The standardization of urine particle counting in medical laboratories – a Polish experience with the EQA programme

Ćwiklińska, Agnieszka; Kąkol, Judyta; Kuchta, Agnieszka; Kortas-Stempak, Barbara; Pacanis, Anastasis; Rogulski, J; Wróblewska, Małgorzata

doi:10.3109/00365513.2011.628688

Cited by 6 publications

(14 citation statements)

References 16 publications

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“…They showed that only 13% of laboratories use automatic systems for sediment examination. Moreover, even though laboratories are asked to use standardized procedure for sediment examination, only 29% of the results could have been considered to be standardized (16% – manual methods, 13% – automated systems) ( 26 ).…”

Section: Discussionmentioning

confidence: 99%

Preanalytics of urine sediment examination: effect of relative centrifugal force, tube type, volume of sample and supernatant removal

Bunjevac¹,

Gabaj

Miler

et al. 2017

Biochemia Medica

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IntroductionLaboratories often modify procedures recommended by the European Urinalysis Guidelines for urine sediment analysis. The aim of this study was to compare the recommended protocol with our routine laboratory procedure and to evaluate the possible impact of modifications in the relative centrifugal force, type of tube, method of supernatant aspiration and urine volume on patient’s results.Material and methodsFirstly, relative centrifugal force was investigated using 20 pairs of samples examined after centrifugation at 400xg and 1358xg. In phase two, 110 samples were examined, paired as: round bottom vs conical tube (N = 46), decanting vs suction of supernatant (N = 100) and 10 mL vs 5 mL of urine sample (N = 101).ResultsThe number of erythrocytes, leukocytes and squamous epithelial cells was significantly lower after centrifugation at 400xg (P = 0.001, 0.002 and 0.004, respectively). The number of leukocytes was significantly lower in conical tubes (P = 0.010), after the suction of supernatant (P = 0.045) and in 5 mL urine (P < 0.001). The number of squamous epithelial cells was significantly lower after the suction of supernatant (P < 0.001) and in 5 mL urine (P < 0.001). The number of erythrocytes (P < 0.001), total non-hyaline casts (P < 0.001) and the frequency of granular casts (P = 0.039) was significantly lower in 5 mL urine.ConclusionLower results of leukocytes, erythrocytes, squamous cells and non-hyaline casts were recorded in recommended procedures (centrifugation at 400xg, suction of supernatant, conical tube, 5 mL of sample) than in routine procedure (centrifugation at 1358xg, decanting of supernatant, round bottom tube, 10 mL) used in our laboratory.

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Section: Discussionmentioning

confidence: 99%

Preanalytics of urine sediment examination: effect of relative centrifugal force, tube type, volume of sample and supernatant removal

Bunjevac¹,

Gabaj

Miler

et al. 2017

Biochemia Medica

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“…Therefore, cytology is often complemented by other tests in parallel. Counting urinary particles is another important part of a routine urinalysis, providing a non-invasive and inexpensive clinical significance 55 . Urine microscopic examination is to identify and quantify the insoluble substances present in the urine under the microscope.…”

