Urinary Decoy Cell Grading and Its Clinical Implications.
10.4132/KoreanJPathol.2012.46.3.233
- Author:
Myoung Ju KOH
1
;
Beom Jin LIM
;
Songmi NOH
;
Yon Hee KIM
;
Hyeon Joo JEONG
Author Information
1. Department of Pathology, Yonsei University College of Medicine, Seoul, Korea. jeong10@yuhs.ac
- Publication Type:Original Article
- Keywords:
Decoy cell;
Polyomavirus nephropathy;
Monitoring
- From:Korean Journal of Pathology
2012;46(3):233-236
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: Examination of urine for decoy cells (DCs) is a useful screening test for polyomavirus (PV) activation. We explored the significance of the amount of DCs in persistent shedding, PV nephropathy and acute rejection. METHODS: A case-controlled study was performed in 88 renal allograft patients who had DCs detected at least once in four or more urine samples. RESULTS: Fifty one patients were classified into the high-grade shedding group (HG) and 37 patients into the low-grade shedding group (LG) according to DC shedding (> or =10 or <10 DCs/10 high power field [HPF]). DC shedding of more than three consecutive months was significantly more prevalent in the HG as compared with their LG counterparts (p<0.0001). Urinary DCs were present for more than one year in 29.4% of the HG and 8.1% of the LG. Real-time polymerase chain reaction for PV was higher in both urine (51.4% vs. 11.1%) and plasma (9.1% vs. 0%) of the HG than the LG. The prevalence of PV nephropathy was higher in the HG than the LG (p=0.019). However, there was no significant difference in the prevalence of acute rejection. CONCLUSIONS: Shedding of > or =10 DCs/10 HPF is associated with sustained shedding, polymerase chain reaction positivity and PV nephropathy, but not a predictor of acute rejection.