Detection of malignant lesions of the urinary bladder using urine cytology and correlating with the histopathology findings - A prospective study

Background: Bladder cancer is the fourth most common cancer in men and the tenth most common cancer in women. It is common in industrialized countries than in developing countries, and in urban than in rural dwellers. Transitional cell carcinoma of urinary bladder may be papillary or non papillary and invasive or in situ. Non papillary tumors or at least the poorly differentiated papillary tumors arise from areas of atypical urothelial proliferation. Materials and methods: A total of 54 cases were included in the study. 67 urine samples from all the 54 cases were categorized on the basis of the guidelines of the “Five-category cytological classification”. The cases were identified on the basis of clinical features of hematuria, frequency, urgency, dysuria or past history of bladder tumor. The criteria for inclusion in our study was either a positive urine cytology with a subsequent positive/ negative biopsy or positive/ negative urine cytology followed by a subsequent biopsy, positive for malignancy. Results: In our study, 54 patients were included and 67 samples were taken. 67 Urine samples from all the 54 cases were categorized on the basis of the guidelines of the “Five-category cytological classification”. Out of 67 urine specimens from 54 patients, 16 were categorized as negative and 51 were categorized as positive for atypical or suspicious cells. Out of the 51 positive suspicious of malignancy or atypical cells, there were 20 cases of high grade lesions and 29 cases of low grade lesions. 3 out of 54 patients were less than 40 years of age and all had low grade lesions on biopsy. Conclusion: Urine cytology is simple, cost effective, non-invasive diagnostic test used for screening and detection of the early cases of bladder cancers. The sensitivity of cytology for detection of low grade and high grade lesions of bladder was 44% and 74% respectively. The specificity for both was 78%.