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Quick‐staining urinary cytology and bladder wash image analysis with an integrated risk classification
Author(s) -
Wiener Helene G.,
Remkes Gerard W.,
Schatzl Georg,
Susani Martin,
Breitenecker Gerhard
Publication year - 1999
Publication title -
cancer cytopathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/(sici)1097-0142(19991025)87:5<263::aid-cncr5>3.0.co;2-o
Subject(s) - medicine , cytology , urinary system , urinary bladder , urology , staining , pathology
BACKGROUND With an end toward an increase in patient quality of life, morphologic methods were tested for their combinatory value in expanding the effectiveness of follow‐up appointments and finding a more specific supervision of patients with bladder cancer. METHODS Voided urine and bladder washing specimens were gathered in 223 follow‐up sessions of 124 patients with a history of bladder cancer. Hemacolor (Merck, Darmstadt, Germany)‐stained cytospin preparations of voided urine specimens were ready for diagnosis within 15 minutes, and results were available shortly before cystoscopy. Feulgen‐Schiff–stained cytospin preparations of bladder washings entered the image analysis system. A special software was used to classify the DNA histogram by a risk factor for bladder cancer. RESULTS Follow‐up of patients revealed 83 tumor recurrences. Depending on the grade of the underlying tumor, the sensitivity of quick‐staining cytology was 86.4%, 46.2%, or 13.6% for grade 3 to grade 1 TCC, respectively. Cytology and image analysis data demonstrated complementary potency. The combination of methods increased sensitivity to 90.9%, 66.7%, and 31.8%, respectively. Although 24 of 140 image analyses denoted high risk for bladder cancer without simultaneously visible tumor, correct evidence of high risk could be found for 92.2%. CONCLUSIONS The combinatory use of quick‐staining urinary cytology and bladder wash image analysis was demonstrated to be most valuable in diagnosing recurrent bladder cancer and selecting patients needing more intensive follow‐up. At a minimum of patients discomfort, the tested combination also seems helpful to surpass diagnostic limits in cystoscopy and cytology caused by therapeutic effects on the bladder epithelium. Cancer (Cancer Cytopathol) 1999;87:263–9. © 1999 American Cancer Society.