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Kidney

Squamous epithelial cells in urine: what a raised count says and how reliable it is

A 2005 US review describes squamous epithelial cells as large and irregularly shaped, with a small nucleus; a 2020 US study assumes they reach a urine sample from the genital surfaces.

A urine sample with squamous epithelial cells is possibly contaminated according to the same review, and with few or no cells the result is as expected. The count can only be determined with a urine test.

Certe uses below 1 per microlitre (µL) for squamous epithelial cells counted with a flow cytometer. A 2016 US study found in adults that the squamous epithelial cell count was a poor predictor of a contaminated urine culture.

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Squamous epithelial cells are large, irregularly shaped cells that are thought to enter the urine from the genital surfaces; their presence can suggest a contaminated sample. Certe gives below 1 per µL as the reference value for squamous epithelial cells counted by flow cytometry.

  • In a US study in an emergency department, other urine values were less accurate when squamous epithelial cells were in the sample.
  • In a US study of adults, the squamous epithelial cell count was a poor predictor of a contaminated urine culture.

Urine Squamous Epithelial Cells: what Dutch laboratories use

There is no nationally agreed reference value; this is what individual laboratories publish.

Reference ranges by group, in /ul
Certe · Everyone · a limit, not a range < 1 /uL
1
0 1.1 /ul

Source: Certe

Each value as the laboratory itself publishes it, retrieved in 2026.

Urine Squamous Epithelial Cells: what this test measures

The squamous epithelial cell count gives the number of these cells in a urine sample, at Certe in cells per microlitre (µL), measured with a flow cytometer; according to the NVKC such a device is much more accurate at measuring cell numbers per volume than the old-fashioned microscope.

Urine Squamous Epithelial Cells: why this value matters

Squamous epithelial cells are a poor predictor of a contaminated urine culture in adults, according to a 2016 US study. According to that study of adults, squamous epithelial cells may predict that the usual urine values show bacteria in the urine less well.

Urine Squamous Epithelial Cells: how the blood test works

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Urine Squamous Epithelial Cells: when is testing worthwhile?

Symptoms that point to kidney disease and urinary tract infections, such as fever, abdominal pain, back pain, passing urine often, pain when passing urine and blood in the urine, are a reason for a urine test according to the NVKC, in which squamous epithelial cells can also be counted. According to the NVKC, a urine test is also usually part of a general physical examination.

Urine Squamous Epithelial Cells: symptoms of a high or low value

Low Levels

Certe sets the reference value for squamous epithelial cells at below 1 per µL for all ages, so a low count is the expected result.

High Levels

A raised squamous epithelial cell count, more than 5 per high-power field, counted as contamination in a 2017 US study in an emergency department, as did growth of mixed or non-pathogenic flora on the urine culture. In the period when that US emergency-department study put up posters with collection instructions, 51.98 percent of the 754 urine tests were contaminated.

Urine Squamous Epithelial Cells: causes of a low or high value

What raises the value

  • Contamination while catching the sample

    Squamous epithelial cells in the sample are thought to come from the genital surfaces; in a study, samples with these cells more often gave a contaminated culture.

  • Female sex

    In an emergency-department study, women more often had squamous epithelial cells in the urine than men.

Urine Squamous Epithelial Cells: lifestyle and this value

According to a 2005 US review, a midstream clean-catch sample is usually adequate in men and women for a urine test, including the squamous epithelial cell count. According to that review, the sample should be examined within two hours of collection.

Urine Squamous Epithelial Cells: frequently asked questions

Are squamous epithelial cells in urine less common in men?

In a 2020 US study in one emergency department, squamous epithelial cells were less common in men than in women, and also less common in older people and with a lower BMI.

Urine Squamous Epithelial Cells: sources

  1. Certe, Bepalingenwijzer (referentiewaarden per bepaling), bepalingenwijzer.certe.nl, geraadpleegd 2026-10-01 (retrieved 2026) bepalingenwijzer.certe.nl
  2. Maher PJ, et al. Squamous epithelial cell presence reduces accuracy of urinalysis for prediction of positive urine cultures. Am J Emerg Med 2020;38(7):1384-1388. (retrieved 2026) pubmed.ncbi.nlm.nih.gov

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These panels measure values from the same category as this marker.

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