Section: Current Technologies For Urine-based Biomarkersmentioning

confidence: 99%

Urine biopsy technologies: Cancer and beyond

Chen¹,

Liao²,

Li³

et al. 2020

Theranostics

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Since the discovery of circulating tumor cells in 1869, technological advances in the study of biomarkers from liquid biopsy have made it possible to diagnose disease in a less invasive way. Although blood-based liquid biopsy has been used extensively for the detection of solid tumors and immune diseases, the potential of urine-based liquid biopsy has not been fully explored. Advancements in technologies for the harvesting and analysis of biomarkers are providing new opportunities for the characterization of other disease types. Liquid biopsy markers such as exfoliated bladder cancer cells, cell-free DNA (cfDNA), and exosomes have the potential to change the nature of disease management and care, as they allow a cost-effective and convenient mode of patient monitoring throughout treatment. In this review, we addressed the advancement of research in the field of disease detection for the key liquid biopsy markers such as cancer cells, cfDNA, and exosomes, with an emphasis on urine-based liquid biopsy. First, we highlighted key technologies that were widely available and used extensively for clinical urine sample analysis. Next, we presented recent technological developments in cell and genetic research, with implications for the detection of other types of diseases, besides cancer. We then concluded with some discussions on these areas, emphasizing the role of microfluidics and artificial intelligence in advancing point-of-care applications. We believe that the benefits of urine biopsy provide diagnostic development potential, which will pave opportunities for new ways to guide treatment selections and facilitate precision disease therapies.

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“…Many laboratories still apply the non-standardised coverslip method with decanting supernatant after centrifugation and inserting the drop of sediment on the slide. Thus, the low precision and wide uncertainty of results obtained with the coverslip method is observed (2,10). Chamber use standardises the volume of sample analysed under the microscope and analysis of uncentrifuged urine enables to avoid errors related with the centrifugation step.…”

Section: Introductionmentioning

confidence: 99%

“…Moreover, different protocols for manual methods can be applied in laboratories, varying in type of analysed specimen (stained or unstained), type of microscope used (bright-field or contrast-phase), the manner of expression of the results (per high power field (HPF) or in a volume unit). If a centrifuged sample is analysed, laboratories can also apply a different force and time of centrifugation, as well as the manner (decanting, using a pipette) and degree of urine concentration (2,(10)(11)(12). Thus, despite the availability of recommendations/guidelines for urine particle analysis, the standardisation of urine particle analysis procedures is poor (2,(10)(11)(12)(13).…”

Section: Introductionmentioning

confidence: 99%

The results of external quality assessment programme on urine leukocyte and erythrocyte counting in Poland

Ćwiklińska

Kowalski

Kortas-Stempak

et al. 2020

Biochem. med. (Online)

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Introduction: Urine particle analysis is an important diagnostic tool. The aim of this study was to evaluate the quality of urine leukocyte (WBC) and erythrocyte (RBC) counting results obtained with manual and automated methods in Polish laboratories participating in the international external quality assessment (EQA) programme. Materials and methods: 1400 WBC and RBC counting results were obtained from 183 laboratories in EQA surveys organised by Labquality (Helsinki, Finland) from 2017 to 2019. The between-laboratory coefficient of variation (CV), the percentage difference between the laboratories' results and target values (Q-score (%)), as well as modified Youden plots were analysed. Results: For automated method groups, the medians of inter-laboratory CVs varied from 14% to 33% for WBC counting and from 10% to 39% for RBC counting. For manual method groups, the medians of CV varied from 53% to 71% (WBC) and from 55% to 70% (RBC), and they were significantly higher, in comparison to CVs for most automated method groups (P < 0.001). The highest percentage of results outside the target limits (36%) and the highest range of Q-score (%) (from - 93% to 706%) were observed for laboratories which participated in the surveys for the first or second time. The percentage of deviating results and the ranges of Q-score decreased with an increased frequency of laboratories’ participation in the surveys. Conclusions: The quality of manual methods of urine WBC and RBC counting is unsatisfactory. There is an urgent need to take actions to improve laboratories’ performance and to increase harmonisation of the results.

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The standardization of urine particle counting in medical laboratories – a Polish experience with the EQA programme

Abstract: The standardization of urine particle counting methods continues to be a significant problem in medical laboratories and requires further recovery activities which can be conducted using the EQA scheme.

Cited by 6 publications

References 16 publications

Preanalytics of urine sediment examination: effect of relative centrifugal force, tube type, volume of sample and supernatant removal

Preanalytics of urine sediment examination: effect of relative centrifugal force, tube type, volume of sample and supernatant removal

Urine biopsy technologies: Cancer and beyond

The results of external quality assessment programme on urine leukocyte and erythrocyte counting in Poland

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