Urine cytology in the detection of XXXX .

@entity1 @entity5 @entity189 @entity1358 @entity703
Whereas urine cytology has proved to be of considerable diagnostic value for nonpapillary @entity189 , @entity189 in situ, and high-grade urothelial @entity5 , controversy has arisen over the accuracy of cytology in the diagnosis of @entity703 . To establish the reliability of urine cytology as a detection technique, 436 urine specimens from 59 @entity1 with histologically proven @entity1358 were examined. Malignant cells in urinary sediment were found in 121 (27.75%) specimens from 31 (52.54%) @entity1 . Seven of 20 (35%) @entity1 with Stage I @entity5 showed neoplastic cells in 16 (16.5%) of 97 urinary samples. Positive cytologic features were found in 36.9% of 84 urinary specimens from 7 (50%) of 14 @entity1 with @entity5 smaller than 5 cm. Using only imaging methods, the @entity703 was diagnosed in 58 (98.3%) cases. Urine cytology is, therefore, of little value in the diagnostic evaluation of known renal masses and in the detection of early-stage disease. In the current series there was not a single case with positive cytologic findings in which radiology did not reveal the @entity5 . The cytologic examination of the urinary sediment is unreliable in the diagnosis of radiologically unresolved cases of @entity703 . In 15 @entity1 (44%) who had @entity5 cells in the urine the @entity5 had not invaded the renal pelvis. In 36% of @entity1 with negative urine cytologic findings the renal pelvis was involved by @entity1358 . In the current study the desquamation of neoplastic cells in the urinary stream did not depend on @entity5 invasion of the renal pelvis. Based on the assumption that the primary objective of a screening procedure is to achieve an adequate sensitivity for early detection of disease, the results led the authors to conclude that the use of urine cytology as a possible screening test of @entity1358 is futile. Factors in the current study that diminished the practical value of cytologic examination of urinary sediment included the large number of specimens without malignant cells and the insensitivity of the procedure in diagnosing early @entity1358 of limited extent. Although this is the largest series reported, the number of cases considered was limited and further detailed studies are mandatory to definitively clarify the value of urine cytology in detecting @entity1358 .
