活体染色法在筛查尿液诱饵细胞中的应用  

Application of in vivo staining for screening decoy cells in urine samples

作　　者：闫立志[1] 张时民[2] YAN Lizhi;ZHANG Shimin(Department of Clinical Laboratory, Baogang Hospital, Baotou 014010, Inner Mongolia;Department of Clinical Laboratory, Peking Union Medical College Hospital, Beijing 100032, China)

机构地区：[1]内蒙古包钢医院医学检验科,包头014010 [2]北京协和医院检验科,北京100032

出　　处：《临床检验杂志》2020年第10期738-740,共3页Chinese Journal of Clinical Laboratory Science

摘　　要：目的用活体染色法筛查长期使用免疫抑制剂的肾移植术后患者尿液中的多瘤病毒感染后的细胞,即“诱饵细胞”。方法留取2019年1月至2020年4月内蒙古包钢医院106例肾移植患者(服用免疫抑制剂在3个月以上)的尿液标本,用未染色直接镜检法、沙黄-结晶紫(SM)染色法、阿利新蓝-派洛宁(S)染色法检查尿液中诱饵细胞,对筛查出诱饵细胞的尿液标本做BK病毒(BKV)和JC病毒(JCV)核酸检测进行确证。结果在106例肾移植术后患者的尿液标本中,用未染色直接镜检法检出12例诱饵细胞,阳性率11.3%;使用SM染色法或S染色法检出21例诱饵细胞,阳性率19.8%;在21例检出诱饵细胞的尿液标本中,BKV和(或)JCV核酸阳性符合率为95.2%,其中BKV核酸阳性6例,占28.6%,JCV核酸阳性10例,占47.6%,BKV和JCV核酸同时阳性4例,占19.0%。结论SM染色法、S染色法2种活体染色法是操作简单、快速而有效的尿诱饵细胞检测方法,在筛查肾移植术后患者因长期使用免疫抑制剂而感染多瘤病毒方面有着重要意义。Objective To screen polyomavirus-infected cells e,g,decoy cells,in urine of kidney transplantation patients received immunosuppressants for long-term by in vivo staining methods.Methods The urine samples from 106 patients who received kidney transplantation surgery and immuno-suppressants for more than 3 months were collected in Baogang Hospital from January 2019 to April 2020.The decoy cells were screened by direct microscopic examination without staining,Sternheimer-Malbin(SM)staining and Sternheimer staining(S staining)and confirmed by amplification of nucleic acid of BK and JC virus in the screened urine samples,thus the specific morphological changes in the cells were believed to be caused by the infection of these virus.Results Among the urine samples from 106 kidney transplantation patients,decoy cells were detectable in 12 cases(11.3%)by direct microscopy without staining and detectable in 21 cases(19.8%)by SM or S staining.Of the 21 samples with decoy cells,20 cases(95.2%)were positive for BK and(or)JC viral nucleic acid,in which 6 cases(28.6%)were positive for BKV nucleic acid,10 cases(47.6%)were positive for JCV nucleic acid and 4 cases(19.0%)were positive for both BKV and JCV nucleic acid.Conclusion Both SM and S staining were simple,rapid and effective methods for detecting decoy cells in the urine samples.The staining methods should be of important clinical significance forscreening the patients infected with human polyoma virus after kidney transplantation surgery due to use of immunosuppressants for long-term.

关 键 词：SM染色法 S染色法 诱饵细胞 BK病毒 JC病毒 

分 类 号：R446[医药卫生—诊断学]