Diagnostic Evaluation of Urine Cytology in Detection of Urothelial Carcinoma
DOI:
https://doi.org/10.21276/apalm.3482Keywords:
Urine cytology, Bladder Carcinoma, High Grade Urothelial Carcinoma, The Paris System of Reporting Urine CytologyAbstract
Background: Bladder carcinoma is the tenth most common carcinoma worldwide, representing three percent of global cancer diagnoses. Urine cytology is an important tool for urothelial carcinoma screening.
Materials and Methods: A cross-sectional study was carried out in two hundred seventy-five cases. Urine samples were collected and processed according to the standard procedure and stained with May-Grünwald Giemsa (MGG) and Papanicolaou (PAP) stain, and reported as per The Paris System. The results were then correlated with histopathological findings of transurethral resection of bladder tumor chips. According to the findings observed, a relevant statistical test was applied.
Results: According to The Paris System of reporting, the distribution was as follows: High-grade urothelial carcinoma – seven percent; Suspicious for high-grade urothelial carcinoma – fourteen percent; Atypical urothelial cells – nine percent; and Negative for high-grade urothelial carcinoma – seventy percent. Out of two hundred seventy-five cases of urine cytology, histopathology was possible in forty-five cases, of which forty-two cases were positive for urothelial carcinoma. The sensitivity of urine cytology for detection of urothelial carcinoma is seventy-seven percent, specificity is one hundred percent, and diagnostic accuracy is seventy-eight percent. Male-to-female ratio was 3:1.
Conclusion: Urine cytology has low sensitivity but high specificity for detection of urothelial carcinoma. Accurate diagnosis of urothelial carcinoma can be made by combination of clinical information, urine cytological findings, and histopathological findings.
References
1. Saginala K, Barsouk A, Aluru JS, Rawla P, Padala SA, Barsouk A. Epidemiology of bladder cancer. Med Sci. 2020 Mar 13;8(1):15.
2. Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2021;71(3):209–49.
3. Hassan M, Solanki S, Kassouf W, Kanber Y, Caglar D, Auger M, et al. Impact of implementing the Paris System for Reporting Urine Cytology on the performance of urine cytology: A correlative study of 124 cases. Am J Clin Pathol. 2016 Sep;146(3):384–90.
4. Doshi B, Athana RS, Woloszynska A. Biological differences underlying sex and gender disparities in bladder cancer: Current synopsis and future directions. Oncogenesis. 2023 Dec;12(1):44.
5. Rai S, Lali BS, Venkataramana CG, Philipose CS, Rao R, Prabhu GL. A quest for accuracy: Evaluation of the Paris System in the diagnosis of urothelial carcinomas. J Cytol. 2019;36(3):169–73.
6. Rohra P, Ocampo Gonzalez FA, Yan L, Mir F, Furlan K, Basu S, et al. Effect of the Paris System for Reporting Urinary Cytology with histologic follow-up. Diagn Cytopathol. 2021 Jun;49(6):691–9.
7. Chen F, Lin X. The Paris System for Reporting Urinary Cytology: An updated review. J Clin Transl Pathol. 2023 Jun 28;3(2):59–74.
8. Nichols MM, Reynolds JP, McKenney JK, Nicolas MM, McIntire PJ, Policarpio-Nicolas MLC. Urine cytology findings in patients with biopsy-confirmed urothelial carcinoma in situ with plasmacytoid features. Cancer Cytopathol. 2021;129(10):798–804.
9. The Paris System for Reporting Urinary Cytology [Internet]. Cham: Springer; [cited 2024 May 25]. Available from: https://link.springer.com/book/10.1007/978-3-030-88686-8
10. Chandrasekhar V, Krishnamurti C. George Papanicolaou (1883–1962): Discoverer of the Pap smear. J Obstet Gynecol India. 2018 Jun;68(3):232–5.
11. Mishra V, Balasubramaniam G. Urinary bladder cancer and its associated factors: An epidemiological overview. Indian J Med Sci. 2021 Sep 24;73(2):239–48.
12. Doshi B, Athans RS, Woloszynska A. Biological differences underlying sex and gender disparities in bladder cancer: Current synopsis and future directions [Internet]. Oncogenesis. [cited 2024 Jun 24]. Available from: https://www.nature.com/articles/s41389-023-00489-9
13. Albakri M, Abu-Hijlih R, Salah S, Al-Ibraheem A, Abuhijla F, Serhan HA, et al. Bladder cancer in young adults: Disease and treatment characteristics of patients treated at a tertiary cancer center. Urol Ann. 2023 Jun;15(2):207.
14. Zhu CZ, Ting HN, Ng KH, Ong TA. A review of the accuracy of bladder cancer detection methods. J Cancer. 2019 Jul 8;10(17):4038–44.
15. Chou WH, McGregor B, Schmidt A, Carvalho FLF, Hirsch MS, Chang SL, et al. Cyclophosphamide-associated bladder cancers and considerations for survivorship care: A systematic review. Urol Oncol. 2021 Oct 1;39(10):678–85.
16. Shephard EA, Stapley S, Neal RD, Rose P, Walter FM, Hamilton WT. Clinical features of bladder cancer in primary care. Br J Gen Pract. 2012 Sep;62(602):e598–604.
17. Holtedahl K, Lars B, Donker GA, Buntinx F, Weller D, Campbell C, et al. Symptoms and signs of urogenital cancer in primary care. BMC Prim Care. 2023 Apr 26;24(1):107.
18. Del Sordo R, Covarelli C, Annese LC, Mandarano M, Bellezza G, Sidoni A. Urinary diagnostic cytology beyond the research of neoplastic cells: Usefulness of erythrocyte morphology evaluation to recognize microhematuria source. J Cytol. 2023 Dec;40(4):200.
19. Yuan L, Gero CTM, Zia S, Aryal CS, Shetty S, Reynolds PJ. Cyto-histo correlation and false-negative urine: Before and after the Paris System for Reporting Urinary Cytology. Diagn Cytopathol. 2022 Jun 2;50(6):404–10.
20. Sciarra A, Di Lascio G, Del Giudice F, Leoncini PP, Salciccia S, Gentilucci A, et al. Comparison of the clinical usefulness of different urinary tests for the initial detection of bladder cancer: A systematic review. Curr Urol. 2021 Mar;15(1):22–32.
21. Rohilla M, Singh P, Rajwanshi A, Gupta N, Srinivasan R, Dey P, et al. Cytohistological correlation of urine cytology in a tertiary center with the application of the Paris System. Cytopathology. 2018 Oct;29(5):436–43.
22. Chan E, Balassanian R, Tabatabai ZL, Lou H, Vohra P. Improved diagnostic precision in urine cytology was achieved by the implementation of the Paris System and the use of cell blocks. Cancer Cytopathol. 2018 Sep;126(9):809–16.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Aradhana Saikia, Junu Devi
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access at http://opcit.eprints.org/oacitation-biblio.html).
