Predictive Value of the Combination of Peripheral Blood Lymphocyte Count and Urinary Cytology in BK Polyomavirus–associated Nephropathy

Kosuke Masutani, akihiro tsuchimoto, Yuta Matsukuma, Shigeru Tanaka, Keizo Kaku, Hiroshi Noguchi, Kei Kurihara, Yasuhiro Okabe, Toshiaki Nakano, Kazuhiko Tsuruya, Hitoshi Nakashima, Masafumi Nakamura, Takanari Kitazono

研究成果: ジャーナルへの寄稿記事

抄録

Background: Graft biopsy is the gold standard for diagnosis of BK polyomavirus–associated nephropathy (BKPyVAN), and polymerase chain reaction is the most specific screening technique. Development of a noninvasive, cost-effective marker for BKPyVAN is important. Methods: We reviewed 492 adult kidney transplant patients. We investigated peripheral blood lymphocyte (PBL)count and urinary cytology at graft biopsy in patients with BKVPyAN (n = 21), acute T-cell–mediated rejection (n = 79), and no evidence of acute rejection (n = 149). We performed univariate and multivariate logistic regression and receiver operating characteristics analyses to compare the test performance of PBL count, urinary cytology, and their combination for diagnosis of BKPyVAN. Results: The PBL count at biopsy was significantly lower in the BKPyVAN group than the acute T-cell–mediated rejection and no acute rejection groups (959 ± 290/μL, 1433 ± 673/μL, and 1531 ± 549/μL, respectively; P <.01). The PBL count was 959 ± 290/μL at diagnosis of BKPyVAN and increased to 1123 ± 377/μL, 1238 ± 419/μL, and 1292 ± 491/μL at 1, 2, and 3 months after treatment, respectively (P <.05). On univariate analysis, the area under the curve was significantly higher for the combined model than for PBL and cytology alone (0.930, 0.797, and 0.875, respectively; P <.01). The improved test performance in the combined model remained significant after multivariate adjustment (0.972, 0.844, and 0.928, respectively; P <.01). Conclusions: Decreased PBL count was found in BKPyVAN, and the predictive performance of the combination of PBL count and urinary cytology was significantly enhanced for diagnosis of BKPyVAN.

元の言語英語
ページ(範囲)1410-1414
ページ数5
ジャーナルTransplantation Proceedings
51
発行部数5
DOI
出版物ステータス出版済み - 6 1 2019

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Lymphocyte Count
Cell Biology
Transplants
Biopsy
ROC Curve
Area Under Curve
Logistic Models
Lymphocytes
Kidney
Costs and Cost Analysis
Polymerase Chain Reaction

All Science Journal Classification (ASJC) codes

  • Surgery
  • Transplantation

これを引用

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title = "Predictive Value of the Combination of Peripheral Blood Lymphocyte Count and Urinary Cytology in BK Polyomavirus–associated Nephropathy",
abstract = "Background: Graft biopsy is the gold standard for diagnosis of BK polyomavirus–associated nephropathy (BKPyVAN), and polymerase chain reaction is the most specific screening technique. Development of a noninvasive, cost-effective marker for BKPyVAN is important. Methods: We reviewed 492 adult kidney transplant patients. We investigated peripheral blood lymphocyte (PBL)count and urinary cytology at graft biopsy in patients with BKVPyAN (n = 21), acute T-cell–mediated rejection (n = 79), and no evidence of acute rejection (n = 149). We performed univariate and multivariate logistic regression and receiver operating characteristics analyses to compare the test performance of PBL count, urinary cytology, and their combination for diagnosis of BKPyVAN. Results: The PBL count at biopsy was significantly lower in the BKPyVAN group than the acute T-cell–mediated rejection and no acute rejection groups (959 ± 290/μL, 1433 ± 673/μL, and 1531 ± 549/μL, respectively; P <.01). The PBL count was 959 ± 290/μL at diagnosis of BKPyVAN and increased to 1123 ± 377/μL, 1238 ± 419/μL, and 1292 ± 491/μL at 1, 2, and 3 months after treatment, respectively (P <.05). On univariate analysis, the area under the curve was significantly higher for the combined model than for PBL and cytology alone (0.930, 0.797, and 0.875, respectively; P <.01). The improved test performance in the combined model remained significant after multivariate adjustment (0.972, 0.844, and 0.928, respectively; P <.01). Conclusions: Decreased PBL count was found in BKPyVAN, and the predictive performance of the combination of PBL count and urinary cytology was significantly enhanced for diagnosis of BKPyVAN.",
author = "Kosuke Masutani and akihiro tsuchimoto and Yuta Matsukuma and Shigeru Tanaka and Keizo Kaku and Hiroshi Noguchi and Kei Kurihara and Yasuhiro Okabe and Toshiaki Nakano and Kazuhiko Tsuruya and Hitoshi Nakashima and Masafumi Nakamura and Takanari Kitazono",
year = "2019",
month = "6",
day = "1",
doi = "10.1016/j.transproceed.2019.01.129",
language = "English",
volume = "51",
pages = "1410--1414",
journal = "Transplantation Proceedings",
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TY - JOUR

