Urine Cytology for Detection of Bladder Carcinoma: Experience of Gezira Hospital for Renal Disease and Surgery(GHRDS)

  • Tayseer M Omer University of Gezira, Faculty of Medicine Department Pathology
  • Sami M Taha
  • A A Mohammadani University of Gezira, Faculty of Medicine Department Pathology
  • M El Imam M Ahmed University of Gezira, Faculty of Medicine department of surgery
  • Moawia M A Elhassan University of Gezira, the National Cancer Institute (NCI-UG), department of Oncology

Abstract

Background: Urine cytology has been and remains the standard in the initial evaluation of lower urinary tract lesions to rule out bladder cancer.


Objectives:  To evaluate the significance of urine cytology as a diagnostic tool for bladder cancer and a to assess the cytological pattern in voided and washed urine.


Methodology: This was a cross-sectional descriptive hospital-based study. A total of 43 patients who were suspected to have bladder tumors based on both clinical and radiological findings. Pre-cystoscopy voided urine specimens and post-cystoscopy bladder wash specimens were collected. Three stains were used in preparation of cytological smears Hematoxylin / Eosin, Diff-Quik and May-Grünwald Giemsa, whenever possible equivalent histopathological diagnosis was obtained.


Results: This study included 86 urine cytology specimens obtained from a total of 43 cases of suspected bladder cancer. Muscle invasive cases had the higher percentage (37.2%) with more prominent features of malignancy in cytology than the earliest stages. In 30.2% of voided urine specimens were excellent, while 79.1% of bladder wash specimens had excellent quality with more cellularity and preservation of cells in cytological smears.


Conclusion: Urine cytology is a reliable method in the diagnosis of bladder cancer. The quality of washed urine is better than voided urine in cytological results.

References

1. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2015. CA Cancer J Clin. 2015;65:5–29.
2. Raghavan D, Shipley WU, Garnick MB, Russell PJ, Richie JP. Biology and management of bladder cancer. N Engl J Med. 1990;322:1129–38.
3. Network NCC. NCCN Clinical Practice Guidelines in Oncology. Bladder Cancer. V.2.2015. 2015
4. Hall MC, Chang SS, Dalbagni G, Pruthi RS, Seigne JD, Skinner EC, et al. Guideline for the management of nonmuscle invasive bladder cancer (stages Ta, T1, and Tis): 2007 update. J Urol. 2007;178:2314–30.
5. Babjuk M, Burger M, Zigeuner R, Shariat SF, van Rhijn BW, Comperat E, et al. EAU guidelines on non-muscle-invasive urothelial carcinoma of the bladder: update 2013. Eur Urol. 2013;64:639–53.
6. van der Aa MN, Steyerberg EW, Bangma C, van Rhijn BW, Zwarthoff EC, van der Kwast TH. Cystoscopy revisited as the gold standard for detecting bladder cancer recurrence: diagnostic review bias in the randomized, prospective CEFUB trial. J Urol. 2010;183:76–80.
7. Hall MC, Chang SS, Dalbagni G, et al. Guidelines for the management on nonmuscle invasive bladder cancer (stages Ta, t1, and Tis): 2007 update. J. Urol 2007;178:2314–2330. [PubMed: 17993339]
8. Montie JE, Abrahams NA, Bahnson RR, et al. Bladder cancer. Clinical guidelines in oncology. J. Natl Compr. Canc. Netw 2006;4:984–1014. [PubMed: 17112448]
9. Almallah YZ, Rennie CD, Stone J, Lancashire MJ. Urinary tract infection and patient satisfaction after flexible cystoscopy and urodynamic evaluation. Urology 2000;56:37–39. [PubMed: 10869618]
10. Botteman MF, Pashos CL, Redaelli A, Laskin B, Hauser R. The health economics of bladder cancer. Pharmoeconomics 2003;21:1315–1330.
11. Denzinger S, Burger M, Walter B, et al. Clinically relevant reduction in risk of recurrence of superficial bladder cancer using 5-aminolevulinic acid-induced fluorescence diagnosis. Urology 2007;69:675. [PubMed: 17445650]
12. Schrag D, Hsieh LJ, Rabbani F, Bach PB, Herr H, Begg CB. Adherence to surveillance among patients with superficial bladder cancer. J. Natl Cancer Inst 2003;95:588–597. [PubMed: 12697851]
13. Wiener HG, Vooijs GP, Hof-Grootenboer BV. Accuracy of urinary cytology in the diagnosis of primary and recurrent bladder cancer. Acta Cytol 1993;37:163–169. [PubMed: 8465635]
14. Grossfeld GD, Litwin MS, Wolf JS Jr, Hirack H, Shuler CL, Agerter DC, et al. Evaluation of asymptomatic microscopic hematuria in adults: The American Urological Association best practice policy – part I: definition, detection, prevalence, and etiology. Urology 2001; 57: 599-603.
15. Grossfeld GD, Litwin MS, Wolf JS Jr, Hirack H, Shuler CL, Agerter DC, et al. Evaluation of asymptomatic microscopic hematuria in adults: the American Urological Association best practice policy – part II: patient evaluation, cytology, voided markers, imaging, cystoscopy, nephrology evaluation, and follow-up. Urology 2001; 57: 604-10.
16. Michelle D Reid, Adeboye O Osunkoya, Momin T Siddiqui, Stephen W Looney; Accuracy of grading of urothelial carcinoma on urine cytology: an analysis of interobserver and intraobserver agreement, International Journal of Clinical and Experimental pathology, 2012-5(9):882-891.
17. Margareta StrojanFlezar . Urine and bladder washing cytology for detection of urothelial carcinoma: standard test with new possibilities, Radiology and Oncology. August 2010, 44(4): 207-214.
18. HussamEldinHelmyMady, AbdAlhady Mohammad Omar, Mohamed Abd-Alla Elgammal, and GhadaHosny Mohamed Ibrahim ,; Utility of urine cytology in evaluating hematuria with sonographically suspected bladder lesion in patients older than 50 years , Urology Annals , 2014 Jul-Sep 6(3): 212–217 .
19. Bong Gi Ok , Yoon SeobJi ,Young HwiiKo , and Phil Hyun Song ,Usefuleness of Urine Cytology as Routine Work-up in the Detection of recurrence in Patients With Prior Non-Invasive Bladder cancer : Practicality and cost-Effectiveness, Korean Journal of Urology . Oct 2014, 55(10):540-546.
20. Rosenthal DL, Raab SS. Cytologic detection of urothelial lesions. In: Rosenthal DL, editors. Essentials in cytopathology series. New York: Springer; 2005. p.57-62.
21. Edmund S. Cibas,, B rbara S. Ducatman . Cytology: Diagnostic Principles and Clinical Correlates, Philadelphia ,USA, Saunders , an imprint of Elsevier Inc, third edition 2009 .
22. Peggy S Sullivan, Jessica B Chan, Mary R Levin, and JianyuRao. Urine cytology and adjunct markers for detection and surveillance of bladder cancer, American Journal of Transitional Research. 2010 , 2(4): 412–440.
Published
2017-12-01
How to Cite
M OMER, Tayseer et al. Urine Cytology for Detection of Bladder Carcinoma: Experience of Gezira Hospital for Renal Disease and Surgery(GHRDS). Gezira Journal of Health Sciences, [S.l.], v. 13, n. 2, dec. 2017. ISSN 1810-5386. Available at: <http://journals.uofg.edu.sd/index.php/gjhs/article/view/913>. Date accessed: 11 dec. 2018.
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Articles