Diagnostic Accuracy of Urine Cytology for Urothelial Carcinoma Screening: Retrospective Study in Ramathibodi Hospital

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Sirithep Plumworasawat, MD, MIAC
Kakanant Chopsri, MLP
Wasana Kanoksil, MD
Suchin Worawichawong, MD
Atcharaporn Pongtippan, MD, MIAC

Abstract

OBJECTIVE:
This study aimed to validate the accuracy of urine cytology and histopathology in all urine specimens examined in Ramathibodi hospital from 2013 to 2016.

MATERIAL AND METHOD:
All urine cytological specimens from all groups of patients submitted for urine cytology with accompanying histological tissue samples collected concurrently or within 1 year after cytological diagnosis and examined from 2013 to 2016 were reviewed and correlated.

RESULTS:
Two hundred and eleven samples were included. Cytological diagnostic results were 47.9%, 27.5% and 24.6% of negative, atypia/low-grade urothelial neoplasm and suspicious for malignancy/malignancy categories, respectively. Histopathological diagnoses comprised 48.3%, 21.8% and 29.9% negative/unremarkable, benign neoplasm/ atypia/low-grade papillary urothelial carcinoma and high-grade papillary urothelial carcinoma/carcinoma in situ/infiltrating urothelial carcinoma categories, subsequently. The sensitivity and specificity of high-grade urothelial carcinoma were 55.6% and 88.5%. Positive predictive value and negative predictive value were 67.3% and 82.4%.

CONCLUSION:
Urine cytology has rather less sensitivity but high specificity for detection of urothelial carcinoma. Nowadays, it plays an important role to facilitate the physician for planning the management. However, integration of clinical information, urine cytological diagnosis and histopathological diagnosis is necessary for the most accurate diagnosis of urothelial carcinoma.

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How to Cite
1.
Plumworasawat S, Chopsri K, Kanoksil W, Worawichawong S, Pongtippan A. Diagnostic Accuracy of Urine Cytology for Urothelial Carcinoma Screening: Retrospective Study in Ramathibodi Hospital. BKK Med J [Internet]. 2018Sep.20 [cited 2020Jul.15];14(2):6. Available from: https://he02.tci-thaijo.org/index.php/bkkmedj/article/view/222450
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Original Article

References

1. Lopez-Beltran A, Sauter G, Gasser T, et al. Infiltrating urothelial carcinoma. In: Eble JN, Sauter G, Epstein JI, Sesterhenn IA, eds. Pathology and genetics of tumours of the urinary systems and male genital organs. France: IARCPress;2004:93-109.
2. Luo Y, She DL, Xiong H, et al. Diagnostic value of liquidbased cytology in urothelial carcinoma diagnosis: a systematic review and meta-analysis. PLoS ONE 2015;10:e0134940.
3. Bibbo M, Birbe R, Kern WH. Urinary tract. In: Bibbo M, Wilbur D, eds. Comprehensive Cytopathology. 4th ed. Philadelphia: Elsevier Saunders; 2015:315-41.
4. Raisi O, Magnani C, Bigiani N, et al. The diagnostic reliability of urinary cytology: A retrospective study. Diagn Cytopathol 2011;40:608-14.
5. Gopalakrishna A, Longo TA, Fantony JJ, et al. The diagnostic accuracy of urine-based test for bladder cancer varies greatly by patient. BMC Urol 2016;16:30.
6. Papanicolaou GN, Marshall VF. Urine sediment smears as a diagnostic procedure in cancers of the urinary tract. Science 1945;101:519-20.
7. Papanicolaou GN. Cytology of the urine sediment in neoplasms of the urinary tract. J Urol 1947;57:375-9.
8. Brimo F, Vollmer RT, Case B, et al. Accuracy of urine cytology and the significance of an atypical category. Am J Clin Pathol 2009;132:785-93.
9. Layfield LJ, Elsheikh TM, Fili A, et al. Review of the state of the art and recommendations of the Papanicolaou Society of Cytopathology for urine cytology procedures and reporting: the Papanicolaou Society of Cytopathology Practice Guidelines Task Force. Diagn Cytopathol 2004;30:24-30.
10. Laucirica R, Bentz JS, Souers, RJ, et al. Do Liquid-based preparations of urinary cytology perform differently than classically prepared cases? Arch Pathol Lab Med 2010;134: 19-22.
11. Lojanapiwat B. Urologic cancer in Thailand. Jpn J Clin Oncol 2015;45:1007-15.
12. Bastacky S, Ibrahim S, Wilczynski SP, et al. The accuracy of urinary cytology in daily practice. Cancer Cytopathol 1999;87:118-28.
13. Karakiewicz PI, Benayoun S, Zippe C, et al. Institutional variability in the accuracy of urinary cytology for predicting recurrence of transitional cell carcinoma of the urinary bladder. BJU Int 2006;97:997-1001.
14. Talwar R, Sinha T, Karan SC, et al. Voided urine cytology in bladder cancer: is it time to review the indications? Urology 2007;70:267-71.
15. Yafi FA, Brimo F, Auger M, et al. Is the performance of urine cytology as high as reported historically? A contemporary analysis in the detection and surveillance of bladder cancer. Urol Oncol 2014;32:27.e1-6.
16. Abdullah LS. The value of urine cytology in the diagnosis of bladder cancer. Saudi Med J 2013;34:937-41.