Urologic Clinics of North America 6(3): 599-612, 1979.
Rife CC, Farrow GM, Utz DC
Historical data on neoplastic tissue in the urine are presented and extrinsic factors that influence the appearance of cells in the urine of patients with neoplasms are discussed. A formal study to assess the diagnostic accuracy of urine cytology was carried out on 8,140 patients (greater than 35 yr old) who had a cytoscopic examination and a cytological examination of voided urine. From 10,338 paired procedures, 913 bladder tumors were clearly visualized at cystoscopy. Of these 913 tumors, 634 were established by examination of tissue. The larger the diameter of the tumor was, or the greater the number of seen at cystoscopy (except for very small tumors which had a small surface area), the higher the percentage of positive results obtained in the cytological examination. Papillary neoplasms were less likely to be detected, and sessile tumors were much more readily detected, by cytology. Among patients with grade 1 tumors, 22% had positive cytological results; grade 2, 65%; grade 3, 84%; and grade 4, 83%. There were 279 patients in whom the cytological findings were atypical and 203 patients in whom the cytological findings were positive for the presence of malignant cells; a very high proportion of these patients were proved at cystoscopy to have cancer. Among the 1,310 patients with bladder cancer, 872 had positive results by cytologic test. The percentage of bladder tumor-free patients that the test correctly called negative was 95.%. (10 Refs)
Rheinische Friedrich- Wilhelms- Universität Bonn