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6th ESACP Congress, Heidelberg, April 7-11, 1999 |
A047
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.
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