Cytomorphological characteristics of low-grade papillary urothelial carcinoma in voided urine samples: Distinction from benign and high-grade papillary urothelial carcinoma

IF 1.2 4区医学 Q4 CELL BIOLOGY

Cytopathology Pub Date : 2024-07-11 DOI:10.1111/cyt.13413

Kotaro Takeda, Adebowale J. Adeniran, Angelique W. Levi, Haiming Tang, Guoping Cai

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Abstract

Objective

Given its frequent recurrence and the potential for high-grade transformation, accurate diagnosis of low-grade papillary urothelial carcinoma (LGPUC) in urine cytology is clinically important. We attempted to identify cytomorphologic features in urine samples, which could be helpful for the identification of LGPUC.

Methods

We conducted a retrospective review of voided urine specimens collected from patients with histopathologic diagnoses of LGPUC. Their cytomorphological features were compared with those from patients with benign conditions and high-grade papillary urothelial carcinoma (HGPUC).

Results

A total of 115 voided urine specimens were evaluated, including 30 benign, 41 LGPUC, and 44 HGPUC cases. In LGPUC, 18 cases (44%) were diagnosed as atypical, a proportion significantly higher than that observed in benign cases (4 cases, 13%), while the remaining 23 cases (56%) were diagnosed as negative. LGPUC urine samples tended to have higher cellularity than benign cases, but the difference was not statistically significant. Three cytological features, namely nuclear enlargement, higher nuclear-to-cytoplasmic (N/C) ratio, and presence of small cell clusters, were statistically more prevalent in LGPUC compared to benign cases, although the changes were relatively subtle. In contrast, cytomorphological distinction between LGPUC and HGPUC was evident, as high cellularity, nuclear enlargement, hyperchromasia, high N/C ratio, irregular nuclear membrane, and apoptosis were significantly more prevalent in HGPUC cases.

Conclusions

Several cytomorphologic features in voided urine samples were more prevalent in cases with LGPUC, albeit not observed in all instances. Since these alterations were relatively subtle, meticulous attention to these cytomorphologic details is crucial to suggest the possibility of LGPUC.

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排空尿液样本中低级别乳头状尿路上皮癌的细胞形态学特征：与良性和高级别乳头状尿路上皮癌的区别。

目的：鉴于低级别乳头状尿路上皮癌（LGPUC）经常复发并可能发生高级别转化，因此在尿液细胞学中准确诊断低级别乳头状尿路上皮癌（LGPUC）具有重要的临床意义。我们试图确定尿液样本中的细胞形态学特征，这可能有助于鉴别 LGPUC：我们对组织病理学诊断为 LGPUC 患者的排空尿液标本进行了回顾性研究。方法：我们对组织病理学诊断为 LGPUC 患者的排空尿液标本进行了回顾性研究，并将其细胞形态学特征与良性病变和高级别乳头状尿路上皮癌（HGPUC）患者的细胞形态学特征进行了比较：结果：共评估了 115 份排尿标本，包括 30 例良性病例、41 例 LGPUC 和 44 例 HGPUC。在 LGPUC 中，18 例（44%）被诊断为非典型，这一比例明显高于良性病例（4 例，13%），而其余 23 例（56%）被诊断为阴性。与良性病例相比，LGPUC 尿液样本的细胞率较高，但差异无统计学意义。与良性病例相比，LGPUC 的三个细胞学特征，即核增大、核与细胞质（N/C）比值升高和出现小细胞团，在统计学上更为普遍，尽管这些变化相对细微。相比之下，LGPUC和HGPUC的细胞形态学区别很明显，因为高细胞度、核增大、高色素沉着、高N/C比值、不规则核膜和细胞凋亡在HGPUC病例中明显更普遍：结论：尽管并非在所有情况下都能观察到LGPUC病例，但排空尿液样本中的一些细胞形态学特征在LGPUC病例中更为普遍。由于这些改变相对微妙，因此仔细观察这些细胞形态学细节对提示 LGPUC 的可能性至关重要。

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来源期刊

Cytopathology 生物-病理学

CiteScore

2.30

自引率

15.40%

发文量

107

审稿时长

6-12 weeks

期刊介绍： The aim of Cytopathology is to publish articles relating to those aspects of cytology which will increase our knowledge and understanding of the aetiology, diagnosis and management of human disease. It contains original articles and critical reviews on all aspects of clinical cytology in its broadest sense, including: gynaecological and non-gynaecological cytology; fine needle aspiration and screening strategy. Cytopathology welcomes papers and articles on: ultrastructural, histochemical and immunocytochemical studies of the cell; quantitative cytology and DNA hybridization as applied to cytological material.