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Lau, Paul, Joseph L. Chin, Stephen Pautler, Hassan Razvi, and Jonathan I. Izawa. "NMP22 is predictive of recurrence in high-risk superficial bladder cancer patients." Canadian Urological Association Journal 3, no. 6 (May 1, 2013): 454. http://dx.doi.org/10.5489/cuaj.1173.
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Introduction: The nuclear matrix protein 22 (NMP22) assay hasbeen shown to have greater sensitivity for the diagnosis and detectionof recurrent urothelial carcinoma of the bladder (UCB) overthat of traditional urine cytology. We assessed the use of NMP22to predict which high-risk superficial UCB patients will have recurrence,progression or disease-related death; we compared theseresults to standard urine cytology.Methods: One hundred consecutive patients with high-risk superficialUCB were enrolled. During surveillance, urine was collectedfor cytology and NMP22 testing. Patients were followed for atleast 6 months. Retrospective chart review was undertaken to collectdata on previous tumour history, tumour characteristics, diseaserecurrences, progression and death. Kaplan-Meier analyseswere performed to determine the significance between NMP22-positive and -negative patients in terms of recurrence-free, progression-free and overall survival. Similar analyses were performedfor urine cytology.Results: From 94 eligible patients, 15 and 79 were NMP22 positiveand negative, respectively. The baseline characteristics betweenthe 2 groups were not significantly different in terms of patientcharacteristics, prior tumour history or intravesical therapiesreceived. Mean recurrence-free survival time was significantlylower in the NMP22 positive group (p = 0.038); however, meanprogression-free and overall survival were not significantly differentbetween the 2 groups (p = 0.297 and 0.519, respectively).Urine cytology demonstrated no significant predictive power fordisease recurrence, progression or survival.Conclusion: The nuclear matrix protein 22 assay appears to havepredictive value for future tumour recurrences, but not progressionor overall survival in patients with high-risk superficial UCB.Introduction : Il a été montré que le test de dépistage de la protéine22 de la matrice nucléaire (NMP22) présentait une sensibi -lité supérieure pour le diagnostic et le dépistage du carcinomeurothélial récurrent de la vessie, en comparaison avec la cytologieurinaire classique. Nous avons évalué l’emploi de la NMP22pour prédire la récurrence, la progression de la maladie et le décèsrelié à la maladie chez des patients atteints de carcinome urothélialde la vessie (CUV) superficiel et présentant un risque élevé. Lesrésultats ont été comparés à ceux obtenus avec une épreuve decytologie urinaire standard.Méthodologie : Cent patients consécutifs présentant un CUV superficielà risque élevé ont été inscrits à l’étude. Pendant la périodede surveillance, un échantillon d’urine a été recueilli en vue del’épreuve de cytologie et du test de dépistage de la NMP22. Lesuivi a duré au moins 6 mois. Un examen rétrospectif des dossiersa fourni des données concernant les antécédents tumoraux, lescaractéristiques de la tumeur, les récurrences, la progression etles décès. Des analyses de Kaplan-Meier ont été effectuées afinde déterminer le niveau de signification entre les patients NMP22-positifs et négatifs en matière de délai sans récurrence, de délaisans progression et de survie globale. Des analyses similaires ontété réalisées pour les données obtenues par cytologie urinaire.Résultats : Sur les 94 patients admissibles, 15 patients étaientNMP22-positifs et 79, NMP22-négatifs. Les caractéristiques audépart entre les deux groupes n’étaient pas significativement différentesen ce qui concerne les caractéristiques des patients, lesantécédents tumoraux et les antécédents de traitements intravésicaux.Le délai moyen de survie sans récurrence était significativementmoins long dans le groupe de patients NMP22-positifs(p = 0,038); cela dit, le délai moyen sans progression et la survieglobale moyenne n’étaient pas significativement différents entreles deux groupes (p = 0,297 et 0,519, respectivement). L’épreuvede cytologie urinaire n’a montré aucune puissance de prédictionsignificative concernant la récurrence de la maladie, la progressionou la survie.Conclusion : Le test de dépistage de la protéine 22 de la matricenucléaire semble avoir une certaine valeur prédictive concernantles récurrences tumorales, mais non la progression ou la survieglobale chez les patients atteints de CUV superficiel présentantun risque élevé de récurrence.
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Pitra, Tomáš, Marie Dikanová, Milan Hora, Michal Michal, Ondřej Hes, and Kristýna Pivovarčíková. "Correlation of invasive methods and urine cytology in detection of urothelial neoplasms: one centre early experience with application of The Paris System for Reporting Urinary Cytology." Czech Urology 22, no. 4 (December 1, 2018): 275–84. https://doi.org/10.48095/cccu2018042.
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Tatomirovic, Zeljka, Radojka Bokun, Ljljana Ignjatovic, Anastasija Aleksic, Vesna Skuletic, and Jovan Dimitrijevic. "The significance of cytologic examination of urine in the diagnosis of renal allograft dysfunction." Vojnosanitetski pregled 60, no. 3 (2003): 299–304. http://dx.doi.org/10.2298/vsp0303299t.
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Background. This paper presents our experience with cytologic examination of urine in diagnosing renal allograft dysfunction. Methods. The study group included 23 patients with renal allograft dysfunction, selected from 56 patients who underwent renal transplantation. Etiologic diagnosis was made according to the clinical picture, histological findings during allograft biopsy, and cytologic examination of urine. Urine sediment was obtained in cytocentrifuge and was air dried and stained with May Grunwald Giemsa. Results. Out of 23 patients with allograft dysfunction in 18 (78.3%) patient it was caused by acute rejection, and in 5 (8.9%) patients by allograft infarction, cyclosporine nephrotoxicity, acute tubular necrosis and chronic nephropathy. In eighteen patients (78.3%) cytologic examination of urine was pathologic, while in 16 (70%) clinical and histology findings coincided with urine cytology findings. Out of 18 patients with acute allograft rejection in 15 patients cytologic examination of urine coincided with acute rejection. Out of 7 patients with expressed cyclosporine nephrotoxicity, in 5 cytologic examination of urine confirmed the cause of allograft dysfunction, as well as in one of 2 patients with acute tubular necrosis. Cytologic examination of urine indicated parenchymal damage in 2 patients with reccurent disease (membranoproliferative and focal sclerosing glomerulonephritis). In 4 of 5 patients suffering from chronic rejection in a year?s monitoring period, urine sediment periodically consisted of lymphocytes, neutrophilic leucocytes, monocyte/macrophages, tubular cells and cilindres, without the predominance of any cell type. In 3 patients allograft dysfunction was caused by infective agents (bacteria, fungus cytomegalovirus). Conclusion. Cytologic examination of urine might be an alternative to histological in diagnosing acute allograft rejection and acute tubular necrosis or nephtotoxicity. Also it might indicate parenchymal disease while the importance of urine cytology in chronic allograft nephropathy needs to be investigated further.
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Astvatsaturyan, Kristine, David Frishberg, and Arsen Ramazyan. "Cytology of the Urinary Tract: Specimen Sampling, Preparation, Adequacy, and Normal Cellular Components." CMAS Journal 1 (April 17, 2024): 2. http://dx.doi.org/10.25259/cmasj_04_01.
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Urine evaluation is one of the oldest tests used in ancient medicine. Cytologic examination of urine is a simple, non-invasive, cost effective, and reliable method to uncover a wide variety of reactive and neoplastic processes in urothelium. Urinary tract lesions are often multifocal, may be inapparent on cystoscopic examination or inaccessible to directly biopsy. Thus, urine cytology remains one of the most common methods for the initial diagnosis of urothelial carcinoma that may be manageable with early detection. In this article we review indications for urine cytology, sampling techniques, preparatory methods, adequacy, and elements of normal urine.
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Longo, Thomas Andrew, Ajay Gopalakrishna, Joseph J. Fantony, and Brant Allen Inman. "Your opinion counts: How do you treat atypical/suspicious cytology?" Journal of Clinical Oncology 34, no. 2_suppl (January 10, 2016): 463. http://dx.doi.org/10.1200/jco.2016.34.2_suppl.463.
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463 Background: Urine cytology has often been reported as a highly specific but poorly sensitive test. Cytology is reported as positive, negative, atypical, or suspicious. Atypical/suspicious cytologies account for roughly a quarter of the results and present a clinical dilemma. Physicians’ risk aversion means they are typically treated as positive and result in clinical action. We test the effects of this assumption on sensitivity and specificity. Methods: After IRB approval, we queried clinical and pathology databases to identify all subjects at Duke University Medical Center who had undergone both a urine cytology and a cystoscopy from 1/2003 to 1/2012. Diagnostic test performance metrics were calculated using logistic models: (a) a generalized estimating equation (GEE) and (b) a generalized linear mixed model (GLMM). These take into account clustered/correlated test results that occur due to repeated testing within subjects. Results: A total of 990 unique subjects were identified that provided 4,733 pairs of cytology and cystoscopy for analysis. Our cohort was 61% male, 75% Caucasian, and had 54% current or former smokers. Of cytologies, 1898 (40%) were negative, 423 (9%) positive, and 2408 (51%) suspicious or atypical. When suspicious/atypical cytology results using the GLMM model were classified as positive, the specificity was 62% [95%CI: 58-66%] and the sensitivity was 41% [95% CI: 38-44%]. When these results were re-classified as negative, this had the effect of a large increase in specificity 100% [95%CI: 100-100%] with a consequent decrease in sensitivity 0% [95%CI: 0-2%]. Conclusions: In our study, the performance of urine cytology depended heavily on how the equivocal (atypical/suspicious) results were classified and dealt with. Our sensitivity was maximized when equivocal cytologies were considered positive, but at significant detriment of the specificity. Contrarily, our specificity improved greatly when the equivocal results were considered negative, but at the expense of a poor sensitivity. Furthermore, the diagnosis of an atypical/suspicious cytology was higher at our medical center than reported in the literature, and therefore significantly overestimated the performance of the urine cytology test.
