Department of Pathology, Loyola University Medical Center, Maywood, Illinois, USA.
Cancer Cytopathol. 2013 Jul;121(7):387-91. doi: 10.1002/cncy.21278. Epub 2013 Mar 27.
In urine cytology, the diagnosis of atypia is subjective and clinical management based on these results can be difficult to determine. In this study, the authors determined the percentage of atypical urine diagnoses that progressed to positive cytology or surgical pathology results over an 11-year period.
In a retrospective review of the authors' institution, 1320 atypical urine cytology diagnoses were identified in specimens from 851 patients obtained from January 2000 through December 2010. All subsequent pathology reports were reviewed to determine which patients developed positive cytology/surgical pathology diagnoses. In total, 4106 cytology and surgical pathology specimen reports were reviewed.
At the authors' institution, 1320 of 16,299 of urine cytology specimens (8.1%) were diagnosed as atypical during the 11-year period. Overall, 271 of 1320 initial atypical urine specimens (21%) progressed to positive cytology or surgical pathology results with a mean time to progression of 155 days. Of the cases that progressed to malignancy, 118 were high-grade urothelial carcinoma and 92 were low-grade urothelial carcinoma.
The rate of atypia in urine specimens at this institution was 8.1%. Of the specimen types, atypia was the most common in urinary diversion specimens (16%) and the least common in upper tract cytology (3.8%). When diagnosed as atypical, upper tract specimens had the highest percentage of progression to high-grade carcinoma. Therefore, the authors concluded that the diagnosis of atypia in this specimen group has higher clinical significance and should be managed more aggressively. Cancer (Cancer Cytopathol) 2013;121:387-391. © 2013 American Cancer Society.
在尿细胞学中，不典型诊断具有主观性，基于这些结果的临床处理可能难以确定。在这项研究中，作者确定了在 11 年期间，尿不典型诊断进展为阳性细胞学或手术病理结果的比例。
在对作者所在机构的回顾性研究中，从 2000 年 1 月至 2010 年 12 月，在 851 例患者的标本中发现了 1320 例尿不典型细胞学诊断。所有后续的病理报告都进行了审查，以确定哪些患者发展为阳性细胞学/手术病理诊断。共审查了 4106 份细胞学和手术病理标本报告。
在作者所在的机构，在 11 年期间，16299 例尿细胞学标本中有 1320 例（8.1%）被诊断为不典型。总体而言，1320 例初始不典型尿标本中有 271 例（21%）进展为阳性细胞学或手术病理结果，平均进展时间为 155 天。进展为恶性肿瘤的病例中，118 例为高级别尿路上皮癌，92 例为低级别尿路上皮癌。
该机构尿标本的不典型率为 8.1%。在标本类型中，尿分流标本中不典型率最高（16%），上尿路细胞学标本中不典型率最低（3.8%）。当诊断为不典型时，上尿路标本进展为高级别癌的比例最高。因此，作者得出结论，该标本组中不典型的诊断具有更高的临床意义，应更积极地处理。癌症（癌症细胞病理学）2013；121：387-391。©2013 年美国癌症协会。
