Demir M A, Ryd W, Aldenborg F, Holmang S
Department of Pathology, Celal Bayar University, Manisa, Turkey.
BJU Int. 2003 Dec;92(9):906-10. doi: 10.1111/j.1464-410x.2003.04523.x.
To evaluate and compare the cytopathological expression of the five major histological types of carcinoma in situ (CIS) in urinary bladder washings from patients with flat urothelial lesions.
Seventy-five cases of primary and secondary urothelial CIS with no concomitant tumours, and having tissue and cytological samples, were identified. Biopsies were evaluated based on the consensus classification as: large-cell pleomorphic; large-cell non-pleomorphic; small-cell; clinging; and cancerization of the urothelium. In the cytological classification the 'clinging' category was excluded, as its definition depends on the histological appearance. kappa statistics were used to evaluate the correlation between histopathology and cytology.
More than one subtype of CIS could often be identified in both the histological and cytological specimens. Cytology often showed more subtypes than did histopathology. Statistically, there was only a moderate correlation between histopathology and cytology for recognising different patterns.
Different patterns of CIS can be identified by cytology; it is important for cytologists to be aware of the cytological spectrum of CIS and not to under-diagnose monomorphic, pagetoid (cancerization) and small-cell forms. Studies on treatments for CIS and of the clinical significance of different subtypes of CIS should include both cytopathology and histopathology.
评估并比较扁平尿路上皮病变患者膀胱冲洗液中原位癌（CIS）五种主要组织学类型的细胞病理学表现。
确定75例无伴随肿瘤且有组织和细胞学样本的原发性和继发性尿路上皮CIS病例。活检根据共识分类评估为：大细胞多形性；大细胞非多形性；小细胞；贴壁型；尿路上皮癌变型。在细胞学分类中，排除“贴壁型”类别，因为其定义取决于组织学表现。采用kappa统计量评估组织病理学与细胞学之间的相关性。
在组织学和细胞学标本中，通常可识别出不止一种CIS亚型。细胞学显示的亚型通常比组织病理学更多。在统计学上，组织病理学与细胞学在识别不同模式方面仅存在中度相关性。
通过细胞学可识别不同模式的CIS；细胞学家了解CIS的细胞学谱且不过度诊断单形性、派杰样（癌变）和小细胞形式非常重要。关于CIS治疗及不同CIS亚型临床意义的研究应同时纳入细胞病理学和组织病理学。
