Clinical utility of squamous and transitional nuclear structure alterations induced by Schistosoma haematobium in chronically infected adults with bladder damage verified by ultrasound in Ghana

Jean Naples, Sumit Isharwal, Clive J. Shiff, Kwabena M. Bosompem, Robert W. Veltri

Research output: Contribution to journalArticlepeer-review

Abstract

OBJECTIVE: To evaluate the clinical utility of quantitative nuclear morphometry-i.e., alteration in nuclear size/shape, DNA content and chromatin structure-of intact cells obtained from the sediment of urine specimens collected from people living in an area highly endemic for Schistosoma haematobium in Ghana. STUDY DESIGN: Digital images of Feulgen-DNA-stained squamous cell (SC) and transitional cell (TC) urothelial nuclei were captured using the AutoCyte imaging system, and nuclear morphometric descriptors (NMDs) were calculated. A total of 3,495 and 4,523 SC and TC nuclei from normal bladder ultrasound subjects (n=21) and 3,465 and 3,064 SC and TC nuclei from severely abnormal bladder ultrasound subjects (n = 20) were captured. RESULTS: Univariate logistic regression analyses of pooled SC and TC nuclei training sets showed that 27/40 NMDs and 24/40 NMDs were univariately significant for differentiating between SCs and TCs of subjects with normal and severely abnormal bladder ultrasound. Multivariate models constructed using NMDs with 50% inclusion frequency yielded AUC-ROCs of 75.23% and 74.42% in the SC training and validation, and 69.90% and 66.70% for TC training and validation. Further, a squamous cell patient-specific model predicted severe bladder damage with an AUC-ROC of 86.90%, yielding the sensitivity, specificity and accuracy of 85.00%, 76.19% and 80.49%, respectively. CONCLUSION: Quantitative nuclear structure alterations can be used to make a noninvasive assessment of cytologic changes observed in both SC and TC bladder epithelia due to S haematobium infection.

Original languageEnglish (US)
Pages (from-to)143-152
Number of pages10
JournalAnalytical and Quantitative Cytology and Histology
Volume31
Issue number3
StatePublished - Jun 2009

Keywords

  • Bladder diseases
  • Quantitative nuclear morphometry
  • Schistosoma haematobium
  • Squamous cells
  • Transitional cells

ASJC Scopus subject areas

  • Anatomy
  • Histology

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