Cytology of Bladder Carcinoma

El-Bolkainy, Mohamed N.

doi:10.1016/s0022-5347(17)55271-4

Cited by 35 publications

(14 citation statements)

References 4 publications

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“…A review of 17 published series showed that, at worst, the false-negative rates were more than 50% for primary bladder cancer and averaged nearly 75% for superficial low grade disease. 6 An important diagnostic principle is that the higher the grade of the tumour, the more accurate the diagnosis. [7][8][9][10] Despite the limitations, urine cytology remains very useful in the monitoring of patients with high-grade, superficial, urothelial carcinoma where sensitivity and specificity are in the region of 90%.…”

Section: Discussionmentioning

confidence: 99%

Is Routine Urine Cytology Useful in the Haematuria Clinic?

Zelhof

et al. 2008

annals

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Ann R Coll Surg Engl 2008; 90: 153-155 153The value of urine cytology in the investigation of haematuria is debatable. 1,2As a small minority of cases of transitional cell carcinoma may only be detected by urine cytology, it has been suggested that one can justify the cost of performing routine cytology on all new patients with haematuria. 3The American Urological Association (AUA) best-practice policy for urine cytology recommends the test only in patients with risk factors for transitional cell carcinoma. 4 Urine cytology may be a useful adjunct in the diagnosis of urothelial carcinoma. Overall sensitivity is, however, dependent on the degree of differentiation. Interpretation of cytology is observer-dependent and lacks a simple reproducible consensus for diagnostic criteria and terminology. Interpretation may be compromised by atypia, low cellular yield, inflammation, degenerative changes and therapeutic interventions. A fresh, uncontaminated specimen is required in order to optimise evaluation.Performing urine cytology on all patients has significant financial and man-power implications. This study evaluates the clinical value and cost-effectiveness of urine cytology in a one-stop haematuria clinic. Patients and MethodsA total of 1000 consecutive patients who attended the onestop haematuria clinic, with either microscopic or macroscopic haematuria, between June 2003 and November 2004 were studied prospectively. The patients were evaluated according to a standard protocol. All patients were seen and examined by a member of the urology team and investigated on the same day. Investigations included urine cytology, blood tests as appropriate, upper tract imaging (IVU for macroscopic haematuria or ultrasound scan for microscopic haematuria) and flexible cystoscopy.Urine samples were obtained at the time of examination before flexible cystoscopy and prepared according to a standard protocol. All abnormal results including malignant cells, suspicious cells and atypical cells were considered positive. 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. Ann R Coll Surg Engl

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Section: Discussionmentioning

confidence: 99%

Is Routine Urine Cytology Useful in the Haematuria Clinic?

Zelhof

et al. 2008

annals

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“…TPA detection in urine cytology aids in the follow-up of UBC patients, focusing on the actual functional status of the neo plastic urothelial cells [12,30,33] derived from un classified tumors. On the basis of our results, the limitations of conventional urinary cytology [16,20] could be successfully reduced by assaying for TPA in well-differentiated tumors. Samples collected at follow-up, as well as those obtained from high-risk patients for UBC, should be assayed for TPA to ac quire more information concerning the biology and behavior of the tumor for a better management of cancer patients.…”

Section: Discussionmentioning

confidence: 70%

“…Conventional urine cytology is often inadequate for distinguishing between cells derived from benign bladder papillomas [18,22,24,27,28] and those from well-differentiated UBC [16]. In particular, it was ob served that urine cytology was less often positive in first grade PTCT than in second or third grades [29], In these conditions, several routine cytological evalua tions of urinary samples from each patient need to be requested to provide a suitable diagnosis in the man agement and follow-up of UBC patients [24,25],…”

Section: Discussionmentioning

confidence: 99%

“…At present, urine cytology in both bladder cancer detection and follow-up has given vari able results [16,17], Although morphological criteria are highly diagnostic for anaplastic urothelial cells [18][19][20], they are of little use in the diagnosis for low-grade lesions characterized by well-differentiated tumor cells [17,20], Moreover, several nonneoplastic conditions can express atypical/dysplastic cells [ 16,21,22] which decrease cytologic accuracy [16].…”

Section: Introductionmentioning

confidence: 99%

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Tissue Polypeptide Antigen (TPA) in Urinary Bladder Cancer Cytology: A Follow-Up Study

