与病理诊断相符率为78.2%(194/248)。结论全自动尿沉渣仪检测到"异型细胞"提示临床开展尿路上皮癌相关检查。

Objective To investigate the value of ＂ atypical cell＂ detected by automatic urine sediment analyzer for screening urothelial carcinoma. Methods A total of 54 852 cases of outpatients or emergency patients in the hospital from September 2014 to August 2015 were enrolled in this study. The urinary particles were analyzed with FUS2000 / FUS200. Three ways were used for manual review of the particles（ tumor cells）,including images manual reclassification,manual microscope and Wright＇s stain. The ＂ atypical cell＂ was determined and the pathological diagnosis was followed up through the medical record system. Results Among the overall 54 852 casesin this study, ＂ atypical cell＂ was found in 271 cases and the positive rate was 0. 5%. Of the 271 ＂ atypical cell＂-positive patients,248 patients were followed-up successfully and 194 patients were diagnosed as urothelial carcinoma by histopathology. The coincidence rate of the reported ＂ atypical cell＂ with histopathological diagnosis was 78. 2%. Conclusion When ＂ atypical cell＂ was visualized,the clinician should be advised to pursue to further confirmatory analyses for the initial finding.