The Significance of Atypical Cell in Urinary Cytology

Jo, Moon Ki; Chung, Jin Soo; Lee, Sang Eun

Abstract

PURPOSE: Atypical cells in urinary cytology are frequently observed in patients who have history of urothelial cancer A study was made to evaluate the significance of atypical cell in urinary cytology for the detection and surveillance of urothelial cancer.
MATERIALS AND METHODS
We studied retrospectively 100 patients with atypical cell in urinary cytology. A bladder washing specimen was used for cytology Four groups of subjects were participated in this study. Group I - patients who showed gross hematuria, or lower urinary tract symptoms, but no history of the urothelial cancer. Group II - patients with urinary tract surgery for urothelial cancers. Group III - patients with intravesical therapy due to transitional cell carcinoma of the bladder. Group IV - patients with history of urothelial cancers, but no recurrence for l year or more.
RESULTS
Mean follow up was 39 months. Cystoscopy and radiography showed urothelial cancer in 72 patients(72%) with atypical cytology. The bladder cancer was found in If of 27(63%) in group I, 26 of 26(100%) in group II, 4 of 5(80%) in group III and 13 of 14(93%) in group IV respectively. The interval from atypical cytology to the detection of urothelial cancer was 4 months. Upper tract tumors developed in 11 patients and prostatic urothelial recurrence in l patient.
CONCLUSIONS
These data demonstrate the clinical importance of atypical cytology and emphasize the search for urothelial cancer. Patients with history of transitional cell carcinoma who showed atypical cells are likely to have a overt transitional cell carcinoma, and require further evaluation of intravesical and extravesical sites to detect the urothelial cancer.