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.
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.
摘要：
目标：鉴于其频繁复发和高级转化的潜力，尿细胞学检查对低级别乳头状尿路上皮癌(LGPUC)的准确诊断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特征，这可能有助于LGPUC的鉴定。
方法：我们对组织病理学诊断为LGPUC的患者的尿液标本进行了回顾性分析。将其细胞形态学特征与良性疾病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个尿液样本，包括30个良性的，41LGPUC，和44例HGPUC病例。在LGPUC，18例（44％）被诊断为不典型，比例明显高于良性病例(4例，13%），而其余23例(56%)诊断为阴性。LGPUC尿液样本往往比良性病例具有更高的细胞密度，但差异无统计学意义。三个细胞学特征，即核扩大，更高的核-细胞质（N/C）比，和小细胞簇的存在，与良性病例相比，LGPUC在统计学上更普遍，尽管变化相对微妙。相比之下,LGPUC和HGPUC的细胞形态学区别很明显，作为高细胞，核扩大,嗜铬症,高N/C比，不规则的核膜，细胞凋亡在HGPUC病例中明显更普遍。
结论：排尿尿样中的一些细胞形态学特征在LGPUC患者中更为普遍，尽管并非在所有情况下都观察到。由于这些改变相对微妙，仔细注意这些细胞形态学细节对于提示LGPUC的可能性至关重要。
方法：我们对组织病理学诊断为LGPUC的患者的尿液标本进行了回顾性分析。将其细胞形态学特征与良性疾病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个尿液样本，包括30个良性的，41LGPUC，和44例HGPUC病例。在LGPUC，18例（44％）被诊断为不典型，比例明显高于良性病例(4例，13%），而其余23例(56%)诊断为阴性。LGPUC尿液样本往往比良性病例具有更高的细胞密度，但差异无统计学意义。三个细胞学特征，即核扩大，更高的核-细胞质（N/C）比，和小细胞簇的存在，与良性病例相比，LGPUC在统计学上更普遍，尽管变化相对微妙。相比之下,LGPUC和HGPUC的细胞形态学区别很明显，作为高细胞，核扩大,嗜铬症,高N/C比，不规则的核膜，细胞凋亡在HGPUC病例中明显更普遍。
结论：排尿尿样中的一些细胞形态学特征在LGPUC患者中更为普遍，尽管并非在所有情况下都观察到。由于这些改变相对微妙，仔细注意这些细胞形态学细节对于提示LGPUC的可能性至关重要。
