title: Clinical utility of squamous and transitional nuclear structure alterations induced by Schistosoma haematobium in chronically infected adults with bladder damage verified by ultrasound in Ghana.
abstract: OBJECTIVE
  To evaluate the clinical utility of quantitative nuclear morphometry--i.e., alteration in nuclear size/shape, DNA content and chromatin structure-of intact cells obtained from the sediment of urine specimens collected from people living in an area highly endemic for Schistosoma haematobium in Ghana.
  
  
  METHODS
  Digital images of Feulgen-DNA-stained squamous cell (SC) and transitional cell (TC) urothelial nuclei were captured using the AutoCyte imaging system, and nuclear morphometric descriptors (NMDs) were calculated. A total of 3,495 and 4,523 SC and TC nuclei from normal bladder ultrasound subjects (n =21) and 3,465 and 3,064 SC and TC nuclei from severely abnormal bladder ultrasound subjects (n = 20) were captured.
  
  
  RESULTS
  Univariate logistic regression analyses of pooled SC and TC nuclei training sets showed that 27/40 NMDs and 24/40 NMDs were univariately significant for differentiating between SCs and TCs of subjects with normal and severely abnormal bladder ultrasound. Multivariate models constructed using NMDs with > or = 50% inclusion frequency yielded AUC-ROCs of 75.23% and 74.42% in the SC training and validation, and 69.90% and 66.70% for TC training and validation. Further, a squamous cell patient-specific model predicted severe bladder damage with an AUC-ROC of 86.90%, yielding the sensitivity, specificity and accuracy of 85.00%, 76.19% and 80.49%, respectively.
  
  
  CONCLUSIONS
  Quantitative nuclear structure alterations can be used to make a noninvasive assessment of cytologic changes observed in both SC and TC bladder epithelia due to S haematobium infection.
authors.affiliation: Department of Molecular Microbiology and Immunology, The Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
authors.forename: Jean
authors.initials: J
authors.lastname: Naples
authors.forename: Sumit
authors.initials: S
authors.lastname: Isharwal
authors.forename: Clive J
authors.initials: CJ
authors.lastname: Shiff
authors.forename: Kwabena M
authors.initials: KM
authors.lastname: Bosompem
authors.forename: Robert W
authors.initials: RW
authors.lastname: Veltri
mesh_terms: D000328:Adult; D000818:Animals; D002467:Cell Nucleus / Q000000981:diagnostic imaging / Q000648:ultrastructure*; D002908:Chronic Disease; D005869:Ghana / Q000453:epidemiology; D006801:Humans; D016015:Logistic Models; D012548:Schistosoma haematobium; D012553:Schistosomiasis haematobia / Q000000981:diagnostic imaging / Q000473:pathology*; D014463:Ultrasonography; D001745:Urinary Bladder Diseases / Q000000981:diagnostic imaging / Q000469:parasitology* / Q000473:pathology* / Q000652:urine; D019459:Urothelium / Q000000981:diagnostic imaging / Q000469:parasitology / Q000473:pathology