6th ESACP Congress, Heidelberg, April 7-11, 1999

A047
CYTOMORPHOLOGY AND IMAGE CYTOMETRY OF VOIDED URINE SEDIMENTS IN CYTOLOGIC DIAGNOSIS
Cuijpers VMJI, Gemmink JH, Van Der Laak Jawm, De Leeuw H, De Wilde PCM, Pahlplatz MMM, Hanselaar AGJM

Department of Pathology, University Hospital Nijmegen, Nijmegen, Netherlands

Light microscopic analysis of urothelial cells in voided urines is a valuable but limited tool for the primary cytological diagnosis of urothelial cell carcinomas (UCC). The cytomorphological distinction between normal urothelium and grades of urothelial cell atypia cannot always be made. Image cytometry (IC) has been shown to be of value for the prediction of recurrence of UCC. The aim of this study was to determine whether cytomorphology, DNA ploidy analysis or cytometric features could generate a useful classifier. All urines were divided into benign (n=29), when the patients histology was proved negative (=no carcinoma) or when 2 subsequent cytological examinations were negative and malignant (n=71), when the follow up showed presence of carcinoma in the histologic examination of the biopsies. Initial cytomorphology classified 23 out of 29 benign-, and 63 out of 71 malignant cases correctly. Besides cytomorphology, IC DNA analysis, including DNA ploidy and cytometric features as morphometric-, densitometric- and chromatine texture features, was performed on these urine sediments. The slides were Schiff Feulgen stained and DNA measurements were performed on the CAS-100 image analysis system. Nuclei of lymphocytes, granulocytes and squamous epithelial cells were used as internal control. Subsequent DNA ploidy measurements showed that 84% of the benign cases were diploid. Of the malignant cases 6% were diploid, 72% aneuploid and 16% polyploid. The overall classification of the cytomorphology, IC DNA ploidy analysis and cytometric features is respectively 86%, 91% and 88%. IC DNA ploidy analysis is a valuable tool for diagnosis of urothelial cells in voided urine sediments.