Can Sensitivity of Voided Urinary Cytology or Bladder Wash Cytology Be Improved by the Use of Different Urinary Portions?

Abstract

Objective: To improve sensitivity by using different portions of voided urine cytology (VUC) and bladder wash material cytology (BWC). Materials and Methods: 52 patients with biopsy-proven superficial transitional cell carcinoma (TCC) of the bladder were studied. Voided urine specimens were divided into a first stream, mid-stream and terminal stream. Bladder wash material was also divided into a first portion, mid-portion and last portion. All portions were investigated for cytology abnormalities. Results: Sensitivity for the detection of malignant cells was 34.6, 38.5 and 38.5% for the first, mid- and terminal stream of VUC and 34.6, 38.5 and 34.6% for the first, mid- and last portion of BWC, respectively. The sensitivity of VUC was 20–25% for grade I, 30–40% for grade II, and 50–75% for grade III tumors, respectively. The sensitivity of BWC was 25% for grade I, 35–45% for grade II, and 33–50% for grade III tumors, respectively. There was no statistical significant difference for sensitivities between either grades (p = 0.06) or portions or streams (p = 0.3) of VUC and BWC. Conclusions: In this small group of patients, we did not find any significant difference, but we found highest sensitivity in grade III tumors with the terminal portion of the voided urine when compared to other portions of VUC. Therefore, we believe that further study in a large series is necessary to investigate this approach of differentiated BWC and especially VUC.

Noninvasive diagnostic imaging using machine-learning analysis of nanoresolution images of cell surfaces: Detection of bladder cancer

“…(accuracy of no-cancer detection) of VUC is high (>90%), the sensitivity is low (20-80%) (13,14), in particular, for the detection of low-grade cancer (20-25%) (15,16). Methods based on noninvasive analysis of chemical biomarkers show promise but still are either not sufficiently accurate or repeatable to be adopted for widespread use (15) and are not currently recommended for diagnosis.…”

Postoperative Bladder Washing Cytology After Transurethral Resection

“…Those studies disclosed sensitivity and specificity of bladder washing cytology of 76% and 100%, respectively, using histologic diagnosis of urothelial carcinoma as a standard. Other studies making this comparison reported a sensitivity of 45-77%, 4-9 which depended highly on grade 5,9 (grade 1, 7-29%; grade 2, 35-56%; grade 3, 75-82%) and stage 5 (noninvasive, 67%; invasive, 89%). This low sensitivity could be improved, particularly for low grade carcinoma, by neural network-based diagnosis 6 or image analysis.…”