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[A new morphological classification of urinary erythrocytes for evaluating the source of hematuria]
1Renal Research Institute, Sun Yet-sen University of Medical Sciences, Guangzhou.
For differentiation of glomerular from urological hematuria more accurately, a new morphological classification of urinary erythrocytes was studied in 74 cases of glomerular and 58 cases of urological hematuria. For each urine sample, 100 urinary erythrocytes were observed with phase-contrast microscopy and classified into 5 "glomerular" shapes (G1-G5), 5 "urological" shapes (N1-N5) and an unclassified shape. The result was that occurrence of G1, G2, G3, G4, G5 or unclassified shape group appeared significantly (P < 0.01) higher in glomerular diseases than in urological diseases, and among them G1 was the most specific shape for glomerular hematuria. Using percentage of sigma G (G1 + G2 + G3 + G4 + G5) and setting the cut-off at 20%, the sensitivity and specificity for the diagnosis of glomerular diseases were 95.9%. When percentage of G1 (doughnut-like cell with one or more blebs) was used at a cut-off of 1%, sensitivity and specificity were 75.7% and 96.5% respectively. These results were more satisfactory as compared with those in most of the previous reports. Moreover, this new classification is more objective, accurate and clear.
For differentiation of glomerular from urological hematuria more accurately, a new morphological classification of urinary erythrocytes was studied in 74 cases of glomerular and 58 cases of urological hematuria. For each urine sample, 100 urinary erythrocytes were observed with phase-contrast microscopy and classified into 5 "glomerular" shapes (G1-G5), 5 "urological" shapes (N1-N5) and an unclassified shape. The result was that occurrence of G1, G2, G3, G4, G5 or unclassified shape group appeared significantly (P < 0.01) higher in glomerular diseases than in urological diseases, and among them G1 was the most specific shape for glomerular hematuria. Using percentage of sigma G (G1 + G2 + G3 + G4 + G5) and setting the cut-off at 20%, the sensitivity and specificity for the diagnosis of glomerular diseases were 95.9%. When percentage of G1 (doughnut-like cell with one or more blebs) was used at a cut-off of 1%, sensitivity and specificity were 75.7% and 96.5% respectively. These results were more satisfactory as compared with those in most of the previous reports. Moreover, this new classification is more objective, accurate and clear.