Does subdivision of the “atypical” urine cytology increase predictive accuracy for urothelial carcinoma?

2014 ◽  
Vol 42 (12) ◽  
pp. 1034-1044 ◽  
Author(s):  
David G. Bostwick ◽  
Deloar Hossain
Keyword(s):  
Urothelial Carcinoma ◽  
Predictive Accuracy ◽  
Urine Cytology

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

2021 ◽  
Vol 8 (02) ◽  
pp. 58-63
Author(s):  
Ranjana Shashidhar Ranade ◽  
Netra Prakash Kori ◽  
Vidisha Sharatchandra Athanikar
Keyword(s):  
Diagnostic Accuracy ◽  
Urothelial Carcinoma ◽  
Predictive Accuracy ◽  
Tertiary Care ◽  
Urine Cytology ◽  
Low Grade ◽  
High Grade ◽  
Tertiary Care Centre ◽  
Screening And Surveillance ◽  
Reporting Systems

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

Urine cytology findings in patients with biopsy‐confirmed urothelial carcinoma in situ with plasmacytoid features

2021 ◽  
Author(s):  
Meredith M. Nichols ◽  
Jordan P. Reynolds ◽  
Jesse K. McKenney ◽  
Marlo M. Nicolas ◽  
Patrick J. McIntire ◽  
...  
Keyword(s):  
Urothelial Carcinoma ◽  
Carcinoma In Situ ◽  
Urine Cytology

Improved Filter Method for Urine Sediment Detection of Urothelial Carcinoma by Fluorescence In Situ Hybridization

2007 ◽  
Vol 131 (10) ◽  
pp. 1574-1577 ◽  
Author(s):  
Isabelle Meiers ◽  
Harpreet Singh ◽  
Deloar Hossain ◽  
Kevin Lang ◽  
Lina Liu ◽  
...  
Keyword(s):  
In Situ Hybridization ◽  
Fluorescence In Situ Hybridization ◽  
Urothelial Carcinoma ◽  
Urine Cytology ◽  
Filter Method ◽  
Urine Sediment ◽  
Specific Test ◽  
Significant Difference ◽  
Time Required

AbstractContext.—Fluorescence in situ hybridization (FISH) of voided urine sediment is a sensitive and specific test for the detection of urothelial carcinoma. The time required for slide preparation using the conventional cytospin method is lengthy.Objective.—To present an alternative to the conventional cytospin method.Design.—We compared the results of an improved filter monolayer method with published results of the conventional cytospin method. A total of 624 patients with cytology and FISH analyses were followed with cystoscopy and/ or bladder biopsy. Fluorescence in situ hybridization analysis was performed on 624 cases using fluorescence-labeled probes to the pericentromeric regions of chromosomes 3, 7, and 17 and band 9p21; cytology was also performed in all cases.Results.—A total of 217 (34.7%) of 624 patients had follow-up bladder biopsies, and 170 of these (78.3%) had urothelial carcinoma. The sensitivity for cancer detection was higher for FISH than for urine cytology (92.9% [158/ 170] for FISH vs 72.9% [124/170] for urine cytology, P = <5%). The specificity was equivalent for FISH and urine cytology (97.5% [443/454] for FISH vs 92.2% [419/454] for cytology). The sensitivity for FISH was better (92.9% vs 81%), and there was no significant difference in specificity (97.5% vs 96%) between the filter method and the conventional cytospin method. Unlike the conventional cytospin method, the filter method did not require multiple centrifugation and decantation steps or investment in dedicated equipment.Conclusions.—The improved filter method was faster, easier, and less expensive than published results with the conventional cytospin method with better sensitivity and equivalent specificity.

scholarly journals Use of the Nuclear Matrix Protein 22 BladderChek Test for the Detection of Primary and Recurrent Urothelial Carcinoma

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Chang-sheng Xia ◽  
Chun-hong Fan ◽  
Ming Su ◽  
Qing-song Wang ◽  
Hui-zhang Bao
Keyword(s):  
Urothelial Carcinoma ◽  
Sensitivity And Specificity ◽  
Nuclear Matrix ◽  
Matrix Protein ◽  
Benign Disease ◽  
Urine Cytology ◽  
Nuclear Matrix Protein ◽  
Combined Use ◽  
Significant Difference ◽  
Low Sensitivity

