Chow N H, Tzai T S, Cheng H L, Chan S H, Lin J S
Department of Pathology, Medical College, National Cheng Kung University, Tainan, Taiwan.
Urol Int. 1994;53(1):18-23. doi: 10.1159/000282625.
In order to assess the clinical implications of the cytology of voided urine we analyzed 65 patients among 147 cases of transitional cell carcinoma (TCC) in relation to the cytohistologic correlation and prognostic significance. Urinary cytology detected 42.6% of bladder tumors, 59% of renal pelvic tumors, and 35.3% of ureteral carcinomas. None of the 3 cases of grade-1 upper urinary tract tumors was detected by preoperative urinary cytology. Tumors with positive cytology were associated with epidermal growth factor receptor expression (p = 0.0009) and a higher fraction of tumor proliferation as defined by Ki-67 immunohistochemistry (p = 0.0038). Anaplastic tumor cells in urine correlated fairly well with muscular invasion (p = 0.018) and the DNA aneuploidy of the tumor (p = 0.0038). Tumors with muscular invasion were more likely to be detected by cytologic examination (p = 0.013). In urinary bladder carcinoma (n = 107), patients with positive cytology had a higher incidence of tumor recurrence (p = 0.004), and had an unfavorable prognosis (p = 0.0001) with a median follow-up of 46 months. In Ta-T1 tumors (n = 87), urinary cytology had prognostic value in terms of risk of recurrence (p = 0.0001), and poor patient outcome (p = 0.0001). Our data suggest that urinary cytology can offer important biological information on TCC and may be used as a simple and effective short-term prognostic indicator.
为了评估排尿尿液细胞学检查的临床意义，我们分析了147例移行细胞癌（TCC）患者中的65例，涉及细胞组织学相关性和预后意义。尿液细胞学检查发现了42.6%的膀胱肿瘤、59%的肾盂肿瘤和35.3%的输尿管癌。术前尿液细胞学检查未发现3例1级上尿路肿瘤。细胞学检查阳性的肿瘤与表皮生长因子受体表达相关（p = 0.0009），并且根据Ki-67免疫组化定义的肿瘤增殖比例更高（p = 0.0038）。尿液中的间变肿瘤细胞与肌肉浸润（p = 0.018）和肿瘤的DNA非整倍体（p = 0.0038）相关性较好。有肌肉浸润的肿瘤更有可能通过细胞学检查被发现（p = 0.013）。在膀胱癌（n = 107）中，细胞学检查阳性的患者肿瘤复发率更高（p = 0.004），并且在中位随访46个月时预后不良（p = 0.0001）。在Ta-T1期肿瘤（n = 87）中，尿液细胞学检查在复发风险（p = 0.0001）和患者预后不良（p = 0.0001）方面具有预后价值。我们的数据表明，尿液细胞学检查可以提供有关TCC的重要生物学信息，并且可以用作一种简单有效的短期预后指标。