Senatore

Zizzi

Blasi³

et al. 1990

Oncology

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Tissue polypeptide antigen (TPA) has been detected by immunocytochemical assay on urine cytological samples from 28 asymptomatic patients, who previously had a histological diagnosis of papillary transitional cell carcinoma (PTCT) of the urinary bladder (UB), in order to evaluate its role in follow-up controls. TPA staining intensity (SI) in urothelial cells was evaluated to improve the diagnostic accuracy of cytology. Differentiated tumor cells were strongly stained for TPA, heavier than normal urothelial cells. Undifferentiated neoplastic cells were less stained for TPA with a wide range of SI. TPA detection revealed positive cytology in 21 (75%) of the considered cases. The accuracy of our cytological findings compared with both routine examinations and subsequent histopathological diagnosis was of 95.2%. Follow-up urinary cytology limits could be reduced by TPA searching in differentiated tumor cells, deriving from low-grade neoplasms.

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“…The reported sensitivity of urinary cytology ranges from 44.7% to 87.3% with a mean of 73.8%, 9 whereas the X 100. ^j X 100 = 90%.…”

Section: Discussionmentioning

confidence: 99%

Comparative Study Between Cytology and Dot-ELISA for Early Detection of Bladder Cancer

Attallah

El-Didi²,

Seif³

et al. 1996

Am J Clin Pathol

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Schistosomiasis remains one of the major public health problems of the tropics. Conservative estimates place the number of infected individuals at about 200 millions. In Egypt, carcinoma of the urinary bladder associated with schistosomiases is the foremost oncologic problem, because of its high frequency and the late presentation of cases. A newly developed monoclonal antibody CK,K, 0 to keratinized grade 1 squamous cell carcinoma was used in a dot enzyme-linked immunosorbent assay (Dot ELISA) to test urine samples of 118 patients with bladder carcinoma, 291 patients with genitourinary pathology other than bladder carcinoma, in addition to 550 healthy controls. The overall sensitivity of the dot ELISA was 90% among 118 patients with bladder carcinoma. Twenty-seven of 33 transitional cell carcinoma cases (82%), 68 of the 71 squamous cell carcinoma cases (96%), 7 of 10 undifferentiated tumors cases (70%), and 4 of 4 adenocarcinoma were positive with this assay. The specificity was 90% in our sample population. A comparative study of diagnosis by cytology and dot ELISA was carried out in 57 patients with bladder carcinoma. Dot ELISA was found to be superior as a screening tool for high risk groups (P < .001 using chi-square test). Cytology detected 21 % of transitional cell carcinoma, 68% of squamous cell carcinoma, 50% of adenocarcinoma, and 86% of undifferentiated tumors. The dot ELISA assay should be useful for screening high-risk groups because it does not require sophisticated equipment, is noninvasive, does not require highly trained staff, and can be performed in less than 30 minutes. Carcinoma of the bladder is the most common malignant disease in Egypt. It accounts for about 20% to 25% of all cases in both sexes and approximately 38% in males. ' Because of the geographic coincidence of bladder cancer and endemic bilharziasis, a causal relationship has long been speculated and established between the tumor and Schistosoma haematobium infestation. This association defines a distinct clinicopathologic entity quite different from that experienced in the Western world. The tumor is found mostly in relatively young age groups. ' It is commonly a well-differentiated squamous carcinoma, the patients usually present in an advanced stage of the disease with the symptoms of cystitis. Accordingly, radical cystectomy is the treatment of choice. Research and Review, Food and Drug Administration, Belhesda, Maryland: and Biotechnology Research Center and National Cancer Institute, Cairo University, Cairo, Egypt. Manuscript received June 19, 1995; revision accepted August 25, 1995. Address reprint requests to Prof. Attallah: Biotechnology Research Laboratories. Gastroenterology Surgery Center, Mansoura University, Mansoura, Egypt. From the Office of BiologicA considerable effort has been made to improve the methods for detection of bladder carcinoma. Cytology has been an important step in that direction, although its use as a screening tool has technical limitations. One tool that appears to have real potentia...

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Cytology of Bladder Carcinoma

Cited by 35 publications

References 4 publications

Is Routine Urine Cytology Useful in the Haematuria Clinic?

Is Routine Urine Cytology Useful in the Haematuria Clinic?

Tissue Polypeptide Antigen (TPA) in Urinary Bladder Cancer Cytology: A Follow-Up Study

Comparative Study Between Cytology and Dot-ELISA for Early Detection of Bladder Cancer

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