Cytological Evaluation And Significance Of Cell Cannibalism In Effusions And Urine Cytology

Cell cannibalism is believed to be an indicator of high-grade aggressive cancers with increased metastatic potential. It denotes both anaplastic grade and invasiveness and is valuable in assessing tumor behavior. The present study was a 2-year retrospective and 1-year prospective study conducted in the Department of Pathology, Government Medical College, Jammu. PAP and MGG stained smears of effusions and urinary cytology were evaluated for cannibalism. Cannibalism was assessed by parameters like cellularity of cannibalism, diameter of cannibalistic cells, chromatin pattern and background of the smears. Of 350 cases evaluated, 260 (74.2%) were benign and 90 (25.8%) were malignant. Cannibalism was absent in all benign cases. Cannibalism was present in 14 ascitic fluids, 7 pleural fluids, 1 pericardial fluid and 3 cases of urine cytology. Comparison of distribution of cannibalism in effusions and urine did not yield statistically significant result (X2 = 0.8678 and p >0.05). Comparison of other parameters between effusions and urine samples also did not yield significant results. We conclude that cytological parameters of cellular cannibalism are better observed in malignant effusions than in urine cytology but did not reach statistical significance. Cannibalism can be assessed morphologically in malignant body fluids and is an indicator of increased tumour growth.

The Significance of Urinary Cytology in the Diagnosis of Primary Ureter Uroepithelium Cancer / 中国肿瘤临床

Objective:To research the relationship of urinary cytology positive rate with the grade and stage of primary ureter uroepithelium cancer.Methods:A total of 104 cases of primary ureter uroepithelium cancer were recruited in this study.The urine of all paitents was collected for preoperative urinary cytology de-tection.The urinary cytology detection rates were compared among different grades and stages of primary ureter uroepithelium cancer.Results:The overall unnary cytology positive rate of primary ureter uroepithelium cancer was 34.26%.The overall urinary cytology positive rate was 43.59%in the advanced stage group and 11.54%in the low stage group,with a significant difference(X2=8.740, P=0.003).The difference in positive rate between the advanced stage group and the low stage group in the high grade with inferior segment group of primary ureter uroepithelium cancer was statistically significant(X2=10.628,P=0.001).The difference in positive rate between the advanced stage group and the low stage group in the high grade group of primary ureter uroepithelium cancer was statistically significant(X2=5.678,P=0.01 7).The difference in positive rate be-tween the high grade group and the low grade group in low stage group of primary ureter uroepithelium can-cer was statistically significant(X2=12.860,P=0.001).Conclusion:The unnary cytology positive rate of primary ureter uroepithelium cancer of high grade and low stage is higher.

The Significance of Atypical Cell in Urinary Cytology / 대한비뇨기과학회지

PURPOSE: Atypical cells in urinary cytology are frequently observed in patients who have history of urothelial cancer A study was made to evaluate the significance of atypical cell in urinary cytology for the detection and surveillance of urothelial cancer. MATERIALS AND METHODS: We studied retrospectively 100 patients with atypical cell in urinary cytology. A bladder washing specimen was used for cytology Four groups of subjects were participated in this study. Group I - patients who showed gross hematuria, or lower urinary tract symptoms, but no history of the urothelial cancer. Group II - patients with urinary tract surgery for urothelial cancers. Group III - patients with intravesical therapy due to transitional cell carcinoma of the bladder. Group IV - patients with history of urothelial cancers, but no recurrence for l year or more. RESULTS: Mean follow up was 39 months. Cystoscopy and radiography showed urothelial cancer in 72 patients(72%) with atypical cytology. The bladder cancer was found in If of 27(63%) in group I, 26 of 26(100%) in group II, 4 of 5(80%) in group III and 13 of 14(93%) in group IV respectively. The interval from atypical cytology to the detection of urothelial cancer was 4 months. Upper tract tumors developed in 11 patients and prostatic urothelial recurrence in l patient. CONCLUSIONS: These data demonstrate the clinical importance of atypical cytology and emphasize the search for urothelial cancer. Patients with history of transitional cell carcinoma who showed atypical cells are likely to have a overt transitional cell carcinoma, and require further evaluation of intravesical and extravesical sites to detect the urothelial cancer.

