What Do Squamous Epithelial Cells in a Urinalysis Indicate?

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The presence of squamous epithelial cells in a urine sample is often an indication that the sample has been contaminated, according to the John Hopkins Lupus Center.

However, epithelial cells can also indicate urogenital problems, including infections, inflammation and malignancies, as Lab Tests Online explains. Typically, doctors report the extent of squamous epithelial cells in a urine specimen as few, moderate or many, based on microscopic examination. The term “few” refers to a normal range while “moderate” and “many” can mean the presence of a medical condition.

What are Squamous Epithelial Cells?

Squamous epithelial cells occur in many different parts of the body and serve to cover a given structure or cavity. Although they are often thought of as skin cells, they can actually be found covering many layers of the human body, both inside and out. For example, squamous cells are found in the mouth, cervix and middle skin layers.

Squamous epithelial cells are flat and thin as opposed to cube-shaped. They are the thinnest type of epithelial cell and have a large surface area. Their shape allows for molecules to move across their membrane easily, making them useful for filtration and diffusion.

How is a Microscopic Examination Performed?

Microscopic urinalysis involves centrifuging a test tube of urine to separate the components. The supernatant, or top layer, is discarded. The urine sediment and remaining urine are then analyzed using a microscope under low-power. This identifies squamous cells, crystals and casts. Then the sample is further analyzed at high power to identify bacteria, additional cells like red and white blood cells or clumps of cells.

What Other Types of Epithelial Cells are Found in Urinalysis?

There are three types lining the urinary tract. As well as squamous cells, there are also renal tubular cells and transitional cells. Determining the type of epithelial cells present in a urine sample can help the doctor determine whether the cells are originating from the bladder, urethra, kidneys or elsewhere, points out Lab Tests Online. Renal tubular cells are found in the kidneys while transitional cells are found in the bladder and uterus.

Is a Certain Level of Squamous Epithelial Cells in Urine Considered Normal?

The absence of any squamous epithelial cells in urine could possibly indicate a urinary tract infection. Generally speaking, a sample of 15 to 20 squamous epithelial cells/hpf is considered to be normal. Anything above that indicates that the sample may be contaminated. If that’s the case, the doctor will request a new sample.

Apart from Contamination, What Else Can High Levels of Squamous Cells Indicate?

If an abundance of cells is found in another, fresh sample, it could indicate a urinary tract infection. Other medical conditions as a result of moderate or many cells could be a yeast infection, kidney disease and liver disease. Squamous epithelial cells can also be linked to types of cancer. Squamous cell carcinoma is the most common type of oral cavity cancer and the second most common type of skin cancer. The latter type spreads to other parts of the body but is treated easily when caught early enough.

If moderate or many squamous cells are found, the doctor will carry out additional tests and evaluate the patient’s symptoms to ascertain if a medical condition is present and what measures can be taken to rectify it.