Adequacy of voided urine specimens evaluated using the Paris system for reporting urine cytology

Abstract

Background: Adequacy (satisfactory) is a source of conflict and controversy in all cytopathology fields including the urinary tract specimens. Aim of the study: To examine the adequacy (satisfactory) factor of urine samples and their importance in the diagnosis of urothelial malignancy using the Paris system for reporting urinary cytology. Methods: This is a retrospective study including (314) cases of patients presented with hematuria or diagnosed as having urinary bladder mass. The slides were taken and centrifuged at 2000 RPM and stained according to the availability of the stains the year from which they obtained; Slides were taken from (2016, 2017 and 2020) were stained with (Hematoxylin and Eosin), while the slides taken from (2018-2019) were stained with (Papanicolaou) stain; In addition to some slides were stained with (Giemsa) stain in special cases, including the patients with age range of (8-98) years. All data were taken from archival files of these patients; we divide the urine volume parameter into more than and less than 30 ml. Results: the occurrence of high grade urothelial carcinoma was encountered in 8 of 103 cases (7.8%) at age below (50) years, and 13 of 74 cases (17.6%) at age from (51-60) years, and 43 of 137 cases (31.4%) at age more than (60) years. According to the association between the urine volume and the diagnosis of high grade urothelial carcinoma, there was 19 of 68 cases (27.9%) of patient’s urine volume obtained was ≥ 30 ml have high-grade urothelial carcinoma, while 45 of 246 (18.3%) of them urine volume was > 30 ml have high-grade urothelial carcinoma. According to the association between adequacy of urine sample with urine volume, there were 32 of 246 (13%) of patient’s urine volume obtained was > 30 ml having unsatisfactory urine sample for cytological analysis, while only 6 of 68 (8.8%) of patient’s urine volume obtained was ≥ 30 having unsatisfactory urine sample. Conclusion: A significant correlation between the detection of high-grade urothelial carcinoma and increase urine volume submitted for cytological evaluation, increased urine volume submitted for cytological examination decrease the frequency of unsatisfactory samples.