The role of cytology in densely populated territories: An experience from Hong Kong

Li, Joshua J.X.; Tse, Gary

doi:10.1002/cncy.22668

Cited by 1 publication

(2 citation statements)

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“…3 Urine specimens showing tumor cells from renal cell carcinomas are uncommon, and apart from Piscioli et al 3 describing a cohort of 59 patients with histologically proven renal cell carcinomas, available evidence is largely limited to case series and case reports. [11][12][13] In this cohort, all consecutive urine cytology specimens matched with a renal carcinoma from three institutions, representing all acute hospitals of the territory with a population coverage of more than 1 million, 14 were reviewed. Despite a collection period of more than 2 decades, there was only a yield of approximately 1000 cases.…”

Section: Discussionmentioning

confidence: 99%

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Urine cytology in the detection of renal cell carcinomas – a territory‐wide multi‐institutional retrospective review of more than 2 decades

Li,

Ng,

Tang

et al. 2024

Cancer Cytopathology

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IntroductionCompared with urothelial lesions of the upper urinary tract, the diagnostic performance of urine cytology in detection of renal cell carcinomas is underreported. This study aims to establish the role of urine cytology in the assessment of renal carcinomas by a multi‐institute review of urine cytology from nephrectomy confirmed renal cell carcinomas, referenced against renal urothelial and squamous cell carcinomas.MethodsRecords of nephrectomy performed from the 1990s to 2020s at three hospitals were retrieved and matched to urine cytology specimens collected within 1 year prior. Patient demographics, specimen descriptors, and histology and staging parameters were reviewed and compared against cytologic diagnoses.ResultsThere were 1147 cases of urine cytology matched with renal cell carcinomas, with 666 renal urothelial/squamous carcinomas for comparison. The detection rate for urothelial/squamous (atypia or above [C3+]: 63.1%; suspicious or above [C4+]: 24.0%) were higher than renal cell carcinoma (C3+: 13.1%; C4+: 1.5%) (p < 0.001). The positive rate for upper tract urine exceeded other collection methods at 45.0% (C3+) and 10.0% (C4+) (p < .01). Other factors associated with increased positive rates were male sex, collecting duct carcinoma histology, nuclear grade, and renal/sinus involvement (p < .05). Multivariate analysis revealed additional positive correlations with presence of sarcomatoid tumor cells, lymphovascular invasion, and perinephric fat involvement (p < .05). Larger lesion size and higher urine volume did not improve detection rates (p < .05).ConclusionsThe detection rate of renal cell carcinomas is suboptimal compared with urothelial carcinomas, although urine samples collected from cystoscopy or percutaneous nephrostomy significantly outperformed voided urine specimens.

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Section: Discussionmentioning

confidence: 99%

“…In this cohort, all consecutive urine cytology specimens matched with a renal carcinoma from three institutions, representing all acute hospitals of the territory with a population coverage of more than 1 million, 14 were reviewed. Despite a collection period of more than 2 decades, there was only a yield of approximately 1000 cases.…”

Section: Discussionmentioning

confidence: 99%