Chahal R, Gogoi N K, Sundaram S K
Department of Urology, Pinderfields and Pontefract NHS Trust, Wakefield, West Yorkshire, WF1 4DG UK.
Eur Urol. 2001 Mar;39(3):283-6. doi: 10.1159/000052454.
All patients with gross haematuria and those older than 50 years with microscopic haematuria need investigations to rule out the presence of a urological malignancy.
To study the role of urine cytology in the evaluation of patients with haematuria.
Two hundred and eighty-five patients were evaluated. All patients underwent evaluation including urine cytology, flexible cystoscopy, ultrasonography and/or IVU.
The mean age of the patients was 62.4 years. Sixty-five percent had gross and 35% microscopic haematuria. Fifty-five tumours were discovered (19.2%); of these 48 were transitional cell carcinomas, 3 renal cell carcinomas and 3 carcinomas of the prostate. Thirty-seven urinary cytologies were abnormal. The overall sensitivity of urinary cytology was 42.4% and specificity 94.3%. Of 18 patients with positive cytology, all were found to have transitional cell carcinomas on cystoscopy or imaging. Of 19 patients with suspicious cytologies, only 6 were found to have tumours. The remaining 13 patients had no evidence of tumour on combined upper tract imaging (IVU and ultrasound) or on rigid cystoscopy and bladder biopsy. Whilst all the other investigation modalities contributed to diagnoses (and/or exclusion of tumours), no additional tumours were discovered solely by urinary cytology. A moderate cost saving could be made without compromising diagnostic accuracy.
Our study suggests that performing routine urine cytology is not relevant in the investigation of patients with haematuria, its role is at best supportive.
所有肉眼血尿患者以及所有年龄超过50岁的镜下血尿患者均需进行检查，以排除泌尿系统恶性肿瘤的存在。
研究尿细胞学检查在血尿患者评估中的作用。
对285例患者进行了评估。所有患者均接受了包括尿细胞学检查、软性膀胱镜检查、超声检查和/或静脉肾盂造影在内的评估。
患者的平均年龄为62.4岁。65%为肉眼血尿，35%为镜下血尿。共发现55例肿瘤（19.2%）；其中48例为移行细胞癌，3例为肾细胞癌，3例为前列腺癌。37例尿细胞学检查结果异常。尿细胞学检查的总体敏感性为42.4%，特异性为94.3%。在18例细胞学检查阳性的患者中，所有患者在膀胱镜检查或影像学检查中均被发现患有移行细胞癌。在19例细胞学检查可疑的患者中，仅6例被发现患有肿瘤。其余13例患者在上尿路联合影像学检查（静脉肾盂造影和超声）或硬性膀胱镜检查及膀胱活检中未发现肿瘤证据。虽然所有其他检查方式都有助于诊断（和/或排除肿瘤），但仅通过尿细胞学检查未发现其他肿瘤。在不影响诊断准确性的情况下，可以节省一定的费用。
我们的研究表明，在血尿患者的检查中进行常规尿细胞学检查并无意义，其作用充其量只是辅助性的。
