[Identification of factors conditioning urinary cytology in bladder cancer]

To identify the clinical and tumoral aspects related with urinary cytology as a means of validating current criteria or determining the usefulness of this test in the diagnosis of bladder tumors.

96 patients that were posteriorly diagnosed as having primary transitional cell carcinoma of the bladder were initially evaluated by urinary cytology. The diagnoses were positive, negative or inconclusive cytology. Any abnormality (for both inconclusive and positive cytologies) were considered as compatible with tumor. To determine the relationship between patient characteristics and tumors, and the results of cytology, standard univariate statistical analysis was performed. To eliminate the confounding factors, a multivariate analysis was performed.

Cytology was positive on 44 (45.8%), inconclusive on 22 (23%) and negative on 30 (31.2%) occasions. Age > or = 55 years (p < 0.05), grade (p < 0.05), tumor aspect (p < 0.01) and size (p < 0.001) were associated with a higher frequency of cytologies compatible with tumor. Multiple regression analysis identified tumor size as the only independent variable related with the cytologies compatible with tumor [odds ratio = 8.68 (2.7-26.9)].

If, as the results of the present analysis suggest, the real effect of cytological analysis in the initial diagnosis of bladder tumors is the anticipation of different features of tumor grade and stage (as patient age, tumor size, aspect and number), its utility would be very limited since other more precise tests (US, cystoscopy...) that provide this information are available.