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Cytomorphological characteristics of low‐grade papillary urothelial carcinoma for differential diagnosis from benign papillary urothelial lesions: logistic regression analysis in SurePath ™ liquid‐based voided urine cytology
Author(s) -
Chung Y. R.,
Won J. K.,
Park I. A.,
Moon K. C.,
Chung S. Y.,
Lee K.,
Ryu H. S.
Publication year - 2016
Publication title -
cytopathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.512
H-Index - 48
eISSN - 1365-2303
pISSN - 0956-5507
DOI - 10.1111/cyt.12230
Subject(s) - medicine , urine cytology , cytology , liquid based cytology , logistic regression , urology , urothelial cell , urothelial carcinoma , urine , pathology , differential diagnosis , univariate analysis , cancer , bladder cancer , urinary bladder , multivariate analysis , urothelium , cervical cancer
Objective The diagnosis of low‐grade papillary urothelial carcinoma ( LGPUC ) in urine cytology specimens is challenging because of its subtle, minimally atypical findings. Furthermore, as SurePath ™ liquid‐based cytology ( LBC ) is becoming a widely used method in urine cytology, the inevitable cytomorphological alterations resulting from this technique call for new morphological diagnostic criteria in LGPUC . Methods Logistic regression analysis was carried out on SurePath slides from surgically proven voided urine specimens. The study was designed to include a test set ( n = 141) and a validation set ( n = 61), and evaluated significant discriminative parameters between LGPUC and benign papillary urothelial neoplasm ( BPUN ). Results Of the seven cytological findings that were found to have statistical significance in univariate analysis, five were found to be independent variables: loss of polarity of papillaroid clusters, irregular contours, absence of columnar cells, hobnail features and hyperchromasia. These independent variables had an area under the curve ( AUC ) of 0.781. Conclusions The distinctive cytological criteria identified above may prove to be helpful in cases in which other conventional criteria for LGPUC are insufficient for diagnosis.