Department of Pathology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas 77030, USA.
Cancer Cytopathol. 2010 Aug 25;118(4):175-83. doi: 10.1002/cncy.20080.
Urinary cytology has a significant role in the detection and surveillance of patients with urothelial carcinoma (UC), which has a high morbidity rate in the United States. Examination of the urine is a comprehensive screen of both the upper and lower urinary tract and is ideal for detecting both primary bladder UC and synchronous or metachronous, multifocal UCs that commonly occur because of a "field effect." This field effect is the result of both clonal and random genetic abnormalities that have resulted from exposure to carcinogens (most frequently in tobacco smoke) in conjunction with the individual's ability to repair DNA damage. Although urinary cytology has high specificity for the detection of UC, its sensitivity is relatively low, especially for more prevalent low-grade tumors. Consequently, several urine-based tests have been investigated, some of which are available commercially and approved by the US Food and Drug Administration. However, these tests also have their limitations and often have lower specificity than urinary cytology. Consequently, urinary cytology, which is a noninvasive, cost-effective test, continues in mainstream use because of its ability to detect high-grade, flat lesions that can be difficult to detect clinically and that often have more aggressive biologic behavior.
尿细胞学在检测和监测尿路上皮癌（UC）患者方面具有重要作用，UC 的发病率在美国很高。尿液检查是对上尿路和下尿路的全面筛查，非常适合检测原发性膀胱 UC 以及常见的因“场效应”而发生的同步或异时性、多灶性 UC。这种场效应是克隆和随机遗传异常的结果，这些异常是由于接触致癌物质（最常见的是烟草烟雾）以及个体修复 DNA 损伤的能力造成的。尽管尿细胞学对 UC 的检测具有很高的特异性，但敏感性相对较低，尤其是对于更常见的低级别肿瘤。因此，已经研究了几种基于尿液的检测方法，其中一些已经商业化并获得美国食品和药物管理局的批准。然而，这些检测方法也有其局限性，通常比尿细胞学的特异性低。因此，尿细胞学作为一种非侵入性、具有成本效益的检测方法，由于其能够检测临床上难以检测到的高级别、扁平病变的能力，继续被广泛应用，这些病变通常具有更具侵袭性的生物学行为。