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Barkan, Güliz A., Eva M. Wojcik, Ritu Nayar, Spasenija Savic-Prince, Marcus L. Quek, Daniel F. I. Kurtycz, and Dorothy L. Rosenthal. "The Paris System for Reporting Urinary Cytology: The Quest to Develop a Standardized Terminology." Acta Cytologica 60, no. 3 (2016): 185–97. http://dx.doi.org/10.1159/000446270.
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The main purpose of urine cytology is to detect high-grade urothelial carcinoma (HGUC). With this principle in mind, The Paris System (TPS) Working Group, composed of cytopathologists, surgical pathologists, and urologists, has proposed and published a standardized reporting system that includes specific diagnostic categories and cytomorphologic criteria for the reliable diagnosis of HGUC. This paper outlines the essential elements of TPS and the process that led to the formation and rationale of the reporting system. The Paris System Working Group, organized at the 2013 International Congress of Cytology, conceived a standardized platform on which to base cytologic interpretation of urine samples. The widespread dissemination of this approach to cytologic examination and reporting of urologic samples and the scheme's universal acceptance by pathologists and urologists is critical for its success. For urologists, understanding the diagnostic criteria, their clinical implications, and the limitations of TPS is essential if they are to utilize urine cytology and noninvasive ancillary tests in a thoughtful and practical manner. This is the first international/inclusive attempt at standardizing urinary cytology. The success of TPS will depend on the pathology and urology communities working collectively to improve this seminal paradigm shift, and optimize the impact on patient care.
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Sharma, Anurag, Shivani Sharma, Niharika Patnaik, Dinesh Pradhan, Kaliprasad Satapathy, Manas R. Pradhan, and Sambit K. Mohanty. "Cytomorphologic and Immunophenotypic Profile of a Cohort of Small Cell Carcinoma of the Urinary Bladder." Acta Cytologica 60, no. 5 (2016): 475–80. http://dx.doi.org/10.1159/000449399.
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Background: The incidence of primary small cell carcinoma (SCC) of the urinary bladder is extremely rare. We sought to analyze the cytologic and immunophenotypic features of SCC of the urinary bladder in urine and reassert the importance of cytologic examination of urine specimens for diagnosis of this tumor. Methods: We studied the clinical and cytomorphologic features in the presurgical urine specimens (4 voided urine and 2 bladder-washing specimens) of histopathologically and immunohistochemically proven cases of SCC of the urinary bladder. Results: There were 6 cases, all males, with an age range of 61-81 years. On cytologic and histopathologic examination, typical SCC morphology was present in all cases. On immunohistochemistry, synaptophysin and CD56 were positive in all 6 cases, while chromogranin was positive in only 3. The Ki-67 labeling index ranged from 30 to 100%. Conclusions: SCC should be kept in the differential diagnosis, when high-grade urothelial carcinoma is suspected in a urine cytology specimen, as this distinction has important therapeutic and prognostic implications. Therefore, a careful observation and, if required, the use of an appropriate immunocytochemical panel on the presurgical urine specimens can lead to a correct diagnosis.
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Boccafoschi, C., F. Montefiore, S. Treffiletti, D. Signorello, and A. Langé. "Preliminary comparative considerations about urinary cytology and the Bard BTA test in the diagnosis and follow-up of superficial bladder cancer." Urologia Journal 62, no. 1_suppl (January 1995): 88–90. http://dx.doi.org/10.1177/039156039506201s23.
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— The value of urinary cytology in the diagnosis and follow-up of superficial transitional cell carcinoma of the bladder is well known. Results of traditional cytologic examinations may be affected by the different methods of urine collection, preservation, manipulation and observation of the samples so that more objective tools are desirable. The aim of this study in to compare the traditional cytologic examinations with a new diagnostic in-vitro test (Bard BTA test), which can detect antigen complexes in the urine due to the contact of the tumour cells with the basement membrane. The Bard BTA test is a latex agglutination assay which identifies the bladder tumour antigens in the urine. The result of the agglutination reaction (positive or negative) may be visually distinguished by the variation in colour of special strips of testing paper. The Authors report on a preliminary experience in the follow-up of patients with previous superficial transitional cell carcinoma of the bladder: they compare the results of traditional cytology, the Bard BTA test and cystoscopy and have found agreement in 70% of the cases.
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Umar, Ahmed M., Uzodimma E. Onwuasoanya, Emmanuel U. Oyibo, Adamu Dahiru, and Ismaila A. Mungadi. "The pattern of urine cytology among patients with clinical diagnosis of bladder tumor in a tertiary hospital northwest Nigeria." International Surgery Journal 6, no. 10 (September 26, 2019): 3521. http://dx.doi.org/10.18203/2349-2902.isj20194402.
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Background: Urine cytology is a simple, safe, non-invasive and cheap investigation that is used as adjunct to cystoscopy in the diagnosis of bladder cancer. Its low sensitivity is a major limitation against its use as a sole diagnostic test for bladder cancer. The objective of this study was to determine the pattern of urine cytology seen in patients with clinical diagnosis of bladder tumour in our practice.Methods: This is a retrospective study of patients with clinical diagnosis of bladder tumour that had urine cytology in our centre. The age and gender of the patients, number of urine cytology per patient per year and cytologic diagnosis were analysed using the SPSS 20.Results: During the period under review, a total of 512 urine cytology was done for patients with clinical diagnosis of bladder tumour. The age range of the patients was 6 to 90 years with modal age of 60 years. 457 (89.3%) were males while 54 (10.5%) were females and 1 (0.2%) was unspecified. Male to female ratio was 8.5:1. The highest number of urine cytology was done in 2013 with 64 (12.5%) while the least number was 1 (0.2%) recorded in 2001 and 2003. Only 68 (13.3%) specimens were reported to be malignant while 245 (47.9%) were reported as negative representing the most common cytological diagnosis in the study.Conclusions: Although urine cytology is useful in the diagnostic workup of patients with bladder mass, it is unlikely it would supplant cystoscopy and biopsy in the diagnosis of bladder cancer.
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Mendoza, R. P., T. Haidary, and R. Gupta. "Paris System Has A Higher Cytohistologic Correlation And Reproducibility Than Traditional Urine Cytology Method." American Journal of Clinical Pathology 154, Supplement_1 (October 2020): S94. http://dx.doi.org/10.1093/ajcp/aqaa161.206.
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Abstract Introduction/Objective The major limitation of urine cytology is the lack of consensus regarding the terminology and diagnostic criteria that should be used for urothelial atypia. The main goal of the newly proposed Paris System for Reporting Urine Cytology is to concentrate primarily on the detection of high grade urothelial carcinoma while minimizing the detection of low grade lesions. This study aimed to apply the criteria and categories of the Paris system in retrospectively collected urine cytology specimens and assess histologic correlation and reproducibility. Methods Two senior pathologists independently reviewed retrospectively collected urine cytology specimens strictly following the Paris system criteria for categorization. Cytologic diagnosis were compared with previous cytology result and histologic diagnosis. Results A total of 67 patients were included in the study. The mean age is 65.8 years (36-89 years), majority were males (73.1%) and African American (89.6%). Urine cytology using traditional method showed mostly atypical results (58.2%), followed by reactive (26.9%), high-grade urothelial carcinoma (11.9%) and suspicious (3.0%). On the other hand, the Paris system had more negative results (62.7%), followed by atypical (19.4%), high-grade urothelial carcinoma (11.9%) and lastly suspicious (6.0%). All of negative cases (18 out of 18) and majority of HGUC cases (7 out of 8) were concordant between the two cytology methods. Traditional urine cytology method only yielded 71.4% histologic concordance, while 100% Paris system results were concordant with bladder histology. Majority of the atypical cases using traditional method were converted to negative, and a few atypical cases were converted to suspicious and high-grade. All results using Paris system were concordant between two general pathologists. Conclusion Using the Paris system in analyzing urine cytology resulted to higher cytohistologic concordance than traditional method. Majority of atypical cases from traditional method were converted to more definitive categories. The cytopathologic analyses from two general pathologists applying the criteria of Paris system had superior reproducibility. Applying the Paris system, therefore, can significantly improve the performance of urine cytopathology.
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Badruddoza, SM, FA Azim, AJE Nahar Rahman, M. Kamal, AR Barua, KH Khan, and T. Chowdhury. "Cytohistologic Correlation of Urothelial Cancers– A study of 57 Cases." TAJ: Journal of Teachers Association 30, no. 1 (December 3, 2018): 1–10. http://dx.doi.org/10.3329/taj.v30i1.39114.
