METHODS: Consecutive urine cytology specimens with atypical/C3, suspicious/C4 or malignant/C5 diagnoses matched with a nephrectomy or ureterectomy specimen with UC or RCC over a 15-year period were reviewed for cellularity, architecture, background composition and cytomorphologic features.
RESULTS: Totally 132 specimens were retrieved, comprising 24 RCCs and 108 UCs. Clear cell RCC (CCRCC) (n = 18) was the most common RCC. Urine cytology specimens from UC showed a trend of higher cellularity (p = 0.071) against RCC and was significant in subgroup analysis with CCRCC (p < .001). Epithelial structures in sheets, tubules, and papillae were exclusive in specimens of UC (p < .05). For background features, squamous cells were more common for RCC (p = .006) including CCRCC (p = .003), whereas polymorphs (p = .011) and necrotic material (p = .010) were associated with UC. Average nuclear size was larger and nuclear size variation (p < .001) and nuclear-cytoplasmic ratio (p = .001) were greater in UC (p = .001) than RCC. Comparing RCC to high-grade UCs only, nuclear-cytoplasmic ratio maintained statistical significance (p = .006) while average nuclear size showed a trend (p = .063).
CONCLUSIONS: A clean background free of tumor necrosis and polymorphs, and the lack of complex tumor fragments favors RCC. UCs also display larger nuclear size, higher nuclear size variation and nuclear-cytoplasmic ratio. These cytomorphological features with corroboration of clinical/radiological findings, can aid in raising a diagnosis of RCC.
方法:连续的尿液细胞学标本,其诊断为非典型/C3,可疑/C4或恶性/C5,并与UC或RCC的肾切除术或输尿管切除术标本相匹配,为期15年。architecture,背景组成和细胞形态学特征。
结果:共检索到132个标本,包括24个RCC和108个UC。透明细胞RCC(CCRCC)(n=18)是最常见的RCC。来自UC的尿细胞学标本显示出针对RCC的较高细胞含量的趋势(p=0.071),并且在CCRCC的亚组分析中具有显着意义(p<.001)。床单中的上皮结构,小管,和乳头在UC标本中是唯一的(p<0.05)。对于背景功能,鳞状细胞更常见于RCC(p=.006),包括CCRCC(p=.003),而多晶型物(p=.011)和坏死物质(p=.010)与UC相关。UC(p=.001)的平均细胞核大小较大,细胞核大小变化(p<.001)和核质比(p=.001)大于RCC。仅将RCC与高品位UC进行比较,细胞核-细胞质比率保持统计学显著性(p=.006),而平均细胞核大小显示出趋势(p=.063)。
结论:干净的背景没有肿瘤坏死和多晶型物,缺乏复杂的肿瘤片段有利于RCC。UC也显示更大的核尺寸,较高的核大小变异和核质比。这些细胞形态学特征证实了临床/放射学发现,可以帮助提高RCC的诊断。