Department of Pathology, Baptist Hospital of Miami, Miami, Florida.
Department of Pathology, Miami Cancer Institute, Miami, Florida.
Cancer Cytopathol. 2019 Feb;127(2):116-119. doi: 10.1002/cncy.22090. Epub 2018 Dec 18.
Previous studies have suggested that urine cytology adequacy may be related to both specimen volume and cellularity.
The authors reviewed cytospin preparations from 314 urine specimens (162 voided and 152 instrumented specimens) found to have high-grade urothelial carcinoma on biopsy.
The sensitivity of instrumented urine cytology was significantly higher than that of voided cytology (82% vs 25%; P < .001). The cellularity (at least 30 urothelial cells/10 high-power fields [HPF]) of instrumented urine specimens also was significantly higher than that of voided specimens (57% vs 9%; P < .001). The sensitivity of voided urine cytology with a cellularity of 20 to 39 cells per 10 HPF was significantly higher than that of cases with <20 cells per 10 HPF (77% vs 19%; P < .001). The sensitivity decreased with higher cellularity for both types of specimens. The sensitivity of voided cases with a volume of at least 30 mL was higher than that of cases with a volume <30 mL, but this was not statistically significant (31% vs 17%; P = .07).
The sensitivity of voided urine cytology for high-grade urothelial carcinoma is significantly associated with urothelial cellularity but not specimen volume. Both the cellularity and sensitivity of voided urine specimens are less than that of instrumented specimens.
先前的研究表明，尿液细胞学标本的充分性可能与标本量和细胞数量都有关系。
作者回顾性分析了 314 份尿液标本（162 份为随机尿标本，152 份为导尿标本）的离心涂片中发现的高级别尿路上皮癌。
导尿尿液细胞学检查的敏感性明显高于随机尿细胞学检查（82%对 25%；P<.001）。导尿标本的细胞数量（至少 30 个尿路上皮细胞/10 个高倍视野[HPF]）也明显高于随机尿标本（57%对 9%；P<.001）。细胞数量为 20 到 39 个/10 HPF 的随机尿细胞学检查的敏感性明显高于细胞数量<20 个/10 HPF 的病例（77%对 19%；P<.001）。对于两种标本类型，敏感性随细胞数量的增加而降低。至少 30 mL 体积的随机尿标本的敏感性高于体积<30 mL 的标本，但无统计学意义（31%对 17%；P=0.07）。
高级别尿路上皮癌的随机尿细胞学检查的敏感性与尿路上皮细胞数量显著相关，但与标本量无关。随机尿液标本的细胞数量和敏感性均低于导尿标本。
