International Journal of Clinical Oncology

, Volume 19, Issue 5, pp 928–934 | Cite as

Isomorphic red blood cells using automated urine flow cytometry is a reliable method in diagnosis of bladder cancer

  • Satoru Muto
  • Syo-ichiro Sugiura
  • Akiko Nakajima
  • Akira Horiuchi
  • Masahiro Inoue
  • Keisuke Saito
  • Shuji Isotani
  • Raizo Yamaguchi
  • Hisamitsu Ide
  • Shigeo Horie
Original Article
First Online:
Received:
Accepted:

Abstract

Background

We aimed to identify patients with a chief complaint of hematuria who could safely avoid unnecessary radiation and instrumentation in the diagnosis of bladder cancer (BC), using automated urine flow cytometry to detect isomorphic red blood cells (RBCs) in urine.

Methods

We acquired urine samples from 134 patients over the age of 35 years with a chief complaint of hematuria and a positive urine occult blood test or microhematuria. The data were analyzed using the UF-1000i ® (Sysmex Co., Ltd., Kobe, Japan) automated urine flow cytometer to determine RBC morphology, which was classified as isomorphic or dysmorphic. The patients were divided into two groups (BC versus non-BC) for statistical analysis. Multivariate logistic regression analysis was used to determine the predictive value of flow cytometry versus urine cytology, the bladder tumor antigen test, occult blood in urine test, and microhematuria test.

Results

BC was confirmed in 26 of 134 patients (19.4 %). The area under the curve for RBC count using the automated urine flow cytometer was 0.94, representing the highest reference value obtained in this study. Isomorphic RBCs were detected in all patients in the BC group. On multivariate logistic regression analysis, only isomorphic RBC morphology was significantly predictive for BC (p < 0.001). Analytical parameters such as sensitivity, specificity, positive predictive value, and negative predictive value of isomorphic RBCs in urine were 100.0, 91.7, 74.3, and 100.0 %, respectively.

Conclusion

Detection of urinary isomorphic RBCs using automated urine flow cytometry is a reliable method in the diagnosis of BC with hematuria.

Keyword

Cancer screening 
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Notes

Acknowledgments

This study was supported in part by a Grant-in-Aid for Progressive Renal Diseases Research, from the Ministry of Health, Labour and Welfare of Japan.

Conflict of interest

The authors declare that they have no conflict of interest.

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Copyright information

© Japan Society of Clinical Oncology 2013

Authors and Affiliations

  • Satoru Muto
    • 1
  • Syo-ichiro Sugiura
    • 1
  • Akiko Nakajima
    • 1
  • Akira Horiuchi
    • 1
  • Masahiro Inoue
    • 1
  • Keisuke Saito
    • 1
  • Shuji Isotani
    • 1
  • Raizo Yamaguchi
    • 1
  • Hisamitsu Ide
    • 1
  • Shigeo Horie
    • 2
  1. 1.Department of UrologyTeikyo University School of MedicineTokyoJapan
  2. 2.Department of UrologyJuntendo University School of MedicineTokyoJapan

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