Urinalysis for atypical cells. Preparing for a urinalysis for bladder cancer. Deciphering the results of a cytological study

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Speaking about the methods of laboratory diagnosis of early oncological pathology in the bladder, they should immediately be divided into routine methods, which are microscopic and cytological examination of the urine sediment, and rather complex biochemical methods, which allow to identify certain states of homeostasis, not only characteristic of a particular form of malignant tumor, but and prior to its occurrence.

We have in mind a biochemical study of urine, which reveals impaired tryptophan metabolism, manifested by the appearance of its carcinogenic metabolites in the urine.

This may be in patients with bladder cancer, and practically healthy people, which indicates a certain predisposition to the onset of the disease and is considered one of the endogenous risk factors.

The same can be said about the significance of the increased activity of β-hyaluronidase - a urine enzyme, under the influence of which non-carcinogenic complexes are decomposed in the bladder with the release of the active principle. So, a complex consisting of 2-amino-1-naphthol, combined with glucuronic or sulfuric acid in the liver and therefore has lost its carcinogenic properties, under the action of β-hyaluronidase or urine sulfatase, breaks down in the bladder with the formation of active 2-amino-1- naphthol, which has a carcinogenic effect on the uroepithelium.

Timely detection of early oncological pathology

Talking about early detection early oncological pathology (ERP) in the bladder, one should agree with the opinion of M. Mebel et al. that, despite significant progress in the field of diagnosis, routine methods - the study of erythrocyturia, examination of the accessible parts of the urinary tract, rectal palpation - remain the basis for early diagnosis, but are clearly not used enough. Suffice it to point out that in many patients who applied to the polyclinic with non-urological complaints, the presence of erythrocytes in the general urine test did not serve as a reason for referral to a urologist, either for general practitioners or for narrow specialists.

And meanwhile, conducting a prospective epidemiological study of a contingent of 3400 practically healthy people in order to identify their ROP of the bladder, we performed a microscopic examination of the urine sediment in 2143 persons (63.0%), and 696 (20.5%) - cytological and revealed a significant percentage of pathology in persons who were not going to apply for medical care who feel almost healthy.

Hematuria was detected in 18.1% of men at risk and 7.9% of controls, in women, respectively, 23.1% and 10.7%. Naturally, all these people need further urological examination, which will determine the cause of urological pathology, including cancer. Here it should be emphasized that laboratory diagnostics early oncological pathology in the bladder cannot be an independent method; as a rule, it must be supplemented by a cystoscopic examination with a biopsy.

All forms of macro- and microhematuria, unclear dysuria, cystalgia, abuse of analgesics, professional contacts with aromatic amines serve as indications for cytological examination of urine sediment. Cytological examination is indispensable for bladder tumors of the intraepithelial type - cancer in situ, which cannot be detected endoscopically, as well as for bladder diverticulum cancer, urethral strictures, and low organ capacity.

It should be emphasized once again that this theoretically ideal method cannot be independent either in diagnosing relapses of cancer in the bladder, or, even more so, in detecting ROP. According to many authors, this confirms a rather high percentage of discrepancies between the cystoscopic picture and the results of urine cytology, only in 70.0% of patients with uroepithelial cancer, cytological examination reveals cancer cells.

J. Tostain et al., analyzing 500 cytological studies in 342 patients with uroepithelial tumors, showed that with typical bladder papillomas, cytological examination is ineffective, with low-grade infiltrative cancers, urine cytology makes it possible to make a diagnosis in 66.0% of cases, with high - at 80.0%.

A number of authors (Mansat A. et al., Droese et al.) established a clear correlation between the degree of cell anaplasia and cytological detection of the tumor. In particular, it was shown that when using the Bergevist classification of I, II, III degrees, depending on cell anaplasia, at the first degree, the tumor was detected only in 19.0%, the second - 30.0, the third - 70.0.

Until now, there are no generally accepted cytological methods for the study of bladder tumors. Some researchers consider the method of exfoliative cytology to be valuable in the study of the urinary sediment of freshly passed urine (Enokhovich V.A., 1966; O.P. Ionova et al., 1972), others prefer aspiration biopsy (Volter D. et al, 1981), others indicate , what best results gives a method for flushing the mucous membrane of the bladder (Lomonosov L.Ya., 1978).