Objective. To evaluate the performance of the nuclear matrix protein 22 (NMP22) BladderChek test in urothelial carcinoma (UC). Methods. We retrospectively analyzed 1318 patients who performed the NMP22 BladderChek tests. Of them, 103 were primary UC patients, 90 were surgical treatment UC patients, and 1125 were benign disease patients. The performance of the NMP22 BladderChek test for the diagnosis of primary and recurrent UC was evaluated. Moreover, the performance of urine cytology and the NMP22 BladderChek test for the diagnosis of primary UC was compared in 90 available subjects including 48 primary UC patients and 42 benign disease patients. Results. The sensitivity and specificity of the NMP22 BladderChek test were 37.9% and 95.8%, respectively, for the diagnosis of primary UC (n=1228). The corresponding parameters of the NMP22 BladderChek test were 31.0% and 88.5%, respectively, for the diagnosis of recurrent UC (n=90). The sensitivity and specificity of urine cytology were 54.2% and 97.6%, respectively, for the diagnosis of primary UC (n=90); the corresponding parameters of the NMP22 BladderChek test were 41.7% and 83.3%, respectively; the corresponding parameters of the two tests combination were 64.6% and 83.3%, respectively. There was a significant difference in the performance between the NMP22 BladderChek test and urine cytology or the combination of two tests (P=0.017 and 0.001, respectively). Conclusions. The NMP22 BladderChek test has a low sensitivity for detecting primary and recurrent UC. Urine cytology is superior to the NMP22 BladderChek test, and combined use of the two tests improves the sensitivity in the detection of primary UC.

scholarly journals Preoperative positive voided urine cytology predicts poor clinical outcomes in patients with upper tract urothelial carcinoma undergoing nephroureterectomy

BMC Cancer ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Wen Liu ◽  
Zhankun Wang ◽  
Shuai Liu ◽  
Yu Yao ◽  
Yong Liu ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Urothelial Carcinoma ◽  
Logistic Regression Analysis ◽  
Tumor Grade ◽  
Urine Cytology ◽  
Upper Tract Urothelial Carcinoma ◽  
Urinary Cytology ◽  
Upper Tract ◽  
The Impact

Abstract Background Performance of urinary cytology is recommended as the part of a standard diagnostic workup and base surveillance regimens in upper tract urothelial carcinoma (UTUC). However, the effect of positive voided urine cytology (VUC) on UTUC prognosis, compared with negative VUC, has not been fully demonstrated. This study aimed to evaluate the impact of preoperative VUC on predicting intravesical recurrence, disease recurrence, and mortality in patients with UTUC who underwent nephroureterectomy (RNU). Methods Clinicopathological information was collected from 315 UTUC patients treated with RNU. The association between VUC and oncological outcomes was analyzed using the Kaplan–Meier method with log-rank test and Cox proportional hazards regression models. Multiple logistic regression analysis was performed to identify the influence of VUC on tumor grade. Results Preoperative positive VUC, presenting in 101 patients (32%), was significantly associated with tumor multifocality (P = 0.017) and higher tumor grade (P = 0.010). On multivariable Cox regression analyses, preoperative positive VUC was an independent prognostic factor of intravesical recurrence-free survival (RFS) (hazard ratio [HR] = 2.21, 95% confidence interval [CI] 1.06–4.64; P = 0.035), RFS (HR = 1.80, 95% CI 1.08–2.99; P = 0.023), and cancer-specific survival (CSS) (HR = 1.87, 95% CI 1.10–3.18; P = 0.020), but not overall survival (HR = 1.32, 95% CI 0.80–2.18; P = 0.28). Logistic regression analysis revealed that VUC was related to high tumor grade in UTUC (odds ratio = 2.23, 95%CI 1.15–4.52). Conclusion Preoperative positive VUC significantly increases the risk of intravesical recurrence in UTUC patients undergoing RNU. In addition, positive VUC is an adverse predictor of RFS and CSS, which might be due to the association between positive VUC and high tumor grade.

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