McVey Rhona J, Persad Ranjiv V, Brown Stephen C W, Robinson Elaine, Payne Stephen R
Department of Cytopathology, Manchester Royal Infirmary, Manchester, UK.
BJU Int. 2004 Sep;94(4):548-51. doi: 10.1111/j.1464-410X.2004.04998.x.
To examine the urinary cytological changes caused by flexible cystoscopy and provide clinical guidelines for a reliable time interval for urinary cytological examination after flexible cystoscopy.
Forty-eight patients attending for flexible cystoscopy were recruited into the study. Each patient was asked to provide eight urine samples before, immediately after and at 1, 2, 7, 14 and 28 days after cystoscopy. Cytospin preparations of the urine samples were made and slides stained using the Papanicolaou stain. Cytology was analysed while unaware of sample origin, by three different cytopathologists.
The cytological changes were characterized by a striking increase in cellularity immediately after flexible cystoscopy, mostly accounted for by urothelial cells. Consistent morphological changes included the formation of 'columnar' cells, papillary clusters, increased nucleo-cytoplasmic ratio and nuclear atypia. These changes were transient, with most disappearing within a day of flexible cystoscopy.
There are cytological changes, on voided urine cytology, after flexible cystoscopy but they were transient, and urine sent more than a day after flexible cystoscopy should be free from artefactual change caused by instrumentation. These results suggest that clinicians sending urine for cytological analysis should provide information about the nature and timing of any endoscopy so as to avoid false-positive interpretations of urine cytology by the cytopathologist.
研究软性膀胱镜检查引起的尿液细胞学变化，并为软性膀胱镜检查后进行可靠的尿液细胞学检查的时间间隔提供临床指导。
48名接受软性膀胱镜检查的患者被纳入本研究。要求每位患者在膀胱镜检查前、检查后即刻以及检查后1天、2天、7天、14天和28天提供8份尿液样本。制作尿液样本的细胞离心涂片，并使用巴氏染色法对玻片进行染色。由三名不同的细胞病理学家在不知道样本来源的情况下对细胞学进行分析。
细胞学变化的特征是软性膀胱镜检查后即刻细胞数量显著增加，主要由尿路上皮细胞构成。一致的形态学变化包括“柱状”细胞的形成、乳头状簇、核质比增加和核异型性。这些变化是短暂的，大多数在软性膀胱镜检查后一天内消失。
软性膀胱镜检查后，排尿尿液细胞学检查会出现细胞学变化，但这些变化是短暂的，软性膀胱镜检查一天后送检的尿液应无器械造成的人为改变。这些结果表明，送检尿液进行细胞学分析的临床医生应提供任何内镜检查的性质和时间信息，以避免细胞病理学家对尿液细胞学做出假阳性解读。