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Transitional cell carcinoma (TCC) comprises about 90% of all primary tumors of urinary bladder. The accuracy of multiple voided urine cytology justifies its continued use as a first line diagnostic and detection technique, particularly for high grade invasive cancers and clinically unsuspected case of carcinoma particularly carcinoma in-situ. In this study 57 cases were taken to see correlation of cytology, histology, stage, morphological pattern and sensitivity and specificity of urothelial cancers. Out of 57, 53 (92.99)% were positive for malignancy and 4(7.01%) were negative. There were 14 (24.56%) non-invasive papillary tumors, 1(1.76%) carcinoma in-situ and 42 (76.68%) invasive carcinoma of all grades and types. Of 14 grade-II non-invasive papillary tumors, 12 (85.72%) were cytologically positive. With only two exceptions, out of 39 all of the invasive carcinomas of all grades and types were identified by cytology as cancerous. A 100% positive cytology was noted in the detection of flat carcinoma in-situ, papillary adenocarcinoma and squamous cell carcinoma of the urinary bladder. Of the total 57 cases of malignant lesions of urinary tract, 53 (92.99%) were positive on cytological examination. The two TCC of the renal pelvis also gave a 100% positive cytologic results. Among invasive carcinoma, stage B1 and B2 urothelial cancers yield highest positive cytologic diagnosis rather than stage 0 and stage A urothelial cancers. For all tumors the sensitivity was 92.99%. The specificity was 100% since there were no false positive cases. The diagnostic accuracy was 93% (approximately). Comparison with previously published data this study showed highest diagnostic accuracy, sensitivity, specificity of voided urine cytology, good correlation with cytology histology and stage of tumor. So voided urine cytology, a very cheap and purely non invasive technique, can be done as an effective method to diagnose urothelial cancers in a developing country like Bangladesh where facilities for other investigations are practically limited.TAJ 2017; 30(1): 1-10
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Oh, Han Yeong, Ha Ju So, Seong Hyun Kim, Dong Wook Kim, and Hyun Chang Kim. "The Development of the Liquid Cell Smear Device for Liquid-Based Cytology Test." Applied Mechanics and Materials 284-287 (January 2013): 1564–68. http://dx.doi.org/10.4028/www.scientific.net/amm.284-287.1564.
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This paper describes the development and validation of the liquid cell smears device for early cancer detection. In this study, the liquid cell smears device with the automated production of cell slides for Liquid-based Cytology Test has been developed. To validate the Liquid cell smear device, we used each 100 samples related to cervix, sputum, urine, body fluids, and thyroid. Experimental conditions were divided into five, which were the distance of the cylinder, the moving party's ascent and descent distance, and time to stop the smears. After staining, their verification was conducted through cytologic and histologic diagnosis. As a result, we found the optimal conditions to produce slide such as cervix(GYN) at the condition 2, sputum(SPUTUM) at the condition 4, urine(URINE) at the condition 5, body fluids(BODY FLUID) at the condition 1, and thyroid(FNA) at the condition 3. Therefore, it is suggested to be possible as cytologic and histologic diagnosis.
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Tatomirovic, Zeljka, Radojka Bokun, Jovan Dimitrijevic, Ljiljana Ignjatovic, Anastasija Aleksic, and Rajko Hrvacevic. "The value of urine cytologic examination findings in the diagnosis of the acute renal allograft rejection." Vojnosanitetski pregled 60, no. 1 (2003): 35–41. http://dx.doi.org/10.2298/vsp0301035t.
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Background. Acute rejection of allograft is one of the most serious complications of renal transplantation that requires fast and precise diagnostic approach. In this paper our experience in cytologic urinalysis as a diagnostic method of the acute renal allograft rejection was reviewed. Methods. The study group included 20 of 56 patients with transplanted kidneys who were assumed for the acute allograft rejection according to allograft dysfunction and/or urine cytology findings. Histological findings confirmed allograft rejection in 4 patients. Urine sediment obtained in cytocentrifuge was air-dried and stained with May-Grunwald-Giemsa. Acute allograft rejection was suspected if in 10 fields under high magnification 15 or more lymphocytes with renal tubular cells were found. Results. Acute transplant rejection occured in 32.1% patients. In 15 patients clinical findings of the acute renal allograft rejection corresponded with cytological and histological findings (in the cases in which it was performed). Three patients with clinical signs of the acute allograft rejection were without cytological confirmation, and in 2 patients cytological findings pointed to the acute rejection, but allograft dysfunction was of different etiology (acute tubular necrosis, cyclosporine nephrotoxicity). In patients with clinical, cytological and histological findings of the acute allograft rejection urine finding consisted of 58% lymphocytes, 34% neutrophilic leucocytes and 8% monocytes/macrophages on the average. The accuracy of cytologic urinalysis related to clinical and histological finding was 75%. Conclusion. Urine cytology as the reliable noninvasive, fast and simple method is appropriate as the a first diagnostic line of renal allograft dysfunction, as well as for monitoring of the graft function.
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Pillay, Pavitra, Lisette van Lieshout, Myra Taylor, Motshedisi Sebitloane, Siphosenkosi Gift Zulu, Elisabeth Kleppa, Borghild Roald, and Eyrun Floerecke Kjetland. "Cervical cytology as a diagnostic tool for female genital schistosomiasis: Correlation to cervical atypia and Schistosoma polymerase chain reaction." CytoJournal 13 (April 20, 2016): 10. http://dx.doi.org/10.4103/1742-6413.180784.
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Background: Female genital schistosomiasis (FGS) is a tissue reaction to lodged ova of Schistosoma haematobium in the genital mucosa. Lesions can make the mucosa friable and prone to bleeding and discharge. Women with FGS may have an increased risk of HIV acquisition, and FGS may act as a cofactor in the development of cervical cancer. Objectives: To explore cytology as a method for diagnosing FGS and to discuss the diagnostic challenges in low-resource rural areas. The correlation between FGS and squamous cell atypia (SCA) is also explored and discussed. Cytology results are compared to Schistosoma polymerase chain reaction (PCR) in vaginal lavage and urine and in urine microscopy. Materials and Methods: In a clinical study, 394 women aged between 16 and 23 years from rural high schools in KwaZulu-Natal, South Africa, underwent structured interviews and the following laboratory tests: Cytology Papanicolaou (Pap) smears for S. haematobium ova and cervical SCA, real-time PCR for Schistosoma-specific DNA in vaginal lavage and urine samples, and urine microscopy for the presence of S. haematobium ova. Results: In Pap smears, S. haematobium ova were detected in 8/394 (2.0%). SCA was found in 107/394 (27.1%), seven of these had high-grade squamous intraepithelial lesion (HSIL). Schistosoma specific DNA was detected in 38/394 (9.6%) of vaginal lavages and in 91/394 (23.0%) of urines. Ova were found microscopically in 78/394 (19.7%) of urines. Conclusion: Schistosoma PCR on lavage was a better way to diagnose FGS compared to cytology. There was a significant association between S. haematobium ova in Pap smears and the other diagnostic methods. In low-resource Schistosoma-endemic areas, it is important that cytology screeners are aware of diagnostic challenges in the identification of schistosomiasis in addition to the cytological diagnosis of SCA. Importantly, in this study, three of eight urines were negative but showed Schistosoma ova in their Pap smear, and one of them was also negative for Schistosoma DNA in urine. In this study, SCA was not significantly associated with schistosomiasis. HSIL detected in this young population might need future consideration.
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Moretti, M., B. Malcangi, A. Cichero, P. Pittaluga, M. Varaldo, and A. Decensi. "Follow-Up Del Carcinoma Vescicale Superficiale: Approccio Integrato e Ipotesi Prognostiche." Urologia Journal 61, no. 1_suppl (January 1994): 7–10. http://dx.doi.org/10.1177/039156039406101s01.
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The follow-up of superficial bladder cancer, after TUR and endovesical administration of BCG or other drugs, involves many methods: we studied two groups of patients who underwent TUR for superficial bladder cancer. A group of 54 patients underwent cystoscopy, urine cytologic examination and cytometry; a second group of 30 patients underwent mapping too. The results of the three examinations were compared: high ploidy values were related both with recurrence and progression. The results of cytology plus cytometry were predictive of mapping results and bladder biopsies were useless in up to 50% of cases. Our results indicate that the association of cytology and cytometry reveals good sensitivity, specificity and prognostic indications.
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Sofocleous, C. T., K. T. Brown, S. Savage, E. Brogi, A. M. Covey, L. A. Brody, J. Schubert, and G. I. Getrajdman. "Upper urinary tract metastases from adenocarcinoma of the colon." Acta Radiologica 46, no. 4 (July 2005): 437–40. http://dx.doi.org/10.1080/02841850510021229.
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An unusual presentation of colorectal metastasis to the upper urinary tract is reported. The metastasis manifested as a filling defect seen during antegrade pyelography. Cytologic evaluation of aspirated material demonstrated metastatic colonic adenocarcinoma. A dilated collecting system may be caused by intraluminal material including tumor and blood clots. Whenever fixed filling defects are encountered, urine cytology should be sent even in the absence of renal parenchymal involvement by tumor. The cytological evaluation may allow for prompt diagnosis and treatment.
