Has Urine Cytology a Role to Play in the Era of Fluorescence in Situ Hybridization?

OBJECTIVE To determine the efficacy of urine cytology as a diagnostic tool and in follow-up of patients with urinary bladder cancer. STUDY DESIGN From 951 cases, 1,831 urine specimens were collected in a 5-year period (2000-2004). Six hundred fifty-two cases were suspected to have primary bladder cancer and formed the basis of the study. The final diagnosis was based on histology. When histology was not available, clinical or radiologic findings formed the basis for the final diagnosis. RESULTS We had 173 false negative and 6 false positive cases in our series, giving an overall sensitivity of 82% and specificity of 96%. The main reason for false negativity was screening error, noticed in low grade urothelial carcinoma. False positivity was due to inflammatory atypia and polyomaviral cytopathic changes. CONCLUSION The sensitivity and specificity in our study compared well with those in the world literature. Urine cytology can be successfully used as a primary diagnostic tool and also as a follow-up modality as the cystoscopically occult malignancy can be detected easily.