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KMID : 0357920120460030233
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Korean Journal of Pathology
2012 Volume.46 No. 3 p.233 ~ p.236
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Urinary Decoy Cell Grading and Its Clinical Implications
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Koh Myoung-Ju
Lim Beom-Jin
Noh Song-Mi
Kim Yon-Hee
Jeong Hyeon-Joo
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Abstract
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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 (≥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 ≥10 DCs/10 HPF is associated with sustained shedding, polymerase chain reaction positivity and PV nephropathy, but not a predictor of acute rejection.
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KEYWORD
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Decoy cell, Polyomavirus nephropathy, Monitoring
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