The role of automated urine particle flow cytometry in clinical practice

被引:92
作者
Delanghe, JR
Kouri, TT
Huber, AR
Hannemann-Pohl, K
Guder, WG
Lun, A
Sinha, P
Stamminger, G
Beier, L
机构
[1] State Univ Ghent Hosp, Dept Clin Chem, B-9000 Ghent, Belgium
[2] Tampere Univ Hosp, Ctr Lab Med, FIN-33521 Tampere, Finland
[3] Kantonsspital Aarau, Ctr Lab Med, CH-5001 Aarau, Switzerland
[4] Marienkrankenhaus, Inst Lab Med Microbiol & Transfus Med, D-22087 Hamburg, Germany
[5] Stadt Krankenhaus Munchen Bogenhausen, Inst Clin Chem, D-81925 Munich, Germany
[6] Humboldt Univ, Univ Clin Charite, Inst Lab Med & Pathobiochem, D-10117 Berlin, Germany
[7] Klinikum Chemnitz GmbH, Inst Lab Med, D-09113 Chemnitz, Germany
关键词
automation; expert system; flow cytometry; urine microscopy; sediment; test strip; urinalysis;
D O I
10.1016/S0009-8981(00)00342-9
中图分类号
R446 [实验室诊断]; R-33 [实验医学、医学实验];
学科分类号
1001 ;
摘要
Urine particle flow cytometers (UFC) have improved count precision and accuracy compared to visual microscopy and offer significant labor saving. The absence of an internationally recognized reference measurement procedure, however, is a serious drawback to their validation. Chamber counting by phase contrast microscopy of supravitally-stained uncentrifuged urine is considered the best candidate for reference. The UF-100 (Sysmex Corporation, Japan) identifies RBC, WBC, squamous epithelial cells, transitional epithelial and renal tubular cells (SRC), bacteria, hyaline and inclusional casts, yeast-like cells, crystals and spermatozoa, using argon laser flow cytometry. Evaluations have established acceptable linearity over useful working ranges, with an imprecision that is consistently and significantly less than microscopy, and with negligible carry-over. Comparisons of UFC with chamber counts, quantitative urine microscopy, sediment counts, test strips, bacterial culture and urine density are reviewed. Clinical studies include diagnosis and monitoring of urinary tract infection; localization of the sites of hematuria; and diagnosis, monitoring and exclusion of renal disease. The most popular approach is to combine test strips with UFC for primary screening either always by both methods or by using test strips for analytes unrelated to particles analyzed by UFC. Expert systems now exist combining both test modalities based on user definable decision rules. The implementation of such a strategy significantly reduces microscopy review and saves time and expense without diminishing clinical utility. (C) 2000 Elsevier Science B.V. All rights reserved.
引用
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页码:1 / 18
页数:18
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