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Tomašov, Martina. "New trends in urine cytology." Urologie pro praxi 22, no. 1 (April 15, 2021): 19–21. http://dx.doi.org/10.36290/uro.2021.003.
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Yamazaki, Hiroyuki, Tsuneyuki Wada, Hiroshi Asano, Hiromasa Fujita, Kazuhira Okamoto, and Hidemichi Watari. "Comparison between Urine and Cervical High-Risk HPV Tests for Japanese Women with ASC-US." Diagnostics 11, no. 10 (October 14, 2021): 1895. http://dx.doi.org/10.3390/diagnostics11101895.
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Most uterine cervical cancers are caused by the persistent infection of the high-risk human papillomavirus (hrHPV). Thus, the hrHPV-DNA test, which examines specimens from the cervix, is the standard screening method as well as cytology in western countries. Urine sampling for the hrHPV-DNA test would be easier and help improving screening rates. This study prospectively investigated the concordance between urine and cervical hrHPV tests for patients with atypical squamous cells of undetermined significance (ASC-US) in cervical cytology. We recruited 338 women with the cytologic diagnosis of ASC-US and performed hrHPV-DNA tests to both samples from the uterine cervix and first void urine, using the Cobas 4800 system. In all hrHPV genotypes, the simple concordance rate was 90.8% (307/338) and the Kappa statistic value was 0.765, which shows substantial concordance. The positive concordance rate was 70.5% (74/105), which was the rate excluding women who had negative results in both tests. When limited to types 16 and 18, the simple concordance rate was 98.8% (334/338), and the Kappa statistical value was calculated to be 0.840, which showed almost perfect concordance. The positive concordance rate resulted in 81.8% (18/22). We conclude that the urine hrHPV-DNA test could substitute the cervical test in women with ASC-US.
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Yamazaki, Hiroyuki, Tsuneyuki Wada, Hiroshi Asano, Hiromasa Fujita, Kazuhira Okamoto, and Hidemichi Watari. "Comparison between Urine and Cervical High-Risk HPV Tests for Japanese Women with ASC-US." Diagnostics 11, no. 10 (October 14, 2021): 1895. http://dx.doi.org/10.3390/diagnostics11101895.
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Most uterine cervical cancers are caused by the persistent infection of the high-risk human papillomavirus (hrHPV). Thus, the hrHPV-DNA test, which examines specimens from the cervix, is the standard screening method as well as cytology in western countries. Urine sampling for the hrHPV-DNA test would be easier and help improving screening rates. This study prospectively investigated the concordance between urine and cervical hrHPV tests for patients with atypical squamous cells of undetermined significance (ASC-US) in cervical cytology. We recruited 338 women with the cytologic diagnosis of ASC-US and performed hrHPV-DNA tests to both samples from the uterine cervix and first void urine, using the Cobas 4800 system. In all hrHPV genotypes, the simple concordance rate was 90.8% (307/338) and the Kappa statistic value was 0.765, which shows substantial concordance. The positive concordance rate was 70.5% (74/105), which was the rate excluding women who had negative results in both tests. When limited to types 16 and 18, the simple concordance rate was 98.8% (334/338), and the Kappa statistical value was calculated to be 0.840, which showed almost perfect concordance. The positive concordance rate resulted in 81.8% (18/22). We conclude that the urine hrHPV-DNA test could substitute the cervical test in women with ASC-US.
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Peña, Karla B., Francesc Riu, Anna Hernandez, Carmen Guilarte, Joan Badia, and David Parada. "Usefulness of the Urine Methylation Test (Bladder EpiCheck®) in Follow-Up Patients with Non-Muscle Invasive Bladder Cancer and Cytological Diagnosis of Atypical Urothelial Cells—An Institutional Study." Journal of Clinical Medicine 11, no. 13 (July 3, 2022): 3855. http://dx.doi.org/10.3390/jcm11133855.
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Urothelial bladder cancer is a heterogeneous disease and one of the most common cancers worldwide. Bladder cancer ranges from low-grade tumors that recur and require long-term invasive surveillance to high-grade tumors with high mortality. After the initial contemporary treatment in non-muscle invasive bladder cancer, recurrence and progression rates remain high. Follow-up of these patients involves the use of cystoscopies, cytology, and imaging of the upper urinary tract in selected patients. However, in this context, both cystoscopy and cytology have limitations. In the follow-up of bladder cancer, the finding of urothelial cells with abnormal cytological characteristics is common. The main objective of our study was to evaluate the usefulness of a urine DNA methylation test in patients with urothelial bladder cancer under follow-up and a cytological finding of urothelial cell atypia. In addition, we analyzed the relationship between the urine DNA methylation test, urine cytology, and subsequent cystoscopy study. It was a prospective and descriptive cohort study conducted on patients presenting with non-muscle invasive urothelial carcinoma between 1 January 2018 and 31 May 2022. A voided urine sample and a DNA methylation test was extracted from each patient. A total of 70 patients, 58 male and 12 female, with a median age of 70.03 years were studied. High-grade urothelial carcinoma was the main histopathological diagnosis. Of the cytologies, 41.46% were cataloged as atypical urothelial cells. The DNA methylation test was positive in 17 urine samples, 51 were negative and 2 were invalid. We demonstrated the usefulness of a DNA methylation test in the follow-up of patients diagnosed with urothelial carcinoma. The methylation test also helps to diagnose urothelial cell atypia.
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Arville, Brent, Emily O’Rourke, Fai Chung, Mahul Amin, and Shikha Bose. "Evaluation of a triple combination of cytokeratin 20, p53 and CD44 for improving detection of urothelial carcinoma in urine cytology specimens." CytoJournal 10 (December 27, 2013): 25. http://dx.doi.org/10.4103/1742-6413.123784.
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Background: Atypical urine cytology results trigger cystoscopy or molecular tests, both of which are costly, complex and difficult to perform tests. Several immunostains are being investigated to improve cancer detection; however, cytology material is limited and restricts the use of multiple immunostains. This study was designed to determine the utility of a cocktail of three stains, cytokeratin (CK20), p53 and CD44 in urine cytology samples for improving the detection of urothelial carcinoma. Materials and Methods: Urine cytology specimens with cell blocks containing adequate cytologic material between 2005 and 2010 and subsequent follow-up biopsy and/or Urovysion test (102 cases including 29 negative, 56 atypical and 17 malignant) were included in the study and evaluated with the triple stain. Results were first validated on the positive and negative cases and then applied to the atypical cases to determine the utility in the diagnosis of urothelial carcinoma. Results: Based on the validation and published literature, two distinct immunoprofiles were defined – malignant, characterized by at least five CK20 and/or p53 positive atypical cells and reactive, all other staining patterns. The malignant immunoprofile showed 88% sensitivity, 78% specificity, 74% positive predictive value (PPV) and 90% negative predictive value (NPV) for detecting urothelial carcinoma. These values improved to 95% sensitivity and 96% NPV when low-grade urothelial carcinoma cases were excluded. Summary: Our results indicate that the triple stain is an inexpensive, easy to perform test most useful for differentiating high-grade urothelial carcinoma from its mimics. However Inclusion of CD44 in the cocktail did not provide additional value and is best excluded.
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Brown, Felix M. "URINE CYTOLOGY." Urologic Clinics of North America 27, no. 1 (February 2000): 25–37. http://dx.doi.org/10.1016/s0094-0143(05)70231-7.
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Vap, Linda M., and Sarah B. Shropshire. "Urine Cytology." Veterinary Clinics of North America: Small Animal Practice 47, no. 1 (January 2017): 135–49. http://dx.doi.org/10.1016/j.cvsm.2016.07.009.
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Glass, Ryan, Lisa Rosen, Karen Chau, Sylvat Sheikh-Fayyaz, Peter Farmer, Constantinos Coutsouvelis, Farah Slim, et al. "Analysis of the Cytomorphological Features in Atypical Urine Specimens following Application of The Paris System for Reporting Urinary Cytology." Acta Cytologica 62, no. 1 (November 18, 2017): 54–61. http://dx.doi.org/10.1159/000481278.
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Background: This study investigates the use of The Paris System (TPS) for Reporting Urinary Cytopathology and examines the performance of individual and combined morphological features in atypical urine cytologies. Methods: We reviewed 118 atypical cytologies with subsequent bladder biopsies for the presence of several morphological features and reclassified them into Paris System categories. The sensitivity and specificity of individual and combined features were calculated along with the risk of malignancy. Results: An elevated nuclear-to-cytoplasmic ratio was only predictive of malignancy if seen in single cells, while irregular nuclear borders, hyperchromasia, and coarse granular chromatin were predictive in single cells and in groups. Identification of coarse chromatin alone yielded a malignancy risk comparable to 2-feature combinations. The use of TPS criteria identified the specimens at a higher risk of malignancy. Conclusion: Our findings support the use of TPS criteria, suggesting that the presence of coarse chromatin is more specific than other individual features, and confirming that cytologic atypia is more worrisome in single cells than in groups.
