Accuracy of urine cytology and the significance of an atypical category.


Journal Article

The "atypical urothelial cell" cytologic category is nonstandardized. We subclassify atypical cases to "atypical, favor a reactive process" or "atypical, unclear if reactive or neoplastic." We evaluated the predictive significance of atypical cases by looking at their histologic follow-up. Among the 1,114 patients and 3,261 specimens included, 282 specimens had histologic follow-up. An atypical diagnosis did not carry a significant increased risk of urothelial neoplasia compared with the benign category. Although an "atypical unclear" diagnosis carried a higher rate of detection of high-grade cancer on follow-up biopsy in comparison with "atypical reactive" or "negative" diagnoses (26/58 [45%] vs 15/52 [29%] and 16/103 [15.5%], respectively), this difference was not statistically significant. These results suggest that dividing atypical cases into 2 categories based on the level of cytologic suspicion of cancer does not add clinically relevant information within the atypical category. They also raise the question of the significance of the atypical category altogether.

Full Text

Duke Authors

Cited Authors

  • Brimo, F; Vollmer, RT; Case, B; Aprikian, A; Kassouf, W; Auger, M

Published Date

  • November 2009

Published In

Volume / Issue

  • 132 / 5

Start / End Page

  • 785 - 793

PubMed ID

  • 19846822

Pubmed Central ID

  • 19846822

Electronic International Standard Serial Number (EISSN)

  • 1943-7722

Digital Object Identifier (DOI)

  • 10.1309/AJCPPRZLG9KT9AXL


  • eng

Conference Location

  • England