Changing Pattern of Bladder Cancer Cytology. (Haynal Imre University Experience)

Urinary cytology reports of 151 patients with histologically verified tumors from the periods 1981-1985 and 1991-1995 were analyzed. No significant change in the overall sensitivity of tumor detection (76% and 76.8%, respectively) was found. In the group of well-differentiated (G0-G1) tumors, however, 60% of the more recent cases were cytologically positive or suspicious, 23% more than ten years ago. A decrease in the detection rate of G2 tumors in the last period (72% versus 89%) was probably caused by false negative reports due to frequent inflammatory changes in the specimens. Poorly differentiated (G3-G4) transitional cell tumors resulted in a high rate of positive cytological diagnoses (93% in both periods). In cases with negative cytology at clinical suspicion of tumor, repeated sampling increased the detection rate of G0-G1 lesions from 53% up to 60%. Optimal sampling and preparation technique, cytopathologists training and improved follow-up of patients are preconditions of sensitive and specific urinary cytology.