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Jones, Eleanor R., Suzanne Carter, Helena O'Flynn, Kelechi Njoku, Chloe E. Barr, Nadira Narine, David Shelton, Durgesh Rana, and Emma J. Crosbie. "DEveloping Tests for Endometrial Cancer deTection (DETECT): protocol for a diagnostic accuracy study of urine and vaginal samples for the detection of endometrial cancer by cytology in women with postmenopausal bleeding." BMJ Open 11, no. 7 (July 2021): e050755. http://dx.doi.org/10.1136/bmjopen-2021-050755.
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IntroductionPostmenopausal bleeding (PMB), the red flag symptom for endometrial cancer, triggers urgent investigation by transvaginal ultrasound scan, hysteroscopy and/or endometrial biopsy. These investigations are costly, invasive and often painful or distressing for women. In a pilot study, we found that voided urine and non-invasive vaginal samples from women with endometrial cancer contain malignant cells that can be identified by cytology. The aim of the DEveloping Tests for Endometrial Cancer deTection (DETECT) Study is to determine the diagnostic test accuracy of urine and vaginal cytology for endometrial cancer detection in women with PMB.Methods and analysisThis is a multicentre diagnostic accuracy study of women referred to secondary care with PMB. Eligible women will be asked to provide a self-collected voided urine sample and a vaginal sample collected with a Delphi screener before routine clinical procedures. Pairs of specialist cytologists, blinded to participant cancer status, will assess and classify samples independently, with differences settled by consensus review or involving a third cytologist. Results will be compared with clinical outcomes from standard diagnostic tests. A sample size of 2000 women will have 80% power to establish a sensitivity of vaginal samples for endometrial cancer detection by cytology of ≥85%±7%, assuming 5% endometrial cancer prevalence. The primary objective is to determine the diagnostic accuracy of urogenital samples for endometrial cancer detection by cytology. Secondary objectives include the acceptability of urine and vaginal sampling to women.Ethics and disseminationThis study has been approved by the North West–Greater Manchester West Research Ethics Committee (16/NW/0660) and the Health Research Authority. Results will be disseminated through publication in peer-reviewed scientific journals, presentation at conferences and via charity websites.Trial registration numberISRCTN58863784.
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Smith, A., M. E. Nielsen, J. Ferguson, A. Manvar, R. Pruthi, E. Wallen, and Y. Lotan. "Patterns of utilization of urine-based markers in non-muscle-invasive bladder cancer: Results from the BCAN/SUO/AUA/LUGPA electronic survey." Journal of Clinical Oncology 29, no. 7_suppl (March 1, 2011): 261. http://dx.doi.org/10.1200/jco.2011.29.7_suppl.261.
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261 Background: In addition to cytologic evaluation, there are currently four urine-based tests approved by the FDA for bladder cancer detection. At this point, the Guidelines panels from the AUA and EAU do not make specific recommendations about the ideal role of these tests. Furthermore, there is a paucity of data on current patterns of care in this area of practice. Methods: An electronic survey was developed by the Bladder Cancer Advocacy Network (BCAN) to elicit self-reported practices of the use of cytology and urine-based markers in the settings of general use, surveillance, and assessment of response after intravesical therapy for patients with NMIBC. The survey was circulated to urologists via the AUA, SUO and LUGPA distribution lists. 512 respondents completed the survey. Results: Among all respondents, 93% report sending cytology routinely (25% via barbotage) in general use. In contrast, 37% report using NMP22 in this setting, 54% report using FISH, and 32% (45% of SUO respondents vs. 31% of AUA respondents, p=0.04) responded that there is “no role for urine-based markers in this setting.” Similar proportions were reported in the specific settings of routine surveillance and post-BCG assessment. When presented with the vignette of a positive marker test and negative cytology and cystoscopy, 36% chose to proceed to the OR for biopsy, 37% chose to repeat cystoscopy and cytology in 3 months, 21% chose “no role for markers in this setting” and 13% chose “other.” Conclusions: In the absence of more specific guidance, the results of this survey suggest considerable variation in the use and interpretation of urine-based markers in NMIBC. FISH is the marker reported to be used most commonly in multiple settings, however 31-45% of respondents report “no role” for any of the tests in their practice. Greater than one out of three respondents reported taking patients for biopsy under anesthesia in the setting of an isolated positive marker. These preliminary data underscore the need for prospective studies to validate the optimal role of urine-based markers in the setting of NMIBC. No significant financial relationships to disclose.
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Raab, Stephen S., Dana Marie Grzybicki, Colleen M. Vrbin, and Kim R. Geisinger. "Urine Cytology Discrepancies." American Journal of Clinical Pathology 127, no. 6 (June 2007): 946–53. http://dx.doi.org/10.1309/xuvxfxmfpl7telce.
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Choi, Song-Yi, Kyung-Hee Kim, Kwang-Sun Suh, and Min-Kyung Yeo. "Diagnostic significance of dual immunocytochemical staining of p53/cytokeratin20 on liquid-based urine cytology to detect urothelial carcinoma." Cytojournal 17 (February 27, 2020): 3. http://dx.doi.org/10.25259/cytojournal_88_2019.
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Background: Urine cytology is a noninvasive and inexpensive method; however, it is limited in low sensitivity for detecting and monitoring urothelial carcinoma (UC). To overcome limitation of cytology, several tests using urine samples have been attempted that immunocytochemical staining is an inexpensive and easy to perform ancillary technique. Dual immunocytochemical staining for p53 and cytokeratin 20 (CK20) is assessed in liquid-based urine cytology slides. Materials and Methods: Liquid-based urine cytology samples collected between 2008 and 2013 and matched follow-up biopsy samples of high-grade UC (HGUC) (n = 44) and low-grade UC (LGUC) (n = 14) were analyzed. Results: Urine cytology showing atypical cells was subjected to dual-color immunostaining for p53 and CK20. The sensitivity of urine cytology combined with p53 and CK20 immunostaining was 77.3% in HGUC and 52.9% in LGUC. Of 20 cases diagnosed with atypia by urine cytology, 13 (65%) were positive for p53 or CK20. Dual immunocytochemical staining for p53/CK20 improved the diagnostic accuracy of urine cytology. Conclusions: The present results indicate that cytomorphology combined with p53/CK20 immunostaining is useful for the detection of HGUC and LGUC.
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Schnadig, Vicki J., Adekunle Adesokan, Durwood Neal, and Zoran Gatalica. "Urinary Cytologic Findings in Patients With Benign and Malignant Adenomatous Polyps of the Prostatic Urethra." Archives of Pathology & Laboratory Medicine 124, no. 7 (June 1, 2000): 1047–52. http://dx.doi.org/10.5858/2000-124-1047-ucfipw.
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Abstract Context.—Urethral adenomatous polyps with prostatic epithelium (also known as benign prostatic epithelial polyps [BPEPs]) are a documented cause of hematuria, dysuria, and hematospermia, conditions that may prompt cytologic evaluation of urine. Design.—The urine cytologic test findings in 5 cases of biopsy-proven BPEPs and in 1 case of prostatic ductal adenocarcinoma (PDA) that presented as a urethral polyp were retrospectively evaluated. Immunocytochemical stain for prostate-specific antigen (PSA), prostatic acid phosphatase (PAP), and high-molecular-weight cytokeratin (34βE12) were used in evaluation of the lesions. Results.—In 4 of 5 cases of BPEPs, clusters of bland columnar cells with uniform, oval nuclei were seen. Positive immunostaining for PSA and PAP confirmed the prostatic origin of the clusters in 2 cases. One urine sample contained abundant goblet cells and extracellular mucin, consistent with intestinal metaplasia coexisting in the bladder biopsy specimen. The urine sample in the fifth case of BPEPs contained no columnar cells. The last case had multiple urine cytologic evaluations that demonstrated PSA-positive, malignant-appearing clusters of columnar cells. A biopsy specimen of the polyps was described as a high-grade prostatic intraepithelial neoplasm in adenomatous polyp. However, in this patient, PDA was diagnosed on transurethral resection of the prostate specimen 4 years after the initial urine cytologic test. Conclusion.—Benign prostatic epithelial polyps should be considered in the differential diagnosis of clusters of columnar cells in urine cytologic testing. Cells with malignant nuclear features should instigate a careful search for a (prostatic) neoplasm, which may present as urethral polyps (eg, PDA). Stains for PSA or PAP are useful adjuncts in differential diagnosis of this condition.
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Kaur, Dr Kanwalpreet. "Role of CK20 immunocytochemistry as an adjuvant to urine cytology in the detection of urothelial malignancy." Journal of Medical Science and clinical Research 12, no. 11 (November 30, 2024): 48–54. https://doi.org/10.18535/jmscr/v12i11.07.