Predictive Value of Urinary Cytology in the Recurrence and the Progression of Superficial Bladder Cancer / 대한비뇨기과학회지

A retrospective analysis was done on 68 patients with primary superficial bladder cancer between September 1989 and December 1995. We evaluated the predictive value of urine cytology in the recurrence and the progression of superficial bladder cancer. Positive cytology was shown in 52.9% (36/68) and was significantly associated with tumor grade (p=0.001). The recurrence rate in patients with negative cytology was 28.1% (9/32) compared to 77.8% (28/36) in those with positive cytology (p=0;001). No patients of negative cytology had tumor progression while 4 out of 36 (11.1%) patients of positive cytology had progression to invasive or metastatic disease. In conclusion, urinary cytology appears to be a significant prognostic factor in superficial bladder cancer.

Urinary Cytologic Findings of Urothelial Lesions / 대한세포병리학회지

Urinary cytology is increasingly accepted as a diagnostic tool in the detection and follow-up of patients with bladder cancer. However, its value is reduced by several limitations, especially by the tack of cytologic criteria specifically reflecting the morphology of low-grade urothelial neoplasm. We reviewed histologically proven 50 cases of urine cytology with emphasis on cytologic findings of benign atypia and differential findings of urothelial neoplasm according to the grade. The diagnoses included 17 benign lesions (including 5 cases of urine calculi) and 33 malignant lesions(including 28 transitional cell carcinomas. 3 squamous cell carcinomas, 1 adenocarcinoma and 1 prostate adenocarcinoma). Diagnostic accuracy was 92%. Important cytodiagnostic criteria for benign atypia and low grade malignancy were cellularity, number of cell clusters, and morphology and arrangement of urothelial cells. The cytologic findings of urothelial neoplasms according to histologic grade were relatively well correlated with the histologic findings. However, the cytologic criteria were not sufficient to readily distinguish grade I from grade II. In view of this, we think that cytologic nomenclature "low-grade" and "high-grade" is a more reliable criterion. Recognition of subtle cellular morphologic features specific for urothelial lesions(including benign or malignancy) and proper fixation, processing and staining of specimen can expand the role of urinary cytology in detection and follow-up of patients.

Comparative study on results between urine flow cytometric DNA analysis and urine cytology in transtional cell carcinoma of bladder / 대한비뇨기과학회지

We compared the roles of urinary cytology and flow cytometric DNA analysis in the evaluation of 26 patients with transitionsl cell carcinoma of bladder from March 1989 to April 1991. When carcinoma was present at the time of specimen collection it was detected by cytology in 65.4 percent and flow cytometric DNA analysis in 73.1 percent. Combination of flow cytemetric DNA analysis and urinary cytology increased the diagnostic yield to 88.5 percent Flow cytometric DNA analysis was slightly more sensitive than urinary cytology for the detection of abnormalities in specimen from low stage. high grade. small size. small number and recurrent cancer but no statistically significant difference was identified. When used in conjunction with urinary cytology. urine flow cytometric DNA analysis was valuable procedure in the diagnosis and follow up of patients with bladder cancer.

The Value of Urinary Cytology in Urinary Tract Malignancy / 대한비뇨기과학회지

The cytologic examination of the urine is simple and inexpensive for the early detection, follow-up and mass screening of genitourinary tumors. Nowadays, besides voiding urine, cytologic examination, of bladder washing, pelvis irrigation, contrast material during retrograde pyelography, prostatic massage fluid increased the diagnostic accuracy. Of 99 patients who were admitted to the department of Urology, National Medical Center from March 1979 to February 1980 for detection of genitourinary tumor, 18 cases were positive. Of 18 cases, 16 cases were proved as tumor by histopathologically. Diagnostic accuracy was 50.2% and false positive 3.0 %, false negative 43.7%. Of the 15 false negative cases, Grade I, U, K were as follows 9, 4, 1. The comparative study was performed on 22 cases of bladder tumor with bladder washing and voiding urine cytology, and the diagnostic accuracy of them were as follows. Bladder washing: 86.4%, voiding urine: 58.1%.