Liu Jing, Katz Ruth, Shin Hyung Ju C, Johnston Dennis A, Zhang Hua-Zhong, Caraway Nancy P
Department of Pathology and Laboratory Medicine, University of Texas at Houston Medical School, Houston, Texas, USA.
Acta Cytol. 2005 Mar-Apr;49(2):157-62. doi: 10.1159/000326125.
To evaluate the usefulness of urine specimens collected via a mailer system and analyzed by cytology and DNA ploidy for the detection of urothelial carcinoma (UC).
We retrospectively reviewed the diagnoses of 91 mailed urine specimens received from 72 patients, 67% of whom had a history of UC. The specimens were fixed in an equal volume of 50% ethanol solution before being mailed. The cytologic findings were interpreted in conjunction with DNA ploidy image analysis. We compared these initial diagnoses with those of follow-up examinations, including biopsies, cystoscopic findings and urinary cytology/DNA ploidy analyses. In addition, to examine the quality of the mailed samples, 3 cytopathologists performed a blinded assessment of cytologic slides of 20 mailed and 17 fresh urinary samples for bacterial overgrowth, urothelial degeneration, and presence of proteinaceous material and crystals.
Follow-up was available for 68 of the 91 mailed specimens. The sensitivity for detecting UC using mailed urine specimens that were analyzed by both cytology and DNA ploidy was 61%, while specificity was 92%. The levels of bacterial overgrowth and urothelial degeneration in the mailed specimens were not significantly greater than in the fresh specimens (p>0.05). The levels of proteinaceous material and crystals were significantly higher in the mailed specimens (p<0.05).
The results of combined cytology and DNA ploidy image analysis by using mailed urine samples were comparable to those of fresh urine specimens for the detection of UC reported in previous publications. The increase in crystals and proteinaceous material did not impede diagnostic interpretation. The mailing system is a reliable and convenient method of monitoring and triaging patients with UC or related symptoms.
评估通过邮寄系统收集并经细胞学和DNA倍体分析的尿液标本用于检测尿路上皮癌（UC）的效用。
我们回顾性分析了从72例患者处收到的91份邮寄尿液标本的诊断情况，其中67%的患者有UC病史。标本在邮寄前用等量的50%乙醇溶液固定。结合DNA倍体图像分析对细胞学检查结果进行解读。我们将这些初步诊断结果与后续检查结果进行比较，后续检查包括活检、膀胱镜检查结果以及尿液细胞学/DNA倍体分析。此外，为了检查邮寄样本的质量，3位细胞病理学家对20份邮寄尿液样本和17份新鲜尿液样本的细胞学玻片进行了盲法评估，以检测细菌过度生长、尿路上皮退变以及蛋白质物质和晶体的存在情况。
91份邮寄标本中有68份有后续随访结果。通过细胞学和DNA倍体分析的邮寄尿液标本检测UC的敏感性为61%，特异性为92%。邮寄标本中的细菌过度生长和尿路上皮退变水平并不显著高于新鲜标本（p>0.05）。邮寄标本中的蛋白质物质和晶体水平显著更高（p<0.05）。
使用邮寄尿液样本进行细胞学和DNA倍体图像分析相结合的结果与先前出版物中报道的用于检测UC的新鲜尿液标本的结果相当。晶体和蛋白质物质的增加并未妨碍诊断解读。邮寄系统是监测和分流UC或相关症状患者的一种可靠且便捷的方法。