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Introduction: Urine cytology has been a non-invasive method of choice for detecting urothelial carcinomas but it has several drawbacks including low sensitivity for low grade urothelial lesions, morphology being easily affected by infection, instrumentation, surgery, chemo or immune therapy. Additional screening tests with high sensitivity and specificity for urothelial tumours of all grades are indicated to help improve the diagnostic ability of urine cytology as well as to reduce the need for frequent cystoscopies, especially in those with low-risk disease. Objective: We studied the role of CK20 immunocytochemistry (CK20 ICC) and compare the results with efficacy of cytology in detecting urothelial carcinomas. Material and Methods: We studied 160 cytospin centrifuged smears of urine cytology stained with hematoxylin and eosin and were reported according to the Paris system. Cell blocks were prepared in each case and stained with CK 20 monoclonal antibodies. Results: Sensitivity, specificity, positive predictive value and negative predictive value of urine cytology was 78.72%, 98.05%, 94.87% and 91.15% respectively while that of CK20 ICC was 85.11%, 94.29%, 86.96% and 93.40% respectively. Conclusion: CK20 ICC is more sensitive than urine cytology for detection of all grades and stages of bladder cancer. It is recommended as useful adjuvant to urine cytology in controversial cases. Keywords: voided urine cytology, The Paris System, CK 20 immunocytochemistry.
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Ann Pereira, Loretta, Hilda Fernandes, and Amritha Chidambaram. "Implementing the Paris System into Reclassifying Urine Cytology: A Descriptive Analysis." International Journal of Science and Research (IJSR) 10, no. 11 (November 27, 2021): 399–403. https://doi.org/10.21275/art20193124.
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Khattab, Ruba, Hui Zhu, and Jordan Reynolds. "Cytologic-histologic Correlation of Benign/Metaplastic Bladder Conditions with Urine Cytology: A Retrospective Slide Review." Journal of the American Society of Cytopathology 3, no. 5 (September 2014): S30. http://dx.doi.org/10.1016/j.jasc.2014.09.062.
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Lee, Paul, Christopher Owens, and Andrew Fischer. "Sensitivity of Urine Cytology for High Grade Urothelial Carcinoma and Explanations for False-Negative Cytologies." Journal of the American Society of Cytopathology 4, no. 6 (November 2015): S19—S20. http://dx.doi.org/10.1016/j.jasc.2015.09.043.
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Viswanath, S., B. Zelhof, E. Ho, K. Sethia, and R. Mills. "Is Routine Urine Cytology Useful in the Haematuria Clinic?" Annals of The Royal College of Surgeons of England 90, no. 2 (March 2008): 153–55. http://dx.doi.org/10.1308/003588408x242006.
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INTRODUCTION The objective of this study was to determine the value of routine urine cytology in the initial evaluation of patients presenting to a one-stop haematuria clinic. PATIENTS AND METHODS A total of 1000 consecutive patients who attended the haematuria clinic between June 2003 and November 2004 were studied prospectively. A standard protocol was used to investigate these patients. This included urine cytology, upper tract imaging and flexible cystoscopy. RESULTS Overall, 986 samples of urine were sent for cytology. In 126 patients, the report was abnormal; of these, 71 patients were found to have bladder transitional cell carcinoma by flexible cystoscopy and a further 3 had upper tract transitional cell carcinoma diagnosed radiologically. The remaining 52 patients with abnormal cytology were not found to have cancer on further investigations. The total cost for urine cytology and additional investigations was £50,535. CONCLUSIONS In this study of the initial evaluation of patients with haematuria, no case of urothelial malignancy was diagnosed on the basis of urine cytology alone. Therefore, urine cytology need not be used routinely in the initial diagnostic workup for haematuria.
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Ikeda, H., Y. Ishida, T. Dejima, M. Nomura, and H. Sanefuji. "The significance of urine NMP22 in the screening of urothelial cancer (comparison of ELISA and immunochromatography method)." Journal of Clinical Oncology 27, no. 15_suppl (May 20, 2009): e16024-e16024. http://dx.doi.org/10.1200/jco.2009.27.15_suppl.e16024.
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e16024 Background: The early diagnosis of urothelial cancer allows for effective local treatment and optimizes the success of surgical therapy. Urine nuclear matrix protein 22 (NMP22) was introduced for the detection of transitional cell carcinoma. Add to old NMP22 (ELISA), new NMP22 (immunochromotography method : BladderChek) can be available from 2004. The objective of this study is to determine whether there are any correlation between urine NMP22 (two methods) and the grade or stage of urothelial cancer, and whether it can serve as a biochemical marker of urothelial cancer. Methods: A total of 246 patients with hematuria or followed up after TUR-BT, from March 2007 to December 2007,visited our hospital and subsequently underwent cystoscopy. The 246 patients provided voided urine samples. We immediately examined urine cytology and NMP22 (two methods). We set the cut off value on 12.0U/ml for NMP22 (ELISA). NMP22 (BladderChek) was judged by qualitative analysis. We decided that in urine cytology, classI,II,III were negative, while IV,V were positive by Papanicolaou classification. Results: Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) were 66.7 %, 98.3 %, 81.8 %, 96.3 % in urine cytology, 40.7 %, 75.9 %, 16.2 %, 91.8 % in NMP22 (ELISA), 59.3 %, 79.3 %, 24.6 %, 94.5 % in NMP22 (BladderChek). In 9 cases with false negative of urine cytology, 4 cases were picked up by NMP22 (ELISA), and 5 cases by NMP22 (BladderChek). Sensitivity of grade 1 was 33.3 % in urine cytology, while 66.7 % in NMP22 (BladderChek). By adding NMP22 (BladderChek) to urine cytology, sensitivity rose about 18 %. Conclusions: The sensitivity of urine cytology was unexpectedly high. NMP22 (BladderChek) is more useful than NMP22 (ELISA) because of higher sensitivity, specificity and advantage of simplicity, rapidity. It seems that the addition of NMP22 (BladderChek) to urine cytology is beneficial. No significant financial relationships to disclose.
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Saharti, Samah, Hessa Aljhdali, Rana Ajabnoor, Reem A. Al Zahrani, Yara Daous, Fahd Refai, Fatima Badawi, Ghadeer Mokhtar, and Doaa Alghamdi. "Cytospin performance when using Paris system for reporting urinary cytology." Cytojournal 19 (August 5, 2022): 47. http://dx.doi.org/10.25259/cytojournal_48_2021.
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Objectives: The Paris System (TPS) for Reporting Urine Cytology has significantly improved the approach to evaluating urine cytology. TPS criteria were defined mainly according to ThinPrep and SurePath preparations, as they are widely utilized. The objective of this study is to validate urine cytology interpretation according to the TPS classification using cytospin technique in relation to the gold slandered histology. Material and Methods: This retrospective study examined and analyzed 316 urine specimens from King Abdulaziz University Hospital between 2015 and 2020. Cytospin technique is performed for all cases. Slides were recategorized using TPS criteria, then compared with the original histology diagnosis. Results: According to the TPS, 108 cases were classified as 101 AUC (32%), 95 NEG (30%), 59 HGUC (18.7%), 31 SHGUC (9.8%), and 30 (9.5%) others. The computed sensitivity of cytospin in urine cytology was 94.7%, with 73.9% specificity, a positive predictive value of 85.6%, a negative predictive value of 89.5%, and overall accuracy of 86.8%. Conclusion: Urine cytology testing is considered to be a non-invasive and sensitive method to screen for urothelial carcinoma. TPS defined standards are reliable on cytospin prepared slides for reporting urine cytology.
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Curling, Marigold, G. Broome, and W. F. Hendry. "How Accurate is Urine Cytology?" Journal of the Royal Society of Medicine 79, no. 6 (June 1986): 336–38. http://dx.doi.org/10.1177/014107688607900609.
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Exfoliative urinary cytology was performed on 260 new cases of histologically proven urothelial cancer. The site, size, shape and histological grade of the tumours were documented, and they were classified by the TNM system. Overall, urine cytology was positive in 135 (52%), suspicious in 28 (11%) and negative in 97 (38%) cases. Malignant cells were found most often when the urothelial tumours were large, papillary and solid, moderately or poorly differentiated and invasive (T2–4). Most upper tract tumours and those situated in bladder diverticula had positive urinary cytology. This study confirms that exfoliative urinary cytology is useful in detecting the more malignant bladder tumours including in-situ carcinoma, and other tumours in less accessible parts of the urinary tract.
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Zaharopoulos, Paul, Jick Y. Wong, and Julie W. Wen. "Matrix crystals in cytologic urine specimens." Diagnostic Cytopathology 6, no. 6 (1990): 390–95. http://dx.doi.org/10.1002/dc.2840060604.
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Ranade, Ranjana Shashidhar, Netra Prakash Kori, and Vidisha Sharatchandra Athanikar. "Utility of Urine Cytology in Genitourinary Lesions and Implication of Paris System in the Diagnosis of Urothelial Carcinoma - Five Years of Experience from a Tertiary Care Centre at North Karnataka." Journal of Evidence Based Medicine and Healthcare 8, no. 02 (January 11, 2021): 58–63. http://dx.doi.org/10.18410/jebmh/2021/12.
