Saarinen Perttu, Jokelainen Otto, Ruotsalainen Liida, Ikonen Essi, Nykopp Timo K
Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland.
Institute of Clinical Medicine, Pathology and Forensic Medicine, University of Eastern Finland, Kuopio, Finland.
Discov Oncol. 2025 Jan 27;16(1):95. doi: 10.1007/s12672-025-01828-5.
This retrospective single-center study aimed to determine the correlation between The Paris System (TPS) urine cytology classification, cystoscopy findings, and non-muscle-invasive bladder cancer diagnosis. In addition, we sought to identify factors that might explain the abnormal cytology classification in cases in which no malignancy was detected.
A Total of 855 patients evaluated with urine cytology between 2017 and 2020 at Kuopio University Hospital were included. Histological diagnoses and urinalysis results were correlated with cytology (TPS). Chi-squared and Fisher's exact tests were used to calculate statistical significance.
In the absence of exophytic tumors on cystoscopy, the risks of bladder cancer was 0.1% for NHGUC, 1.5% for AUC, 22.7% for SHGUC, and 83.3% for HGUC. Positive urinalysis corresponded to lower cytological diagnostic categories in both males and females. A statistically significant difference was observed in males with respect to moderate pyuria, hematuria, and higher cytological categories.
This study provides evidence that a biopsy or follow-up may not be necessary for patients without a prior history of urothelial carcinoma and without exophytic tumors observed on cystoscopy, when the cytological diagnosis is NHGUC or AUC. Furthermore, concurrent hematuria and pyuria may result in a higher cytological classification.
本回顾性单中心研究旨在确定巴黎系统（TPS）尿液细胞学分类、膀胱镜检查结果与非肌层浸润性膀胱癌诊断之间的相关性。此外，我们试图找出在未检测到恶性肿瘤的病例中可能解释细胞学分类异常的因素。
纳入2017年至2020年在库奥皮奥大学医院接受尿液细胞学检查的855例患者。组织学诊断和尿液分析结果与细胞学（TPS）相关。采用卡方检验和费舍尔精确检验计算统计学意义。
膀胱镜检查未发现外生性肿瘤时，NHGUC患者患膀胱癌的风险为0.1%，AUC患者为1.5%，SHGUC患者为22.7%，HGUC患者为83.3%。尿液分析阳性在男性和女性中均对应较低的细胞学诊断类别。在男性中，中度脓尿、血尿和较高的细胞学类别存在统计学显著差异。
本研究提供的证据表明，对于无尿路上皮癌既往史且膀胱镜检查未发现外生性肿瘤、细胞学诊断为NHGUC或AUC的患者，可能无需进行活检或随访。此外，同时出现血尿和脓尿可能导致更高的细胞学分类。