T1 - Predictive Value of the Combination of Peripheral Blood Lymphocyte Count and Urinary Cytology in BK Polyomavirus–associated Nephropathy

AU - Masutani, Kosuke

AU - tsuchimoto, akihiro

AU - Matsukuma, Yuta

AU - Tanaka, Shigeru

AU - Kaku, Keizo

AU - Noguchi, Hiroshi

AU - Kurihara, Kei

AU - Okabe, Yasuhiro

AU - Nakano, Toshiaki

AU - Tsuruya, Kazuhiko

AU - Nakashima, Hitoshi

AU - Nakamura, Masafumi

AU - Kitazono, Takanari

PY - 2019/6/1

Y1 - 2019/6/1

N2 - Background: Graft biopsy is the gold standard for diagnosis of BK polyomavirus–associated nephropathy (BKPyVAN), and polymerase chain reaction is the most specific screening technique. Development of a noninvasive, cost-effective marker for BKPyVAN is important. Methods: We reviewed 492 adult kidney transplant patients. We investigated peripheral blood lymphocyte (PBL)count and urinary cytology at graft biopsy in patients with BKVPyAN (n = 21), acute T-cell–mediated rejection (n = 79), and no evidence of acute rejection (n = 149). We performed univariate and multivariate logistic regression and receiver operating characteristics analyses to compare the test performance of PBL count, urinary cytology, and their combination for diagnosis of BKPyVAN. Results: The PBL count at biopsy was significantly lower in the BKPyVAN group than the acute T-cell–mediated rejection and no acute rejection groups (959 ± 290/μL, 1433 ± 673/μL, and 1531 ± 549/μL, respectively; P <.01). The PBL count was 959 ± 290/μL at diagnosis of BKPyVAN and increased to 1123 ± 377/μL, 1238 ± 419/μL, and 1292 ± 491/μL at 1, 2, and 3 months after treatment, respectively (P <.05). On univariate analysis, the area under the curve was significantly higher for the combined model than for PBL and cytology alone (0.930, 0.797, and 0.875, respectively; P <.01). The improved test performance in the combined model remained significant after multivariate adjustment (0.972, 0.844, and 0.928, respectively; P <.01). Conclusions: Decreased PBL count was found in BKPyVAN, and the predictive performance of the combination of PBL count and urinary cytology was significantly enhanced for diagnosis of BKPyVAN.

AB - Background: Graft biopsy is the gold standard for diagnosis of BK polyomavirus–associated nephropathy (BKPyVAN), and polymerase chain reaction is the most specific screening technique. Development of a noninvasive, cost-effective marker for BKPyVAN is important. Methods: We reviewed 492 adult kidney transplant patients. We investigated peripheral blood lymphocyte (PBL)count and urinary cytology at graft biopsy in patients with BKVPyAN (n = 21), acute T-cell–mediated rejection (n = 79), and no evidence of acute rejection (n = 149). We performed univariate and multivariate logistic regression and receiver operating characteristics analyses to compare the test performance of PBL count, urinary cytology, and their combination for diagnosis of BKPyVAN. Results: The PBL count at biopsy was significantly lower in the BKPyVAN group than the acute T-cell–mediated rejection and no acute rejection groups (959 ± 290/μL, 1433 ± 673/μL, and 1531 ± 549/μL, respectively; P <.01). The PBL count was 959 ± 290/μL at diagnosis of BKPyVAN and increased to 1123 ± 377/μL, 1238 ± 419/μL, and 1292 ± 491/μL at 1, 2, and 3 months after treatment, respectively (P <.05). On univariate analysis, the area under the curve was significantly higher for the combined model than for PBL and cytology alone (0.930, 0.797, and 0.875, respectively; P <.01). The improved test performance in the combined model remained significant after multivariate adjustment (0.972, 0.844, and 0.928, respectively; P <.01). Conclusions: Decreased PBL count was found in BKPyVAN, and the predictive performance of the combination of PBL count and urinary cytology was significantly enhanced for diagnosis of BKPyVAN.

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U2 - 10.1016/j.transproceed.2019.01.129

DO - 10.1016/j.transproceed.2019.01.129

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EP - 1414

JO - Transplantation Proceedings

JF - Transplantation Proceedings

SN - 0041-1345

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