Barasch Samuel, Choi Michael, Stewart Jimmie, Das Kasturi
Department of Pathology and Laboratory Medicine, University of Wisconsin-Madison, Madison, Wisconsin.
Department of Pathology and Laboratory Medicine, University of Wisconsin-Madison, Madison, Wisconsin.
J Am Soc Cytopathol. 2014 May-Jun;3(3):118-125. doi: 10.1016/j.jasc.2013.10.001. Epub 2013 Oct 31.
The goal of this study was to evaluate the clinical significance of atypical cytology in voided urine samples. We also studied any differences in outcome that may exist between the patients being surveyed versus high risk for urothelial carcinoma (UC).
This was a retrospective study of all voided urine specimens with "atypical" cytology over a 10-year period. The patients were categorized into those with and without a prior diagnosis of UC as the "surveillance" and "de novo" (DG) groups. Follow-up was obtained. Clinical impact and outcomes of the 2 groups were compared.
In this study, 5.7% of voided urine specimens were atypical. Mean age of patients in years, male/female ratio, and time to diagnosis in days was 59 versus 71, 23:15 versus 22:1, and 95 versus 43 in the DG and surveillance group, respectively. Rate of progression to UC was similar in both groups. High-grade UC was significantly higher in the DG.
Approximately 20% of patients in the DG were subsequently diagnosed with UC. The common causes for the atypical diagnosis that did not progress to UC were stones and benign prostatic hyperplasia. In the absence of an etiology for the atypia, further investigations are warranted.
本研究的目的是评估排尿样本中非典型细胞学的临床意义。我们还研究了接受调查的患者与尿路上皮癌（UC）高风险患者之间可能存在的结果差异。
这是一项对10年间所有具有“非典型”细胞学的排尿标本进行的回顾性研究。患者被分为有和无UC既往诊断的两组，即“监测”组和“新发”（DG）组。进行了随访。比较了两组的临床影响和结果。
在本研究中，5.7%的排尿标本为非典型。DG组和监测组患者的平均年龄（岁）、男/女比例和诊断时间（天）分别为59对71、23:15对22:1和95对43。两组进展为UC的发生率相似。DG组中高级别UC明显更高。
DG组中约20%的患者随后被诊断为UC。未进展为UC的非典型诊断的常见原因是结石和良性前列腺增生。在没有非典型病因的情况下，有必要进行进一步调查。
