Chung Y R, Won J K, Park I A, Moon K C, Chung S Y, Lee K, Ryu H S
Department of Pathology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea.
Department of Pathology, Cancer Center, Dongnam Institute of Radiological and Medical Sciences (DIRAMS), Busan, South Korea.
Cytopathology. 2016 Apr;27(2):83-90. doi: 10.1111/cyt.12230. Epub 2015 Jan 12.
The diagnosis of low-grade papillary urothelial carcinoma (LGPUC) in urine cytology specimens is challenging because of its subtle, minimally atypical findings. Furthermore, as SurePath(™) liquid-based cytology (LBC) is becoming a widely used method in urine cytology, the inevitable cytomorphological alterations resulting from this technique call for new morphological diagnostic criteria in LGPUC.
Logistic regression analysis was carried out on SurePath slides from surgically proven voided urine specimens. The study was designed to include a test set (n = 141) and a validation set (n = 61), and evaluated significant discriminative parameters between LGPUC and benign papillary urothelial neoplasm (BPUN).
Of the seven cytological findings that were found to have statistical significance in univariate analysis, five were found to be independent variables: loss of polarity of papillaroid clusters, irregular contours, absence of columnar cells, hobnail features and hyperchromasia. These independent variables had an area under the curve (AUC) of 0.781.
The distinctive cytological criteria identified above may prove to be helpful in cases in which other conventional criteria for LGPUC are insufficient for diagnosis.
尿细胞学标本中低级别乳头状尿路上皮癌（LGPUC）的诊断具有挑战性，因为其表现细微、非典型性极小。此外，由于SurePath™液基细胞学（LBC）在尿细胞学中应用日益广泛，该技术不可避免地导致细胞形态学改变，这就需要针对LGPUC制定新的形态学诊断标准。
对经手术证实的排尿尿液标本的SurePath玻片进行逻辑回归分析。该研究设计包括一个测试集（n = 141）和一个验证集（n = 61），并评估LGPUC与良性乳头状尿路上皮肿瘤（BPUN）之间的显著鉴别参数。
在单变量分析中发现具有统计学意义的7个细胞学表现中，有5个被确定为独立变量：乳头样细胞簇极性丧失、轮廓不规则、柱状细胞缺失、鞋钉样特征和核深染。这些独立变量的曲线下面积（AUC）为0.781。
上述独特的细胞学标准可能有助于诊断其他常规LGPUC标准不足以诊断的病例。
