Atypical cells parameter in Sysmex UN automated urine analyzer: feedback from the field

Abstract

Background “Atypical cells” parameter in automated urinalysis has recently been introduced. An instrument capable of measuring quantitative and qualitative features of nuclear and cytoplasmic properties of a cell has the potential to detect cellular atypia. Instruments using flow cytometry have been detecting atypical cells in blood for a long time; yet instruments using the same methodology very lately developed this parameter in urinalysis. Materials and methods Samples with an atypical cells value higher than 1 atypical cell/µL were included in the study. Besides automated urinalysis, every sample was reflexed to modular unit for digital imaging. The remainder of each sample was stained with Sternheimer dye and examined manually under a light microscope. Results 50 samples with higher than1 atypical cell/µL result were included in the study. Patients were composed of 43 females (86 %) and 7 males (14 %). The mean age was 47.12 ± 19.45 years. The median atypical cells value was 1.8/µL (95 % range 1.5–2.4/µL). Manual microscopic evaluation of the 50 samples showed atypical cells in 1 sample. The patient had papillary lesions on cystoscopy and pathology report informed a high grade urothelial carcinoma. Other 49 samples were negative for atypical cells in manual microscopy. They were crowded samples with leucocytes and squamous epithelial cells. Conclusions The positive case provided evidence for Sysmex UN’s capability to detect atypical cells in urine. The negative cases presented clues that probable vulvovaginal contamination and crowded specimens could be deceptive for Sysmex UN in this particular parameter.

Investigation of Atypical Cell Parameter in the Surveillance of Patients with NMIBC; Initial Outcomes of a Single Center Prospective Study

“…In a study by Aydın et al, vaginal clue cells were observed when the urine sample of a patient with atypical cell value of 13.7/µL was examined by manual microscopy. 10 Another possibility is that malignancy may be detected in these patients in the future as mentioned above. For this reason, we continue to follow up these patients to perform cystoscopy again if necessary.…”

“…Atypical cells have enlarged nuclei and a higher nucleus/cytoplasm ratio, as evidenced by side uorescence and scattered light properties. 10 There is no subjective interpretation at any stage of this measurement. Therefore, it gives objective results.…”

The UF-5000 Atyp.C parameter is an independent risk factor for bladder cancer

“…First, only Atyp.C was analyzed as a risk factor for BC, with other known risk factors for BC, such as smoking, heavy use of antibiotics, and common history, omitted. Moreover, urinary Atyp.C values were easily affected by high squamous cell counts and pyuria, and its repeatability was unstable owing to different urinary sample qualities and clinical treatments and interventions in the same patient 15 , 16 . Therefore, using urinary Atyp.C levels alone as a diagnostic index is difficult.…”

“…Recent studies of human urothelial cancers have demonstrated that “Atyp.C” can identify cancer cells with a 71.1% agreement with urine cytology, which has some auxiliary significance in the clinical diagnosis of urothelial carcinoma 15 , 16 . The purpose of this study was to explore the relationship between Atyp.C and BC risk in detail, which should lay a foundation for the later optimization of Atyp.C as an early non-invasive diagnostic and monitoring indicator of BC.…”

Comparison of the clinical performance of the Atyp.C parameter of the UF-5000 fully automated urine particle analyzer with that of microscopic urine sediment analysis

“…The concordance between the results of the two tests was 96.3% and 76.9% in the low- and high-risk groups, respectively. Additionally, Ozgur presented a case in which Atyp.Cs were detected by microscopy when the Atyp.C value was >1/mL [ 27 ]. The results of our study suggest that the Atyp.C value increases with an increase in intracytoplasmic inclusion-bearing cells and severe leukocyturia, but why this occurs has not been explained.…”