15
Urinary Tract
Table 15.5 Cytologic Classification of 1543 Tumors of the Urinary Tract
Tumor type
Cases
Urine cytology
Negative
Suspicious
Positive
Urothelial carcinoma, in situ
113
2 (2%)
35 (31%)
76 (67%)
Urothelial carcinoma, grade I
279
97 (35%)
96 (34%)
86 (31%)
Urothelial carcinoma, grade II
468
93 (20%)
165 (35%)
210 (45%)
Urothelial carcinoma, grade III
392
24 (6%)
74 (19%)
294 (75%)
Squamous cell carcinoma, bladder
26
1 (4%)
5 (19%)
20 (77%)
Adenocarcinoma, bladder
28
2 (7%)
6 (22%)
20 (71%)
Squamous cell carcinoma, urethra
8
0
2 (25%)
6 (75%)
Adenocarcinoma, urethra
2
0
0
2 (100%)
Adenocarcinoma, kidney
63
51 (81%)
12 (19%)
0
Adenocarcinoma, prostate
114
63 (55%)
25 (22%)
26 (23%)
Metastatic carcinoma
49
10 (21%)
14 (28%)
25 (51%)
Malignant melanoma
1
0
0
1 (100%)
Total
1543
343 (22%)
434 (28%)
766 (50%)
invasive transitional cell carcinoma should be made if justified
by the findings and may be of value in clinical management. In
a large meta-analysis of 42 studies, cytology was shown as the
test with the best specificity (94%), significantly better than of
other markers.103-105
Concluding Remarks
of the kidneys or prostate. Screening programs for high-risk pop-
ulations may be useful, but the experience with such programs
is still limited. Although urine-based molecular techniques have
a current limited role in surveillance for bladder cancer, in the
future greater use of these techniques will allow less invasive
monitoring for this tumor and potentially serve as a screening
tool in identifying high-risk patients.106,107
In summary, urine cytology is an established diagnostic proce-
dure in the primary diagnosis and follow-up of patients with
urothelial carcinoma and has an acceptable sensitivity and high
specificity. It is not reliable in the diagnosis of adenocarcinomas
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