Potts S A, Thomas P A, Cohen M B, Raab S S
Department of Pathology, University of Iowa Hospitals and Clinics, Iowa City 52241-1009, USA.
Mod Pathol. 1997 Jul;10(7):657-62.
This study examined the diagnostic accuracy of upper urinary tract cytology and defined key cytologic criteria by logistic regression analysis for the diagnosis of high-grade transitional cell carcinoma (TCC). The upper urinary tract cytologic diagnosis was retrospectively reviewed for 153 patients, and diagnostic accuracy was calculated. Cases were scored for the presence or absence of 32 cytomorphologic criteria, and key features to distinguish high-grade TCC from benign lesions were assessed. There were two false-positive and four false-negative diagnoses of TCC. Likelihood ratios for the diagnoses of benign, atypical, suspicious, and TCC were 0.2, 1.4, 3.9, and 32.8, respectively. Regression analysis showed that the cytologic features of aniso-nucleosis, high nuclear/cytoplasmic ratio, and nuclear overlapping were important in the separation of high-grade TCC from benign lesions. We conclude that by using these criteria, the accuracy of diagnosis of high-grade TCC could be improved.
本研究通过逻辑回归分析，检验了上尿路细胞学检查的诊断准确性，并确定了诊断高级别移行细胞癌（TCC）的关键细胞学标准。对153例患者的上尿路细胞学诊断进行回顾性分析，并计算诊断准确性。对病例是否存在32项细胞形态学标准进行评分，并评估区分高级别TCC与良性病变的关键特征。TCC诊断中有2例假阳性和4例假阴性。良性、非典型、可疑和TCC诊断的似然比分别为0.2、1.4、3.9和32.8。回归分析表明，核大小不等、高核质比和核重叠的细胞学特征对于区分高级别TCC与良性病变很重要。我们得出结论，通过使用这些标准，可以提高高级别TCC的诊断准确性。
