Atypical cells parameter in an automated urine analyzer: Does it have a future?

Area of Science:

• Uropathology
• Clinical Chemistry
• Medical Diagnostics

Background:

• The Sysmex UN-Series automated urine analyzer now includes an "atypical cells" parameter.
• These cells are suspected to be neoplastic epithelial cells in urine samples.

Discussion:

• The "atypical cells" parameter in urinalysis has potential utility, akin to the blast parameter in hematology.
• However, it presents significant disadvantages and limitations compared to established hematologic markers.
• Its current quantitative reporting may lead to misinterpretation and over-reliance.

Key Insights:

• The "atypical cells" parameter should be utilized as a qualitative "caution flag" rather than a precise quantitative measurement.
• Establishing a defined decision limit is crucial for appropriate clinical application.
• Integrating the "atypical cells" parameter with other urinalysis findings, such as the color parameter for hematuria, could enhance diagnostic accuracy.

Outlook:

• Further research is needed to validate the clinical significance and refine the interpretation of the "atypical cells" parameter.
• Development of standardized protocols for its use in conjunction with other diagnostic tools is recommended.
• Future iterations may focus on improving specificity and reducing false positives/negatives in detecting neoplastic cells in urine.