Vom Dorp Frank, Pal Philip, Tschirdewahn S, Rossi Roberto, Börgermann C, Schenck Markus, Becker Markus, Szarvas Tibor, Hakenberg Oliver W, Rübben Herbert
Department of Urology, University of Essen, Essen, Germany.
Urol Int. 2011;86(1):36-40. doi: 10.1159/000321017. Epub 2010 Dec 16.
Cystoscopy and cytology are standard procedures for diagnosis and follow-up of patients with bladder cancer. Urinary cytodiagnosis is a descriptive method for tumor characterization. We correlated histopathologic diagnosis of noninvasive urothelial carcinomas with cytological evaluation and, furthermore, we validated cytology by cytometric analysis.
94 patients with a history of bladder cancer were included in the study. 25 patients were negative for tumors, 22 showed pTa G1 carcinomas, 25 had pTaG2 and 22 patients had G3 carcinomas. All patients underwent cytological and cytometric evaluation. Nuclear diameter and circumference were measured for 15 representative nuclei per specimen. Statistical evaluation was performed using Graph Pad Software.
Cytology showed excellent tumor detection for G2 and G3 carcinomas, with a sensitivity of 100% combined with a specificity of 100%. Using cytometry, we can significantly distinguish between unsuspicious patients and G1 carcinomas on the one hand and high-grade carcinomas on the other. Furthermore, in 6 of 25 patients (24%) with noninvasive G2 carcinomas, but G3 cytological evaluation, tumor progression occurred.
Urinary cytology is an excellent instrument for detection of clinically relevant high-grade bladder cancer. Descriptive alterations of the cytopathology can be validated by objective data using cytometric analysis.
膀胱镜检查和细胞学检查是膀胱癌患者诊断和随访的标准程序。尿液细胞诊断是一种用于肿瘤特征描述的方法。我们将非侵袭性尿路上皮癌的组织病理学诊断与细胞学评估进行了关联，此外，我们通过细胞计量分析对细胞学进行了验证。
94例有膀胱癌病史的患者纳入本研究。25例患者肿瘤为阴性，22例显示为pTa G1癌，25例为pTa G2癌，22例为G3癌。所有患者均接受了细胞学和细胞计量评估。每个标本测量15个代表性细胞核的核直径和周长。使用Graph Pad软件进行统计学评估。
细胞学检查对G2和G3癌显示出优异的肿瘤检测能力，敏感性为100%，特异性为100%。通过细胞计量分析，我们可以显著区分无可疑病变的患者与G1癌患者以及高级别癌患者。此外，在25例非侵袭性G2癌但细胞学评估为G3的患者中，有6例（24%）发生了肿瘤进展。
尿液细胞学检查是检测临床相关高级别膀胱癌的优秀手段。细胞病理学的描述性改变可以通过细胞计量分析的客观数据进行验证。
