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.
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.
Naples
Jean
J
Department of Molecular Microbiology and Immunology, The Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
Isharwal
Sumit
S
Shiff
Clive J
CJ
Bosompem
Kwabena M
KM
Veltri
Robert W
RW
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