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BACKGROUND Urine cytology when combined with cystoscopy remains a gold standard in screening and surveillance of urothelial carcinoma. Paris system for reporting urine cytology (PSRUC) gives seven well defined diagnostic criteria. We aimed to analyse utility of urine cytology in patients with urogenital symptoms, compare existing institutional system (EIS) with PSRUC and assess the performance of both reporting systems in predicting subsequent high-grade urothelial carcinoma on histopathology. METHODS A five year retrospective study included a total of 146 urine samples from 74 patients. Each case was assigned a category according to both EIS and PSRUC system. After cyto-histological correlation, sensitivity, specificity and diagnostic accuracy of urine cytology in detecting malignancy using PSRUC and EIS were determined. Performance of urine cytology in predicting subsequent high grade urothelial carcinoma (HGUC) was assessed for both reporting systems. RESULTS PSRUC resulted in reduction in number of cases assigned to atypical category (10.5 % vs. 3.4 %) and increase in low grade carcinomas assigned to NGUC category (66 % vs. 100 %). Positive predictive value (PPV) for predicting subsequent high grade urothelial carcinoma for HGUC and SHGUC category remained the same (100 %). Sensitivity (66.67 % vs. 55.5 %), specificity (100 % vs. 85.71 %) and diagnostic accuracy (81 % vs. 68.75 %) was improved with application of PSRUC when compared to EIS. Two cases of genitourinary tuberculosis were diagnosed. CONCLUSIONS PSRUC improves predictive accuracy of subsequent high-grade urothelial carcinoma on histopathology and it ensures uniformity in reporting. Judicious use of urine cytology might aid in early diagnosis of infectious conditions like tuberculosis. KEYWORDS PSRUC, Urine Cytology, High Grade Urothelial Carcinoma
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Allison, Derek B., Rajni Sharma, Morgan L. Cowan, and Christopher J. VandenBussche. "Evaluation of Sienna Cancer Diagnostics hTERT Antibody on 500 Consecutive Urinary Tract Specimens." Acta Cytologica 62, no. 4 (2018): 302–10. http://dx.doi.org/10.1159/000489181.
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Objectives: Telomerase activity can be detected in up to 90% of urothelial carcinomas (UC). Telomerase activity can also be detected in urinary tract cytology (UTC) specimens and indicate an increased risk of UC. We evaluated the performance of a commercially available antibody that putatively binds the telomerase reverse transcriptase (hTERT) subunit on 500 UTC specimens. Study Design: Unstained CytospinTM preparations were created from residual urine specimens and were stained using the anti-hTERT antibody (SCD-A7). Two algorithms were developed for concatenating the hTERT result and cytologic diagnosis: a “no indeterminates algorithm,” in which a negative cytology and positive hTERT result are considered positive, and a “high-specificity algorithm,” in which a negative cytology and positive hTERT result are considered indeterminate (and thus negative for comparison to the gold standard). Results: The “no indeterminates algorithm” and “high-specificity algorithm” yielded a sensitivity of 60.6 and 52.1%, a specificity of 70.4 and 90.7%, a positive predictive value of 39.1 and 63.8%, and a negative predictive value of 85.0 and 85.8%, respectively. Conclusions: A positive hTERT result may identify a subset of patients with an increased risk of high-grade UC (HGUC) who may otherwise not be closely followed, while a negative hTERT immunocytochemistry result is associated with a reduction in risk for HGUC.
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Jess, Heidi, Alaa Afify, and Eric Huang. "A Retrospective Review of Atypical Clusters in Urine Cytology: Analysis of Cytologic Features and Clinical Significance." Journal of the American Society of Cytopathology 1, no. 1 (November 2012): S28. http://dx.doi.org/10.1016/j.jasc.2012.08.059.
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Shadab, Rangrez, Saziya R. Bidi, Shridhar C. Ghagane, and R. B. Nerli. "EMERGING ROLE OF URINARY BIOMARKERS IN DETECTION OF UROTHELIAL BLADDER CARCINOMA IN SOUTH INDIAN POPULATION." Journal of Advanced Scientific Research 13, no. 09 (October 31, 2022): 104–12. http://dx.doi.org/10.55218/jasr.202213914.
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Urine cytology is used for screening of exfoliated bladder cells from voided urine but lacks sensitivity. This study aims to check the efficacy of 5-aminolevulinic acid (5- ALA) fluorescence cytology and establish a high sensitivity approach in detecting flat, in-situ and/or small lesions that are hardly visible under conventional cystoscopy. Intracellular PPIX allows red fluorescence detection. In this study, 5-ALA fluorescent cytology using urine was compared with conventional cytology in the diagnosis of bladder tumors. In this prospective study, we compared the sensitivity and specificity between conventional cytology, 5-ALA fluorescent cytology and FDA approved commercially available kits (NMP-22 and BTA). The percentage of Protoporphyrin IX facilitated by 5-ALA was amplified in cancer urothelial cells compared to normal urothelial cells. The sensitivity of conventional cytology and 5-ALA fluorescent cytology was 64% and 96% respectively, whereas the specificity was 92% and 98.67% respectively. In conclusion, 5-ALA induced fluorescent urine cytology demonstrated promising outcomes in the detection of bladder carcinoma cells. Furthermore, low grade and low stage tumor cells as well as flat lesions were also positively and accurately interpreted using 5-ALA fluorescent cytology.
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Rahman, Mohammad Shafiqur, ASM Azizur Rahman Siddique, Mohammad Saiful Islam, and Faika Farah Ahmed. "Combined urine Cytology and Cystoscopy can detect recurrence of superficial transitional cell carcinoma of the urinary bladder." Bangabandhu Sheikh Mujib Medical University Journal 12, no. 1 (March 13, 2019): 1–5. http://dx.doi.org/10.3329/bsmmuj.v12i1.38821.
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The study was aimed to evaluate the accuracy of combined urine cytology and cystoscopy for the detection of recurrence of superficial transitional cell carcinoma of the urinary bladder without bladder biopsy. Total 60 patients of superficial TCC of urinary bladder were selected of these 48 were male and 12 were female with age were between 41 to 80 years (mean age- 63.15 years).Urine cytology was done for all patients .Then cystoscopy done with targeted biopsy taken from any apparently visible growth in the bladder and systematic biopsy were taken where there was no growth. Reports of the cytology and cystoscopy were compared with the histopathology reports.It was found that 18 patients were cytology positive (false positive 2) and 42 patients were cytology negative (false negative 10) with sensitivity 61.5% and specificity 94%. During cystoscopy 24 patients were found recurrent growth in the bladder (false positive 3) and 36 patients were negative (false negative 5) with sensitivity 80.7% and specificity 91%. But when combined urine cytology and cystoscopic findings evaluated, the sensitivity and specificity were found 100% and 91% respectively.So, combined urine cytology and cystoscopy can be used for the detection of recurrence of superficial TCC. Key Ward- Urine Cytology, Cystoscopy, Bladder Biopsy
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Abdulwahab-Ahmed, Abdullahi, Kabiru Abdullahi, Mohammed A. Umar, Ngwobia P. Agwu, Abubakar S. Muhammad, and Abdullahi Khalid. "The pattern of urine cytology in a tertiary health care facility Northwest Nigeria." International Surgery Journal 6, no. 5 (April 29, 2019): 1458. http://dx.doi.org/10.18203/2349-2902.isj20191866.
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Background: Urine cytology is an important investigation in the management of urothelial cancer. It is particularly an important test in the management of urinary tract cancers because of its non-invasive nature. Objective of study to review our practice of urine cytology as a diagnostic tool in the management of urinary tract pathology.Methods: A seventeen years retrospective study from 1st January, 2001 to 31st December, 2017 where records of patients who had urine cytology in Usmanu Danfodio University Teaching Hospital (UDUTH), Sokoto, Nigeria were reviewed and data was extracted and analyzed using the SPSS 20.Results: Of the 766 specimens, representing 10.1% of all cytology done in UDUTH (7,554) during the period under review, the highest number of urine cytology was done in 2013 (12%). The age range of the patients was between 2 to 90 years with modal age of 60 years. Majority of the patients were between the ages of 51 to 60 years (24.7%) and male to female ratio was 6.3:1. The commonest indication for urine cytology was bladder tumour (66.8%). However, the commonest cytological diagnosis was negative (44.6%) while 19.3% showed Non Specific Chronic Inflammation and only 77 specimens were malignant representing 10.1% of the specimen.Conclusions: Despite its variable sensitivity, urine cytology remains a useful tool in evaluating suspected bladder malignancies and can serve as an adjunct to cystoscopy in these cases.
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Kral, Milan, Pavel Zemla, David Hradil, Hynek Skotak, Igor Hartmann, Katerina Langova, Jan Bouchal, and Daniela Kurfurstova. "Iodinated Contrast Medium Affects Urine Cytology Assessment: A Prospective, Single-Blind Study and Its Impact on Urological Practice." Diagnostics 12, no. 10 (October 13, 2022): 2483. http://dx.doi.org/10.3390/diagnostics12102483.
