Voided Urinary Cytology in Bladder Cancer: Is It Time to Review the Indications?

Talwar, Rajnish; Sinha, Tapan; Karan, S.C.; Doddamani, D; Sandhu, A.S.; Sethi, GS; Srivastava, Anand; Narang, Vikram; Agarwal, Ashok; Adhlakha, N.

doi:10.1016/j.urology.2007.03.070

Cited by 45 publications

(49 citation statements)

References 22 publications

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“…The sensitivity of the diagnostic modalities used in our case is not 100%. Urine cytology has a sensitivity of 21.1% for detecting bladder TCC [2]. Abdominal CT has a sensitivity of 80% for upper urinary tract tumor and a sensitivity of 60% for bladder tumors [3,4].…”

Section: Discussionmentioning

confidence: 99%

Biopsy-Proven Transitional Cell Carcinoma of a Lung Mass Without an Urothelial Origin - A Rare Case Report

Liao¹,

Huang²

2017

J Clin Case Rep

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A 77-year-old man with smoking history visited Thoracic Surgery department with a complaint of dry cough and dyspnea for months. Chest CT showed a mass over left upper lobe, mediastinal lymph node enlargement and bilateral lung nodules. CT-guide biopsy of the left upper lung mass revealed transitional cell carcinoma. Nevertheless, no primary origin was discovered after a thorough evaluation of genitourinary tract, including abdominal CT, FDG-PET, cystoscopy and retrograde pyelography. We will discuss the possible reasons for the unknown primary origin of transitional cell carcinoma in a lung mass.

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Section: Discussionmentioning

confidence: 99%

Biopsy-Proven Transitional Cell Carcinoma of a Lung Mass Without an Urothelial Origin - A Rare Case Report

Liao¹,

Huang²

2017

J Clin Case Rep

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“…A significant number of urine specimens from non-urologists are either poorly preserved or inadequate due to either obtaining the first urine sample in the morning or sending urine samples to laboratories in wrong preservatives [12] . There are differences in pathological interpretation of urine cytology specimens [13] with significant institutional variability in its accuracy in predicting recurrence of TCC of the bladder [14] , which further raises important clinical implications.…”

Section: Discussionmentioning

confidence: 99%

“…These patients would still require periodic surveillance cystoscopy based on established protocols and imaging studies, thus questioning the overall contribution of urine cytological examination in their management. Although cystoscopy continues to be the reference standard for the detection and follow up of bladder cancer, its accuracy can be reduced in certain situations, including poor visualization caused by inflammatory conditions, bleeding, enlarged median lobe of the prostate and bladder diverticula [14] . Moreover, small and flat lesions can be difficult to detect and differentiate from benign bladder lesions at cystoscopy [21,22] .…”

Section: Discussionmentioning

confidence: 99%

Urine Cytology in the Evaluation of Urological Malignancy Revisited: Is It Still Necessary?

Falebita¹,

Lee

Sweeney³

2010

Urol Int

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Objective: We aim to determine if urine cytology was still necessary as a routine part of the evaluation for the presence of urological malignancy and to evaluate its cost effectiveness. Methods: Urine cytology reports over a 6-year period (2000–2005) were retrieved from our institution’s pathology department database. Patients with urine cytology positive for malignant cells were identified. We retrospectively reviewed the charts of these patients for age, sex, flexible cystoscopy and radiological imaging results. The cost of urine cytology was retrieved from the pathology department. Results: There were a total of 2,568 urine cytological examinations. Of these, 25 were positive for malignant cells. There were 19 male (76%) and 6 female (24%) patients with a mean age of 72 years (range: 49–97). In 21 patients with positive cytology, a bladder tumor was identified at flexible cystoscopy and/or imaging studies. For a positive cytology yield of 1%, EUR 210,000 was spent. Conclusions: Routine urine cytology was not cost effective and did not add to the diagnostic yield beyond cystoscopy and diagnostic imaging. It may be omitted in the initial evaluation of urological malignancy.

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“…En la literatura también se encuentran muchos estudios valorando la utilidad del NMP22 como método alternativo a la citología de orina en la detección del carcinoma vesical, y aunque se presentan resultados a favor 10,11 , los datos son contradictorios y en trabajos recientes se reconoce una menor especificidad 12,13 .…”

Section: Discuciónunclassified

“…Si la neoplasia es pequeña o plana, es difícil de detectar o de diferenciar de otras lesiones benignas. En los casos de carcinoma urotelial recurrente o persistente, tras tratamiento con quimioterapia, radioterapia o cirugía, las áreas patológicas del epitelio vesical pueden ser extremadamente complicadas de visualizar y de encontrar para biopsiar 10 .…”

Section: Discuciónunclassified

Utilidad de la citología de orina para el diagnóstico del carcinoma vesical: estudio comparativo con biopsia

et al. 2008

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Objetivo: La citología de orina se ha considerado la técnica de elección para el cribado de carcinoma vesical. La existencia de otros métodos diagnósticos adicionales, han puesto en duda su utilidad. Aportamos un estudio comparativo cito-histológico para comprobar su valor.Método: Hemos realizado un estudio retrospectivo de 109 biopsias vesicales en relación con los diagnósticos citológicos previos. Todas las citologías eran de micción espontánea, procesadas por citocentrifugación y teñidas con Papanicolaou.Resultados: Encontramos 70 casos verdaderos positivos, y 24 casos verdaderos negativos, consiguiendo una sensibilidad del 97% y una especificidad del 96-100%. Destacando que 12 casos positivos tenían la primera cistoscopia y biopsia negativa, diagnosticándose la neoplasia en la segunda biopsia.Conclusiones: Los pacientes con citologías de orina claramente positivas, que no se confirman en una primer estudio citoscópico, deben ser seguidos, para identificar una posible neoplasia vesical o de vías urinarias altas. La citología de orina puede seguir considerándose como una técnica de elección para el cribado y control de neoplasia vesical.Palabras clave: Citología de orina. Biopsia. Cistoscopia. Carcinoma vesical. ABSTRACT USEFULNESS OF URINE CYTOLOGY FOR BLADDER CARCINOMA DIAGNOSIS: COMPARATIVE STUDYWITH BIOPSY Objectives: Traditionally, urine cytology has been considered as the gold standard for bladder cancer screening. However, new methods are playing new roles in these cases. In order to assess the value of cytology of voided urine we performed one comparative study between cytology and biopsy.Methods: We retrospectively analyzed the results of urine cytology and biopsy follow-up in 109 patients. All cytologies were from voided urine. They were cytocentrifuged and stained with Papanicolaou stain.Results: We found 70 true positive cases and 24 true negative cases. Sensitivity was calculated to be 97% and specifity 96-100%. 12 cases had the first cystoscopy test and biopsy negative, as the cancer was diagnosed in the second biopsy.Conclusions: Patients with clearly positive urine cytology, which was not confirmed in a first cystoscopic study, should be carefully followed up to identify a possible bladder or upper urinary tract cancer. The urine cytology still has a significant role as the gold standard for bladder cancer screening.

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Voided Urinary Cytology in Bladder Cancer: Is It Time to Review the Indications?

Cited by 45 publications

References 22 publications

Biopsy-Proven Transitional Cell Carcinoma of a Lung Mass Without an Urothelial Origin - A Rare Case Report

Biopsy-Proven Transitional Cell Carcinoma of a Lung Mass Without an Urothelial Origin - A Rare Case Report

Urine Cytology in the Evaluation of Urological Malignancy Revisited: Is It Still Necessary?

Utilidad de la citología de orina para el diagnóstico del carcinoma vesical: estudio comparativo con biopsia

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