尿液有形成分分析仪检测“非典型细胞”在膀胱癌筛查中的价值  

Value of atypical cell detection via urinary sediment analyzer in bladder cancer screening

作　　者：徐巧萍[1] 余林涛 陈娟[1] 吴志成[1] XU Qiao-ping;YU Lin-tao;CHEN Juan;WU Zhi-cheng(Department of Clinical Laboratory,Peking University Shenzhen Hospital,Shenzhen 518036,Guangdong,China)

机构地区：[1]北京大学深圳医院检验科,广东深圳518036

出　　处：《广东医学》2025年第2期278-283,共6页Guangdong Medical Journal

基　　金：吴阶平医学基金会临床科研专项资助基金(320.6750.2022-06-21)。

摘　　要：目的探讨全自动尿液有形成分分析仪检测“非典型细胞”(Atyp.C)对膀胱癌筛查的价值。方法使用SYSMEX UF-5000全自动尿液有形成分分析仪检测2022年9月至2023年3月的19362例疑似泌尿系统疾病尿液标本,获得231例Atyp.C阳性标本,同时随机选取100例Atyp.C阴性标本,均进行瑞氏染色及形态学分类。采用阳性预测值、阴性预测值以及受试者工作特征(ROC)曲线评价Atyp.C诊断膀胱癌的效能。结果231例Atyp.C阳性的患者标本中有84例显示细胞形态学异常,其中有18例临床诊断为膀胱癌。以尿液分析仪结果比较临床诊断膀胱肿瘤的阳性预测值为7.8%,阴性预测值为100.0%,敏感度为100.0%,特异度为31.9%,一致性为35.6%。ROC曲线下面积为0.647,敏感度为70.7%,特异度为54.8%。结论Atyp.C检测可作为疑似膀胱癌患者的辅助检查,因为它能够识别可能需要进一步随访或治疗的高危患者。Objective To evaluate the value of detecting the atypical cells(Atyp.C)using an automated urine sediment analyzer for bladder cancer screening.Methods Using the SYSMEX UF-5000 automated urine sediment analyzer,19362 urine specimens from suspected urinary system disease cases were analyzed between September 2022 and March 2023.Among these,231 specimens tested positive for Atyp.C,while 100 Atyp.C-negative samples were randomly selected for comparison.All samples underwent Wright staining and morphological classification.The diagnostic efficacy of Atyp.C for bladder cancer was evaluated using positive predictive value(PPV),negative predictive value(NPV),and receiver operating characteristic(ROC)curve analysis.Results Among the 231 Atyp.C-positive samples,84 showed abnormal cellular morphology,with 18 cases clinically diagnosed as bladder cancer.The positive predictive value for bladder cancer diagnosis using the urinary sediment analyzer was 7.8%,while the negative predictive value was 100.0%,with a sensitivity of 100.0%,specificity of 31.9%,and overall concordance of 35.6%.The area under the ROC curve(AUC)was 0.647,with a sensitivity of 70.7%and specificity of 54.8%.Conclusion Atyp.C detection can serve as an adjunctive screening method for bladder cancer,enabling identification of high-risk patients who may require further follow-up or treatment.

关 键 词：膀胱癌 尿液分析 非典型细胞 细胞学 尿液有形成分分析仪 

分 类 号：R446.12[医药卫生—诊断学] R737.14[医药卫生—临床医学]