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During endoscopic procedures for suspected urothelial tumors of the upper urinary tract, radiographic imaging using an iodinated contrast medium is often required. However, following ureteropyelography, we detected changes in cytology characteristics not correlating with real cytology findings in naive urine. The aim of our study was to assess cytology changes between naive and postcontrast urine according to The Paris System of cytology classification. Methods: We prospectively assessed urine samples from 89 patients (23 patients with histologically proven urothelial cancer and 66 healthy volunteers). The absence of malignancy was demonstrated by CT urography and/or ureteroscopy. The study was single blind (expert cytopathologist) and naïve Paris system for urine cytology assessment was used. Furthermore, additional cytological parameters were analyzed (e.g., specimen cellularity, degree of cytolysis, cytoplasm and nucleus color, chromatin and nucleo-cytoplasmic ratio). Results: Our study showed statistically significant differences when comparing naïve and postcontrast urine in healthy volunteers (only 51 % concordance, p = 0.001) versus malignant urine specimens (82 % concordance). The most important differences were in the shift from The Paris System category 2 (negative) to 1 (non-diagnostic) and from category 2 (negative) to 3 (atypia). Other significant changes were found in the assessment of specimen cellularity (p = 0.0003), degree of cytolysis (p = 0.001), cytoplasm color (p = 0.003), hyperchromasia (p = 0.001), course chromatin (p = 0.002), nucleo-cytoplasmatic ratio (p = 0.001) and nuclear borders' irregularity (p = 0.01). Conclusion: Our unique study found crucial changes in the cytological assessment of naive and postcontrast urine and we confirm that postcontrast urine is more often assessed as abnormal, suspect or non-diagnostic. Therefore, before urine collection for cytology, the clinician should avoid administration of iodinated contrast into the urinary tract.
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Guo, Aiye, Xiuhua Wang, Juan Shi, Changyi Sun, and Zhen Wan. "Bladder tumour antigen (BTA stat) test compared to the urine cytology in the diagnosis of bladder cancer: A meta-analysis." Canadian Urological Association Journal 8, no. 5-6 (May 21, 2014): 347. http://dx.doi.org/10.5489/cuaj.1668.
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Introduction: We evaluate the diagnostic value of bladder tumour antigen (BTA stat) tests compared with urine cytology test in detecting bladder cancer.Methods: We searched public databases including PubMed, MEDLINE Springer, Elsevier Science Direct, Cochrane Library and Google Scholar before December 2012. To collect relevant data of BTA stat tests and urine cytology tests in patients with bladder cancer, we studied meta-analyses of sensitivity, specificity, positive likelihood ratio (LR), negative LR and diagnostic odds ratios (DOR) of BTA stat tests and cytology tests from published studies. We applied the software of Rev. Man 5.1 and Stata 11.0 to the meta-analysis.Results: A total of 13 separate studies consisting of 3462 patients with bladder cancer were considered in the meta-analysis. We found that the BTA stat test had a higher sensitivity than the urine cytology test (0.67, 95% confidence interval [CI] 0.64 to 0.69 vs. 0.43, 95% CI 0.40 to 0.46), but the specificity, positive LR, negative LR, DOR, the area under the curve (AUC) and Q index of the BTA stat test were lower compared with the urine cytology test. The results of the Egger’s linear regression test showed no publication bias (p > 0.05).Conclusions: Specificity, positive LR, negative LR, DOR, the AUC and the Q index of the urine cytology test may be superior to the BTA stat test, but the BTA stat test has greater sensitivity than the urine cytology test.
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Badruddoza, SM, FA Azim, AJE Nahar Rahman, M. Kamal, AR Barua, KH Khan, and T. Chowdhury. "Utility of Exfoliative Cytology of Voided Urine in Comparison with Ultrasonogram and Cystoscopy Findings in the Diagnosis of Urothelial Cancers." TAJ: Journal of Teachers Association 30, no. 2 (December 3, 2018): 39–46. http://dx.doi.org/10.3329/taj.v30i2.39136.
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Carcinoma of the urinary bladder affects men more often than women and occurs in patients over the age of 50 years. Transitional cell carcinoma (TCC) comprises about 90% of all primary tumor of urinary bladder. In this study a total of 57 cases were taken. The aim of the study was to establish diagnostic role of voided urine cytology, ultrasonography and cystoscopy in urothelial cancers. Out of 57 cases, cytological diagnosis was positive in 53 cases (93%) and negative in 4 cases (7%). There were no atypical or suspicious cases. Of the total cases, cytology was negative only in 7% cases. Among 42 invasive carcinomas 14 (33%) grade III invasive flat carcinoma, one (2%) invasive papillary adenocarcinoma and two (5%) invasive squamous cell carcinoma, each of them gave 100% positive cytology. Of the remaining 25 (60%) invasive papillary TCC, 21 were in grade II and 4 were in grade III. They gave 90% and 100% positive cytologic results. Ultrasonogram of urinary bladder gave 95% (approx.) positive results and out of 57 cases, 3 cases failed to give positive results in ultrasonogram (USG) of the urinary tract. Cystoscopy detected tumor mass in 98% cases and it gave false negative result in 2% cases. Fifty-two tumors had a diameter ranging 1.1- 6 cm. Single lesions were seen in 40 cases, double lesion in one case and multiple in 13 cases. The probability of later invasive carcinomas nearly tripled in-patients with multiple lesions on presentation (13.6%) compared with those who presented with a single lesion (4.6%). Consistent with previously published data, this study showed the highest diagnostic accuracy with high-grade tumors and lowest with low-grade tumors. So in a proper clinical setting, non-invasive technique like voided urine cytology and ultrasonography could be done as a first line cost effective method in the diagnosis of urothelial cancers.TAJ 2017; 30(2): 39-46
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Dhakhwa, Ramesh, Ozone Shrestha, Ram Thapa, and Sailesh Pradhan. "Utility of reporting urine cytology samples as per the Paris system." Journal of Pathology of Nepal 12, no. 1 (March 31, 2022): 1881–85. http://dx.doi.org/10.3126/jpn.v12i1.41443.
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Background: Urinary tract cytology is an accurate test for the detection of urothelial malignancy especially high-grade urothelial carcinoma. The Paris System for Reporting Urinary Cytology was introduced to standardize urinary tract cytology reporting. We aim to evaluate the utility of reporting urinary cytology as per this system and correlate with histopathology. Materials and Methods: This is a descriptive cross-sectional prospective study conducted on urine samples submitted for cytological examination at Kathmandu Medical College Teaching Hospital, Sinamangal, Nepal between 1st November 2020 to 31st July 2021. Ethical consent was taken from the Institutional Review Committee. Urine cytology was reported as per The Paris System for Reporting Urinary Cytology and correlated with the histopathologic diagnosis. Sensitivity, specificity, positive predictive value, and negative predictive value were calculated for the high-grade and low-grade urothelial lesion. Results: A total of 104 urine samples were evaluated. Biopsy specimens were available for 38 cases. Urine cytology consisted of 1.92% non-diagnostic cases, 69.23% negative for high-grade urothelial carcinoma, 5.76% atypical urothelial cells, 5.76% suspicious for high-grade urothelial carcinoma, 13.46% high-grade urothelial carcinoma, and 3.84% low-grade urothelial neoplasm respectively. Sensitivity, specificity, negative predictive value and positive predictive value were 90.48%, 82.35%, 86.37% and 87.5% respectively for high grade urothelial carcinoma and 40%, 93.9%,50% and 91.17% respectively for low grade urothelial lesions. Conclusions: Our study shows that reporting urine cytology as per The Paris System for Reporting Urinary Cytology provides high sensitivity for the detection of high-grade urothelial lesions.
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Eissa, Sanaa, Soheir Badr, Shadia Abd Elhamid, Azza Salah Helmy, Mohamed Nour, and Mohamed Esmat. "The Value of Combined Use of Survivin mRNA and Matrix Metalloproteinase 2 and 9 for Bladder Cancer Detection in Voided Urine." Disease Markers 34, no. 1 (2013): 57–62. http://dx.doi.org/10.1155/2013/341578.
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Objective: In a trial to improve the diagnostic efficacy of conventional urine cytology we determine survivin RNA and matrix metalloproteinase 2 and 9 in urine of bladder cancer cases.Method: Voided urine specimens were collected from patients with histologically confirmed bladder urothelial carcinoma (Group 1;n= 46), urological patients without urothelial carcinoma (Group 2;n= 20), and healthy volunteers (Group 3;n= 20). Urine cytology, survivin RNA was estimated by qualitative nested RT-PCR and MMP-2, MMP-9 activity were detected by gelatin zymography. The expression of survivin RNA and matrix metalloproteinase 2 and 9 in bladder cancer was compared with benign and normal cases.Results: Positivity rates of survivin RNA and MMPs zymography were significantly different among the 3 groups. Urine survivin detection by qualitative nested RT-PCR showed 76.1% sensitivity and 95% specificity. The overall sensitivity, specificity of urinary MMP zymography was 67.3%, 90% respectively. The combined use of urine cytology with urine survivin or MMPs zymography increased sensitivity of urine cytology from 50% to 84.7%. The highest sensitivity (95.6%) was obtained on combining the three markers.Conclusion: Survivin RNA and MMPS zymography can be considered as promising noninvasive markers for bladder cancer early detection. Combined use of the three markers improved the sensitivity for detecting bladder cancer.
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Bondhus, M., R. Leif, D. Bobbitt, J. Lockhart, A. Ng, M. Silverman, V. A. Politano, and D. Hindman. "Centrifugal cytology: A new technique for urine cytology." Urology 28, no. 5 (November 1986): 432–33. http://dx.doi.org/10.1016/0090-4295(86)90082-8.
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