title: Diagnostic value of urine erythrocyte morphology in the detection of glomerular disease in SurePath™ liquid-based cytology compared with fresh urine sediment examination.
abstract: OBJECTIVE
  To assess whether the morphology of urine erythrocytes can be an effective tool for distinguishing glomerular disease from lower urinary tract disease in SurePath™ liquid-based cytology (SP-LBC).
  
  
  METHODS
  We examined four morphological parameters of erythrocytes: (1) irregular erythrocytes (of all types including fragmented forms) comprising greater than or equal to 20% of erythrocytes; (2) uniform erythrocytes (>80%); (3) doughnut or target-like shaped (D/T) erythrocytes (≥1%); and (4) acanthocytes (≥1%) in glomerular disease (n = 32) and lower urinary tract disease (n = 20) with SP-LBC slides in cases that had also been assessed by fresh urine sediment examination.
  
  
  RESULTS
  Sensitivity of D/T erythrocytes and acanthocytes (dysmorphic erythrocytes) for glomerular disease were 100% and 87.5%, respectively, with urine sediment examination, and 81.3% and 46.9%, respectively, in SP-LBC slides. Specificity was 100% for D/T erythrocytes and acanthocytes using either procedure. While irregular erythrocytes were specific for glomerular disease using urine sediment examination, they were seen in 70% of those with lower urinary tract disease using SP-LBC slides as a result of the deformation of erythrocytes by the fixative.
  
  
  CONCLUSIONS
  Although the sensitivity of D/T erythrocytes and acanthocytes for glomerular disease was lower in SP-LBC slides than fresh urine sediment examination, their specificity was equally high. Therefore, urine erythrocyte morphology is useful in the detection of glomerular disease with the SP-LBC slides. However, morphological features apart from D/T erythrocytes and acanthocytes are not useful in SP-LBC slides.
authors.affiliation: Department of Medical Technology, Ehime Prefectural University of Health Sciences, Japan. ohsaki@epu.ac.jp
authors.forename: H
authors.initials: H
authors.lastname: Ohsaki
authors.forename: T
authors.initials: T
authors.lastname: Hirouchi
authors.forename: N
authors.initials: N
authors.lastname: Hayashi
authors.forename: E
authors.initials: E
authors.lastname: Okanoue
authors.forename: M
authors.initials: M
authors.lastname: Ohara
authors.forename: N
authors.initials: N
authors.lastname: Kuroda
authors.forename: E
authors.initials: E
authors.lastname: Hirakawa
authors.forename: Y
authors.initials: Y
authors.lastname: Norimatsu
mesh_terms: D000050:Acanthocytes / Q000473:pathology; D048430:Cell Shape; D004909:Erythrocyte Indices; D004912:Erythrocytes / Q000473:pathology*; D005921:Glomerulonephritis / Q000652:urine*; D006417:Hematuria / Q000175:diagnosis*; D006801:Humans; D007678:Kidney Glomerulus / Q000473:pathology; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D013194:Staining and Labeling; D013997:Time Factors; D016482:Urinalysis / Q000379:methods; D014570:Urologic Diseases / Q000652:urine*