Brisuda Antonín, Háček Jaromír, Čechová Marcela, Škapa Petr, Babjuk Marek
2nd Faculty of Medicine, Department of Urology, Charles University, Prague, Czech Republic.
2nd Faculty of Medicine, Department of Pathology and Molecular Medicine, Charles University, Prague, Czech Republic.
Cytopathology. 2018 Dec;29(6):537-544. doi: 10.1111/cyt.12580. Epub 2018 Aug 13.
The methodology of cell blocks (CBs) has long been an integrated part of cytology. However, there are very few data on CBs derived from urine. Their main disadvantage is a lack of cellularity, which limits their broader clinical applicability. Factors affecting cellular adequacy in urine remain unclear. We assessed the impact of basic clinical and cytopathological factors on the adequacy of cellularity in urinary CBs.
Freshly voided urine was collected from 401 consecutive individuals. Of these, 167 patients were diagnosed with urothelial carcinoma. The remaining 234 patients had various benign urological conditions. Papanicolaou classes were determined and CBs produced. Cellular adequacy was assigned to each CB (acellular, hypocellular, moderate cellularity, high cellularity), and moderately and highly cellular CBs were considered as adequate. Several factors were analysed to find any correlation with the adequacy of the cellularity.
In univariate analysis, seven factors significantly correlated with the adequacy of the CBs. In the multivariate model, positive sediment (OR = 3.7), female sex (OR = 2.7), positive urinary cytology (OR = 2.6) and positive leucocyturia (OR = 2.1) were independent predictors of adequate cellularity. Positive predictive value and negative predictive value of the model were 65.0% and 77.7%, respectively.
We determined four clinical and cytopathological factors which independently predict adequate cellularity in urinary CBs. Based on these results, several clinical situations have been proposed, in which the highest probability of adequate cellularity in urinary CBs can be achieved.
细胞块（CBs）方法长期以来一直是细胞学的一个组成部分。然而，关于源自尿液的细胞块的数据非常少。它们的主要缺点是细胞数量不足，这限制了它们更广泛的临床应用。影响尿液中细胞充足性的因素仍不清楚。我们评估了基本临床和细胞病理学因素对尿细胞块中细胞充足性的影响。
从401名连续的个体中收集新鲜排出的尿液。其中，167例患者被诊断为尿路上皮癌。其余234例患者患有各种良性泌尿系统疾病。确定巴氏分级并制作细胞块。为每个细胞块确定细胞充足性（无细胞、细胞过少、中等细胞数量、高细胞数量），中等和高细胞数量的细胞块被视为充足。分析了几个因素以发现与细胞充足性的任何相关性。
在单变量分析中，七个因素与细胞块的充足性显著相关。在多变量模型中，阳性沉渣（比值比[OR]=3.7）、女性（OR=2.7）、阳性尿液细胞学检查（OR=2.6）和阳性白细胞尿（OR=2.1）是细胞充足性的独立预测因素。该模型的阳性预测值和阴性预测值分别为65.0%和77.7%。
我们确定了四个独立预测尿细胞块中细胞充足性的临床和细胞病理学因素。基于这些结果，提出了几种临床情况，在这些情况下可以实现尿细胞块中细胞充足性的最高概率。
