尿細胞診による腎移植急性拒絶反応とシクロスポリン腎障害の鑑別診断

Abstract

急性拒絶反応17症例, CS腎障害20症例について, Papanicolaou染色, 免疫細胞化学染色による尿細胞診を行った.CS腎障害時には, 尿中の近位尿細管細胞の優位性が認められた.急性拒絶反応時には, 尿中単核細胞の増加に加え, 免疫細胞化学染色で, CD25, CD8, CD2陽性細胞の増加, HLA-DR/cytokeratin陽性細胞比の上昇が認められた

To make the differentiation of kidney transplant acute rejection and ciclosporin (CS) nephrotoxicity urine cytology by classical Papanicolaou with immunocytochemical stain has been performed. Increased numbers of renal tubular cells with lymphocytes and monocytes were found in both rejections and CS toxicities. CS toxicities were associated with increased numbers of proximal tubular cells. In immunocytochemical stain, increased numbers of CD25 and CD8 positive cells as well as increased ratio of HLA-DR/cytokeratin positive cells were typically found in rejections. It is concluded that the proposed analysis of urine cytology is a non-invasive and reliable method for daily graft monitoring of acute rejection and CS toxicity.