Risk Prediction of Bladder Carcinomas in Atypical Urine Specimens by Redefining Diagnostic Cytomorphological Criteria
Introduction: Urine cytology in bladder tumors is challenging due to the lack of definite cytomorphological criteria in categorizing atypical cases. The study aims to re-evaluate atypia in the light of three definitive cytological parameters (high N/C ratio, hyperchromasia, and irregular nuclear con...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2025-01-01
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| Series: | Acta Medica International |
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| Online Access: | https://journals.lww.com/10.4103/amit.amit_92_24 |
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| author | Prakriti Shukla Tushar Ojha |
| author_facet | Prakriti Shukla Tushar Ojha |
| author_sort | Prakriti Shukla |
| collection | DOAJ |
| description | Introduction:
Urine cytology in bladder tumors is challenging due to the lack of definite cytomorphological criteria in categorizing atypical cases. The study aims to re-evaluate atypia in the light of three definitive cytological parameters (high N/C ratio, hyperchromasia, and irregular nuclear contours) and correlate with the follow-up histopathology and cytopathology with an attempt to redefine the morphological features that would aid in distinguishing reactive atypia from malignancy.
Materials and Methods:
A retrospective analysis of 56 atypical urine specimens was performed considering three definitive cytomorphological parameters. All cases were classified into the following categories: atypical urothelial cells (AUCs)-favor reactive, AUCs-not otherwise specified (AUC-NOS), AUCs-favor neoplastic (AUC-FN), urothelial carcinoma (UC), and negative for malignancy (NEM). The cases reviewed were correlated with follow-up histopathology and cystoscopy. The sensitivity and specificity of urine cytology were then assessed.
Results:
Out of 56 cases, 20 cases (35.7%) were positive on urine cytology (AUC-FN/UC), and amongst them, 16 cases (80%) showed positive follow-up. Among the AUC-NOS category, 71% of the cases showed positive follow-up. The sensitivity and specificity of urine cytology in atypical cases were 89.8% and 87.5%, respectively.
Conclusions:
Urine cytology can be potentially useful in predicting the risk of bladder carcinomas when definite cytomorphological features are analyzed stringently. Moreover, urine cytology in conjunction with cystoscopy can increase the detection rate of malignancy with greater accuracy. |
| format | Article |
| id | doaj-art-720026ee40eb4e46b989bbd56d7ebb6e |
| institution | Kabale University |
| issn | 2349-0578 2349-0896 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Acta Medica International |
| spelling | doaj-art-720026ee40eb4e46b989bbd56d7ebb6e2025-08-20T03:48:46ZengWolters Kluwer Medknow PublicationsActa Medica International2349-05782349-08962025-01-011211610.4103/amit.amit_92_24Risk Prediction of Bladder Carcinomas in Atypical Urine Specimens by Redefining Diagnostic Cytomorphological CriteriaPrakriti ShuklaTushar OjhaIntroduction: Urine cytology in bladder tumors is challenging due to the lack of definite cytomorphological criteria in categorizing atypical cases. The study aims to re-evaluate atypia in the light of three definitive cytological parameters (high N/C ratio, hyperchromasia, and irregular nuclear contours) and correlate with the follow-up histopathology and cytopathology with an attempt to redefine the morphological features that would aid in distinguishing reactive atypia from malignancy. Materials and Methods: A retrospective analysis of 56 atypical urine specimens was performed considering three definitive cytomorphological parameters. All cases were classified into the following categories: atypical urothelial cells (AUCs)-favor reactive, AUCs-not otherwise specified (AUC-NOS), AUCs-favor neoplastic (AUC-FN), urothelial carcinoma (UC), and negative for malignancy (NEM). The cases reviewed were correlated with follow-up histopathology and cystoscopy. The sensitivity and specificity of urine cytology were then assessed. Results: Out of 56 cases, 20 cases (35.7%) were positive on urine cytology (AUC-FN/UC), and amongst them, 16 cases (80%) showed positive follow-up. Among the AUC-NOS category, 71% of the cases showed positive follow-up. The sensitivity and specificity of urine cytology in atypical cases were 89.8% and 87.5%, respectively. Conclusions: Urine cytology can be potentially useful in predicting the risk of bladder carcinomas when definite cytomorphological features are analyzed stringently. Moreover, urine cytology in conjunction with cystoscopy can increase the detection rate of malignancy with greater accuracy.https://journals.lww.com/10.4103/amit.amit_92_24atypicalbladder tumorcytomorphologicaldefinitive criteriaurine |
| spellingShingle | Prakriti Shukla Tushar Ojha Risk Prediction of Bladder Carcinomas in Atypical Urine Specimens by Redefining Diagnostic Cytomorphological Criteria Acta Medica International atypical bladder tumor cytomorphological definitive criteria urine |
| title | Risk Prediction of Bladder Carcinomas in Atypical Urine Specimens by Redefining Diagnostic Cytomorphological Criteria |
| title_full | Risk Prediction of Bladder Carcinomas in Atypical Urine Specimens by Redefining Diagnostic Cytomorphological Criteria |
| title_fullStr | Risk Prediction of Bladder Carcinomas in Atypical Urine Specimens by Redefining Diagnostic Cytomorphological Criteria |
| title_full_unstemmed | Risk Prediction of Bladder Carcinomas in Atypical Urine Specimens by Redefining Diagnostic Cytomorphological Criteria |
| title_short | Risk Prediction of Bladder Carcinomas in Atypical Urine Specimens by Redefining Diagnostic Cytomorphological Criteria |
| title_sort | risk prediction of bladder carcinomas in atypical urine specimens by redefining diagnostic cytomorphological criteria |
| topic | atypical bladder tumor cytomorphological definitive criteria urine |
| url | https://journals.lww.com/10.4103/amit.amit_92_24 |
| work_keys_str_mv | AT prakritishukla riskpredictionofbladdercarcinomasinatypicalurinespecimensbyredefiningdiagnosticcytomorphologicalcriteria AT tusharojha riskpredictionofbladdercarcinomasinatypicalurinespecimensbyredefiningdiagnosticcytomorphologicalcriteria |