The Value of Urine Cytology in the Diagnosis and Follow-up of the Bladder Tumors

Lee, Chong Koo; Lee, Sang Eun

Abstract

The cytologic examination of voided urine and bladder washings was done in 220 patients with bladder tumors from January, 1986 to June, 1989. Sixty hundred and thirty six specimens including 415 voided urine specimens and 221 bladder washings were examined. Among those, 160 paired specimens of both voided urine and bladder washings were taken from one patient on the same day. Specimens were stained by the Papanicolaou method, and they were interpreted as being negative when the cytologic examination was normal or showed benign atypia and positive when malignant cells were suspected or clearly evident. Sensitivity and specificity of the cytologic examination were 41.8%, 91.9% as a whole, and 34,6%, 96.6% in voided urine and 54.4%, 82.4% in bladder washings. The sensitivity of voided urine and bladder washings was increased as the tumor size, number, grade and stage were increased. A positive urine cytology without a visible tumor in voided urine was seen in 5 cases and the tumor recurred in all 3 patients who were followed up for more than 3 months. Among fifteen cases of a positive cytology without a visible tumor in bladder washings, 9 cases were followed up for more than 3 months, and the tumor recurred in 2 of 9 cases. In conclusion, the voided urine and bladder washings were complementary for the diagnostic accuracy of cytologic examination, and careful follow-up is necessary for a patient with a positive cytology without a visible tumor.