尿细胞学检查的临床价值：615例患者的12年经验
The clinical value of urinary cytology: 12 years of experience with 615 patients.
作者信息
Maier U, Simak R, Neuhold N
机构信息
Department of Urology, University of Vienna, Austria.
出版信息
J Clin Pathol. 1995 Apr;48(4):314-7. doi: 10.1136/jcp.48.4.314.
AIMS
To analyse the diagnostic value of cytological examination compared with histological findings in a large series of patients (n = 615) with tumours of the urinary tract epithelium.
METHODS
Cytological examinations (n = 785) after bladder washing and exfoliative cytology were retrospectively compared and correlated with histological findings. In addition, 1527 bladder washings were obtained during follow up of patients after transurethral resection of bladder tumours.
RESULTS
Cytology in bladder washings (overall diagnostic accuracy 66%) provides considerably more information that exfoliative cytology (overall accuracy 49%). Cytological examinations (n = 1125) in patients with bladder tumours receiving intravesical cytostatic drugs (for example, mitomycin C) yielded suspicious or positive results in 28% of patients, without being confirmed by endoscopy during follow up.
CONCLUSION
Our results illustrate two major drawbacks of urinary cytology. First, a high rate of false positive results in patients on intravesical chemotherapy. Second, a high rate of false negative results in highly differentiated carcinomas, stressing the need for additional diagnostic tests such as staining with monoclonal antibodies directed against tumour antigens or assessment of ploidy.
目的
分析细胞学检查与组织学检查结果相比，在大量（n = 615）尿路移行上皮肿瘤患者中的诊断价值。
方法
回顾性比较膀胱冲洗后的细胞学检查（n = 785）和脱落细胞学检查，并将其与组织学检查结果进行关联分析。此外，在经尿道膀胱肿瘤切除术后的患者随访期间，共获取了1527次膀胱冲洗样本。
结果
膀胱冲洗液细胞学检查（总体诊断准确率66%）提供的信息比脱落细胞学检查（总体准确率49%）多得多。接受膀胱内化疗药物（如丝裂霉素C）的膀胱肿瘤患者的细胞学检查（n = 1125）中，28%的患者结果可疑或呈阳性，但随访期间未得到内镜检查的证实。
结论
我们的结果说明了尿细胞学检查的两个主要缺点。第一，膀胱内化疗患者的假阳性结果率较高。第二，高分化癌的假阴性结果率较高，这强调了需要进行额外的诊断测试，如使用针对肿瘤抗原的单克隆抗体染色或评估倍性。
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