Postoperative Bladder Washing Cytology After Transurethral Resection

Iczkowski, Kenneth A.; Katz, Guy; Cascione, Carl J.

doi:10.1159/000326388

Cited by 3 publications

(4 citation statements)

References 13 publications

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“…Therefore, whereas urine cytology has a critical role in the evaluation of urothelial cells, the cytological diagnosis of urothelial carcinoma can be very challenging . In general, urine cytology has been used as a screening tool to detect urothelial cancers in high‐risk patients, as an initial test for individuals with hematuria, and as a follow‐up test in patients with a previous diagnosis of urothelial cancer to rule out the tumor recurrence . When a diagnosis of “atypical” cytology is made on urinary specimens, invasive procedures may be triggered that result in patient's discomfort, anxiety, and/or increase in cost.…”

Section: Discussionmentioning

confidence: 99%

ProExC as an adjunct marker to improve cytological detection of urothelial carcinoma in urinary specimens

Moatamed

Rao

Alexanian

et al. 2013

Cancer Cytopathology

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BACKGROUND ProEx C is an antibody cocktail targeting the expression of topoisomerase IIα and minichromosome maintenance protein‐2. ProEx C staining is being used to assist in diagnoses of the gynecological specimens. This study was designed to determine the utility of ProEx C in urine cytology samples for improving the detection of urothelial carcinomas where a significant number of urine cytology specimens are diagnosed as “atypia.” METHODS Sixty urinary specimens (12 negative, 13 positive, and 35 atypical cases) were stained with ProEx C, and ProEx C results were recorded as positive when nuclear staining was only seen in at least one morphologically atypical urothelial cell. RESULTS All 12 benign cytology samples showed negative staining with ProEx C. Twelve of 13 cases that had a malignant cytologic diagnosis showed a positive nuclear staining of the malignant cells. Eighteen of 35 cases with atypical cytologic diagnoses showed positive nuclear staining. Of the 35 cases with “atypia,” 17 had a malignant histopathologic follow‐up. In this study, ProEx C stain had an overall sensitivity of 78.4%, specificity of 95.7%%, positive predictive value of 96.7%, and negative predictive value of 73.3% for the detection of urothelial carcinoma. CONCLUSIONS ProEx C stain is a useful adjunct test to urine cytologic analysis, even in specimens with limited cellularity. In urinary smears, this test is most useful in stratification of the “atypical” diagnoses into benign and malignant subsets. To the authors' knowledge, this is the first study of ProEx C application in urine cytology as an adjunct marker for detection of urothelial carcinoma. Cancer (Cancer Cytopathol) 2013;121:320–8. © 2013 American Cancer Society.

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Section: Discussionmentioning

confidence: 99%

ProExC as an adjunct marker to improve cytological detection of urothelial carcinoma in urinary specimens

Moatamed

Rao

Alexanian

et al. 2013

Cancer Cytopathology

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“…[23] 4-It has been used after transurethral resection for assessment of the completeness of tumor removal. [24] 5-Recently it has been applied as a test for detecting inflammation or infection, especially in kidney transplant patients where the presence or absence of polyoma virus infection may have significant clinical implications for rejection. [25] Urine sample processing…”

Section: Urinary Cytologymentioning

confidence: 99%

Comparison of Nmp22 Urinary Marker Test and Urine Cytology in the Early Detection of Recurrent Transitional Cell Carcinoma of Urinary Bladder

Mhdai¹

2017

WJPPS

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“…Light microscopic evaluation of cell morphology in preparations from urine or bladder washing is a standard and primary method for the detection of bladder tumor. Bladder washings are used to obtain cytologic specimens of well‐preserved epithelium from patients at high risk for development of new or recurrent bladder tumors . Bladder wash or barbotage as well as cystoscopically obtained urine from the ureter has a high diagnostic significance in cases of bladder and renal‐pelvis or ureteral neoplasms, respectively .…”

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confidence: 99%

“…Low‐grade urothelial neoplasia is a recommended combined cytologic term by the Paris System for low‐grade papillary urothelial neoplasms, which include urothelial papilloma, PUNLMP, and LGPUC. This system mentions that cytologic distinction between low‐grade lesions and even normal epithelium is extremely difficult, and there are only some circumstances in which a definitive diagnosis can be performed for low‐grade neoplasias . Recently, many different markers and ancillary tests either cell based or soluble urine markers were developed to improve the diagnosis of low‐grade bladder carcinoma on urinary samples .…”

mentioning

confidence: 99%

Cytopathologic differential diagnosis of low-grade urothelial carcinoma and reactive urothelial proliferation in bladder washings: a logistic regression analysis

Çakır

Küçük

Pala

et al. 2017

APMIS

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Conventional cytomorphologic assessment is the first step to establish an accurate diagnosis in urinary cytology. In cytologic preparations, the separation of low-grade urothelial carcinoma (LGUC) from reactive urothelial proliferation (RUP) can be exceedingly difficult. The bladder washing cytologies of 32 LGUC and 29 RUP were reviewed. The cytologic slides were examined for the presence or absence of the 28 cytologic features. The cytologic criteria showing statistical significance in LGUC were increased numbers of monotonous single (non-umbrella) cells, three-dimensional cellular papillary clusters without fibrovascular cores, irregular bordered clusters, atypical single cells, irregular nuclear overlap, cytoplasmic homogeneity, increased N/C ratio, pleomorphism, nuclear border irregularity, nuclear eccentricity, elongated nuclei, and hyperchromasia (p ˂ 0.05), and the cytologic criteria showing statistical significance in RUP were inflammatory background, mixture of small and large urothelial cells, loose monolayer aggregates, and vacuolated cytoplasm (p ˂ 0.05). When these variables were subjected to a stepwise logistic regression analysis, four features were selected to distinguish LGUC from RUP: increased numbers of monotonous single (non-umbrella) cells, increased nuclear cytoplasmic ratio, hyperchromasia, and presence of small and large urothelial cells (p = 0.0001). By this logistic model of the 32 cases with proven LGUC, the stepwise logistic regression analysis correctly predicted 31 (96.9%) patients with this diagnosis, and of the 29 patients with RUP, the logistic model correctly predicted 26 (89.7%) patients as having this disease. There are several cytologic features to separate LGUC from RUP. Stepwise logistic regression analysis is a valuable tool for determining the most useful cytologic criteria to distinguish these entities.

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Postoperative Bladder Washing Cytology After Transurethral Resection

Cited by 3 publications

References 13 publications

ProExC as an adjunct marker to improve cytological detection of urothelial carcinoma in urinary specimens

ProExC as an adjunct marker to improve cytological detection of urothelial carcinoma in urinary specimens

Comparison of Nmp22 Urinary Marker Test and Urine Cytology in the Early Detection of Recurrent Transitional Cell Carcinoma of Urinary Bladder

Cytopathologic differential diagnosis of low-grade urothelial carcinoma and reactive urothelial proliferation in bladder washings: a logistic regression analysis

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