Comparison of Urinary Cytology with Histopathological Examination in Bladder Transitional Cell Carcinoma - A Prospective Study.

Raja Elavarasan, D (2007) Comparison of Urinary Cytology with Histopathological Examination in Bladder Transitional Cell Carcinoma - A Prospective Study. Masters thesis, Madras Medical College, Chennai.

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Abstract

INTRODUCTION : Bladder cancer accounts for 7% of all cancers in male and 2% of all cancers in female.Urinary cytology has an increasingly prominent role in the multidisciplinary diagnosticapproach to bladder cancer. It is used as a valuable adjunct to cystoscopy and biopsy fordiagnosis and follow up of patients with bladder cancer. Urine cytology remains gold standard for bladder cancer screening. It is the test againstwhich all others are compared when evaluating potential bladder tumor markers. It hasexcellent specificity with few false positive casesCytological examination of voided urine is a non-invasive screening test for bladdertumors, which can be carried out in remote areas of the country. By cytology one can evenclassify type and grade malignancy. Urine cytology can detect bladder tumor before it can be detected cystoscopically. Urinecytology is still indispensable in the management of patients with transitional cell carcinoma. Itremains as a gold standard for bladder cancer screening. AIMS : 1. To correlate urine cytology with histopathology of the bladder Transitional Cell Carcinoma. 2. To study the role of urinary cytology in the diagnosis of bladder Transitional Cell Carcinoma. 3. To find out the correlation between the grading by urine cytology and histopathology. 4. To analyze the reason for false positive and false negative cytological results. MATERIALS AND METHODS :The present study was undertaken in the Department of Urology in co-ordination withInstitute of Pathology and Electron Microscopy, Madras Medical College, Govt. GeneralHospital, Chennai.From November 2004 to Feb 2007, voided urine specimens were obtained from 52 menand 2 women patients, who had symptoms suggestive of bladder tumor. Those with hematuriadue to other causes like other bladder tumors, RCC, Upper tract TCC, calculus, infection wereruled out from the study. Voided urine specimens were collected from 54 patients and subsequently bladderbiopsy specimens were obtained from these patients and results were correlated. CONCLUSION : Cytological examination of urine specimen is valuable as an aid in the diagnosis of bladder tumors. Voided urine cytology correlates with histological diagnosis in more than 60% of cases. The accuracy is more with high grade tumors. Urine cytology grading correlates in most cases with histopathological grading. The voided urine cytology is not only of diagnostic, but also of prognostic value;positive cytology of high grade presumably identifies patients at high risk for high grade and invasive tumours. Cystoscopy is essential in diagnosing low grade tumors which were mostly missed by voided urine cytology. Voided urine cytological study can be a valuable adjunct to the clinician in the evaluation of suspected urothelial malignancy, as it is simple, non-invasive and withgood accuracy in the diagnosis of TCC.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Urinary Cytology ; Histopathological Examination ; Bladder Transitional Cell Carcinoma ; Prospective Study.
Subjects: MEDICAL > Urology
Depositing User: Kambaraman B
Date Deposited: 09 Aug 2017 04:14
Last Modified: 09 Aug 2017 04:14
URI: http://repository-tnmgrmu.ac.in/id/eprint/2529

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