Errors in cytological diagnostics

Mistakes in cytological diagnosis are determined by several factors: poor material, which was obtained during the inflammatory process or tumor necrosis, a small amount of it, or mild atypia of cells. Therefore, naturally, a search is underway for the most rational taking of material for work. So N. Holmguist indicates a high degree of detection of bladder cancer (1.2 per 1000) in the cytological study of wet urine sediment preparations and suggests using this technique for screening.

L.Ya. Lomonosov recommends for mass preventive examinations high-risk groups, the method of active flushing of the bladder in its own modification, when the bladder is thoroughly washed with furacillin before flushing, then 50-100 ml of an alcohol solution of novocaine is injected at the rate of 15 ml of 96 ° alcohol per 100 ml of 1% solution of novocaine.

After 5-10 minutes, the solution is collected in a clean dish. After macrodescription of the washout, the material is centrifuged at 3000 rpm for 15 minutes, the supernatant is washed off, and smears are prepared from the centrifugate.

At the same time, a number of authors worked on a rational technique for preparing smears, since the delay in the introduction of cytological examination is largely due to the difficulties of staining cells in the urine. Therefore, C. Fiedler et al. several stains are carried out - with methylene green, pyronine and chromalun according to the method modified by them.

False-positive results are most often associated with an incorrect assessment of urothelial cells with dysplastic changes in urolithiasis, a chronic inflammatory process. So, out of 135 patients with calculi of the upper urinary tract, 7.2% had a cytological picture similar to highly differentiated cancer. In the urine of persons who have long suffered from urolithiasis, C. Dimopoulos et al. observed the presence of cells of 3 and 4 degrees of malignancy according to Pappanicolaou and their disappearance after surgical removal of stones.

O.P. Ionova et al. in inflammatory processes, atypical cells were found in cytograms, which differed little from tumor cells. The interpretation of the cytograms seems to be quite tricky business, perhaps that is why there are still no generally accepted criteria for malignancy of epithelial tumors of the bladder.

The available numerous data on this issue concern mainly the diagnosis of cancer relapses and rather rare cases of recognition of "cancer in the cell" - cancer In situ. Only a few authors describe cytograms for simple and proliferating papillomas of the bladder - G.A. Arzumanyan, V.A. Enohovich, O.P. Ionova et al., L.Ya. Lomonosov.

A number of others - M. Beyer-Boon et al. indicate that papillomas cannot be diagnosed at all on the basis of cytograms, the latter with typical papillomas do not differ from normograms, and only the detection of papillary fragments of the tumor allows a diagnosis to be made.

The fact is that cytograms of bladder washouts are normally poor in cellular elements. Most of the cells encountered are cells of the integumentary zone of the transitional epithelium. They are large, polygonal or elongated. The nuclei are small, round or oval, located centrally or slightly eccentric.

The cells of the intermediate zone are cylindrical in shape, arranged either in the form of papillary fern-like structures, or in the form of rosettes, or in the form of grape-like clusters. The nuclei are oval, the chromatin is small-lumpy, evenly distributed over the area of the nucleus. In some works, attention is drawn to the giant multinucleated cells specific for washouts with frequent mitotic figures.

From non-epithelial elements, erythrocytes, leukocytes, salt crystals are found. In the work of A.V. Zhuravlev indicates that in the washouts, normally there should be no shaped elements. During inflammation, there is an increase in the number of cellular elements due to cells of the intermediate and basal zones, transitional epithelium and cells of an inflammatory nature.

In smears with a typical papilloma, cells of the same size are found, cylindrical, oval, round and spindle-shaped. There may be "tailed" cells. Their nuclei are monomorphic with a compact chromatin structure, contain 1-2 nucleoli. The nuclear-cytoplasmic ratio is not disturbed.

According to G.A. Arzumanyan, the absence of multinucleated cells characteristic of the upper, differentiated layer of the transitional epithelium is characteristic. M.P. Ptokhov considers the most characteristic moment - the presence of elongated tailed cells.

Cytological criteria for malignancy of papillomas

Cytograms of proliferating papillomas are distinguished by more pronounced polymorphism and polychromasia of cells. The nuclei are enlarged in size, the number of nucleoli increases in them. V.A. Enochovich finds the presence of oval and rounded tumor cells characteristic of this group of papillomas. N. Hanschke notes a large number of binuclear cells.

