Upper urinary tract washings outperform voided urine specimens to detect upper tract high-grade urothelial carcinoma

Research output: Contribution to journalArticle

Abstract

Background: Cytological examination of voided urine (VU) can reliably diagnose high-grade urothelial carcinoma (HGUC) of the lower urinary tract, but its value in the diagnosis of upper tract HGUC (UTHGUC) is less well-established. To clarify the utility of VU in the setting of UTHGUC, we examined urinary specimens from patients with UTHGUC on follow-up surgical pathology. Methods: 52 VU specimens (47 patients) with subsequent biopsy-proven UTHGUC were identified over a 12-year period; 32 had a corresponding upper tract urinary washing (UW) specimen. Patients with concurrent bladder HGUC were excluded. The diagnoses of VU specimens were tabulated and compared to those of UW specimens. Results: Three UW specimens had a less severe diagnosis, 8 had the same diagnosis, and 21 had a more severe diagnosis than the corresponding VU specimen from the same patient. Significantly more UW specimens demonstrated high-risk features as compared with VU specimens (P =.003). In specimens with atypia, a definitive diagnosis of HGUC was made significantly more often on UW vs. VU specimens (P =.003). Conclusions: Among patients with confirmed UTHGUC, 50% of preceding VU specimens demonstrated high-grade features compared to almost 90% of UW specimens. Though VU cytology shows atypia in the majority of cases, it performs inferiorly to UW for the detection of UTHGUC. Diagn. Cytopathol. 2017;45:700–704.

Original languageEnglish (US)
Pages (from-to)700-704
Number of pages5
JournalDiagnostic Cytopathology
Volume45
Issue number8
DOIs
StatePublished - Aug 1 2017

Keywords

  • bladder cancer
  • urine
  • urothelial carcinoma
  • urothelial neoplasia

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Histology

Fingerprint Dive into the research topics of 'Upper urinary tract washings outperform voided urine specimens to detect upper tract high-grade urothelial carcinoma'. Together they form a unique fingerprint.

  • Cite this