尿沈渣進階鏡檢新知

The Updated Knowledge of Urine Sediment Microscopy

尿沉渣鏡檢是一個古老的檢驗，然而，至今尚未有國際的檢驗標準法。雖然如此，仍有許多相關專業領域的學會提出標準化的尿沉渣鏡檢程序用以改善檢驗的品質。有些腎臟醫學專家認為尿沉渣鏡檢是一個低風險的液態切片檢查，然而，這是基於高品質之尿沉渣鏡檢結果才能達成的成果。本篇尿沉渣鏡檢的綜合評述將簡短的介紹尿沉渣鏡檢的發展史，系統性的探討與比較相關標準化尿沉渣鏡檢程序的差異。關於尿沉渣中的細胞型態，紅血球的部分以明視野與相位差顯微鏡同時呈現非腎絲球型與腎絲球型紅血球的差異。上皮細胞的部分，將以Sternheimer染色法呈現各種上皮細胞的特點。此篇文章的主要目的是想要增進醫檢師與腎臟科醫師對於尿沉渣鏡檢中的細胞判定能更有一致性，進而協助臨床醫師做出正確的診斷與進行及時治療用以提升醫療照護的品質。 Urine sediment microscopy is a historical examination. Currently, there is no international standard for urine sediment microscopy. However, there are some professional institutes published standardized protocols to improve the quality of urine sediment microscopy. Nowadays, this examination is considered as a risk-free liquid biopsy by nephrologists based on a high quality of urine sediment microscopy. In this mini review article, the history of standardized urine sediment microscopy is briefly introduced and the discrepancies between protocols are systemically compared. As the formed elements of urine sediment, the shapes of isomorphic and dysmorphic red blood cells are systemically collected and observed with bight-field and phase contrast microscope. Epithelial cells are advanced observed with Sternheimer stain. The major purpose is to increase the morphological consensus for the medical technologists and the nephrologists, which can effectively improve the quality of urine sediment microscopy and help physicians to make a correct diagnosis in order to proceed a necessary treatment on time.