Cytological and Morphometric Study of Urinary Epithelial Cells with Histopathological Correlation

Abstract

This study has been done to asses the utility and accuracy of urinary cytology and morphometric study of exfoliated cells in early detection and follow-up of urothelial neoplasms and thereby help to reduce the disease-related mortality and morbidity. A total 100 patients with urinary symptoms were studied by cytological examination of urine along with morphometric analysis of suspicious epithelial cells. Immunostaining to detect CK-20 expression and p53 over expression was done in smears showing atypical cells. Histopathological confirmation was done in cases which were suspicious on cystoscopy. P value was determined by using unpaired t-test. Statistically significant difference was found between neoplastic and non-neoplastic lesions of the urinary bladder as far as morphometry is concerned. Urinary cytology along with morphometry is an important tool in early detection of urothelial neoplasms. It is also helpful to find out the recurrences during post-operative follow-up period. Overexpression of CK-20 and p53 immunostain in cytology can act as an adjunct to the cytological diagnosis.

The pattern of urine cytology in a tertiary health care facility Northwest Nigeria

“…12 Cytological examination of the urine specimens revealed 77 specimens (10.1%) to be positive for malignancy as against 512 specimens (66.8%) with clinical diagnosis of bladder cancer. This is slightly higher than 9.8% reported by Obiora et al and 5.9% reported by Nabi et al but lower than 25% reported to be malignant by Manna et al 9,12,13 The reason for the lower positive result for malignancy in our study may be because of the method of obtaining urine specimen in our center, which is mostly voided urine and usually single specimen. Majority of positive cytology, 45 (58.4%) were in patients aged <51 years.…”

“…However, Nabi et al reported 87% of their positive urine cytology to be in men aged >50 years. 9 There were 50 (6.5%) specimens reported to be suspicious of malignancy which is higher than 4% reported by Manna et al but lower than 11.35% reported by Nabi et al and 27.5% reported by Obiora et al 9,12,13 We reported 148 specimens (19.3%) to be non specific chronic inflammation which is also higher than the 17% reported by Manna et al 13 Interestingly, only 1 (0.1%) request for urine cytology was due to clinical suspicion of urinary schistosomiasis. However urine cytology was able to detect schistosomiasis in 13 specimens (1.7%).…”

Urine cytology as seen in Uyo, Nigeria: How relevant is it to medical practice?

“…Although previous studies have argued in favor of or against the usefulness of UC, especially in respect to its low sensitivity, nondefinitive nature of its diagnoses, high cost, and the need to always follow-up diagnosis with cystoscopy and biopsy, in our setting, it is still useful considering its affordability (less than 7 dollars), absence of general population health insurance coverage, and relative high cost of cystoscopy (100 dollars). [ 1 3 4 5 6 7 8 9 10 11 ]…”

“…The indications for UC in the index study are wide and nonspecific, similar to the study in Sokoto, Nigeria, and Bengal, India. [ 9 10 ] This is different from more specific bladder associated hematuria which was the main indication in Jeddah, Saudi Arabia, Midland, United Kingdom, and the Florida, United States of America. [ 1 6 11 ] The reason for the varied nonselective indications is due to the lack of other diagnostic aids.…”

“…[ 3 4 5 6 7 8 ] Following a literature search, only one study on UC has been done in Nigeria, while numerous studies on UC has been done in various countries. [ 1 3 4 5 6 7 8 9 10 11 ]…”