L.Ya. Lomonosov identifies the following cytological criteria for malignancy of papillomas:

Increased mitotic activity of cells;
polymorphism of nuclei with coarsening of the structure;
decrease in glycogen content in the cytoplasm;
an increase in cell layers of more than five.

He points out that sometimes beginning malignancy is easier to detect in cytograms than histological preparations.

In transitional cell carcinoma of the bladder, all authors note polymorphism, polychromasia of cytogram cells, a violation of the nuclear-cytoplasmic ratio in favor of the nucleus, and a change in the structure of chromatin. hypertrophy and hyperplasia of the nucleoli and degenerative changes in the cytoplasm. B.L. Polonsky and G.A. Arzumanyan consider multinucleated cells characteristic of cancer.

Naturally, such a study should be carried out by an experienced specialist and requires a relatively long time. Therefore, in order to become an automatic screening method, they began to use pulse cytophotometry, which allows counting 1000 cells stained with fluorescent dye in one second.

A number of works (Klein F. et al., 1982; Frankfurt O. et al., 1984; Dean P. et al., 1986) point to a promising role in the diagnostics of the state of cytological examination of urine and the method of flow cytometry in which the measurement is made content of DNA, RNA and size of nuclei.

Pulse cytophotometry was used to quantify DNA and proteins in epithelial cells of freely flowing urine, bladder lavages, and suspensions from tumor tissue. Thus, a relationship was revealed between the presence of aneuploid cells in the washings of the bladder and the development of invasions in patients.

It has been established that most superficial bladder tumors are diploid, and aneuploidy accompanies invasion. Therefore, flow cytometric analysis of DNA content is a quantitative measure for predicting the degree of malignancy of a tumor, as well as for diagnosing cancer in situ.

In the work of K. Nielsen, a stereological assessment of the volume of the nuclei or the mucosa of the bladder in the normal and malignant process is given. The author examined 27 biopsies from the bladder: 10 - normal, 5 - with infection, 12 - with tumors. Morphometric study established the average volume of the nucleus in the norm and during infection, equal to 133 and 182 µm3, with cancer in situ - 536 µm3.

The test offered by the firm "CYTODIAGNOSTICS" based on the quantitative determination of fluorescence can help identify cells with an increased content of DNA. The applied dye is bound by cells with a high content of DNA, and this circumstance makes it possible to identify one cancer cell among a thousand normal ones. The firm suggests using this test to screen for populations at increased risk of bladder cancer.

But it should be noted that the use of the proposed methods for the prevention of bladder tumors encounters great difficulties, which begin immediately, already when urine is taken - cells in stale urine change significantly. It is clear that for preventive examinations, the most acceptable cytological examination may be the study of fresh urine sediment, neither the method of aspiration biopsy, nor the method of flushing from the bladder mucosa can become widespread.

The cytological study of urine sediment, which we used to detect early oncological pathology of the bladder in prophylactically examined contingents, did not justify our hopes - not once during the examination were 696 practically healthy individuals, of which 185 (38.6%) were at risk, and 511 (17.4%) - to the control, no signs of cell atypia were found, although the study was carried out by experienced cytologists in the central cytological laboratory of the city

Separate methods of laboratory research

Separate methods of laboratory research reveal a known predisposition to the occurrence of this form of cancer. We mean endogenous risk factors - impaired tryptophan metabolism with the appearance in the urine of its carcinogenic metabolites - 3-hydroxyanthranilic acid, 3-hydroxykynurenine, kynurenine, etc., as well as increased activity of urinary β-hyaluronidase.

The presence of carcinogenic metabolites of tryptophan in the urine indicates an increased risk of the disease; it is often determined in patients with bladder cancer, including recurrent ones, and indicates the need to correct tryptophan metabolism, i.e. engage in biochemical prophylaxis of the tumor.

When forming risk groups according to epidemiological tests, the identification of individuals with the presence of carcinogenic metabolites of tryptophan in the urine helps to further narrow the circle of individuals. requiring the close attention of a urologist.

To determine the spectrum of tryptophan metabolites in the urine of the examined, one-dimensional descending chromatography on paper can be used. The extraction of metabolites is performed once from 100 ml of morning urine according to the Makino method in the modification of Wachstein, Lobel.

To do this, urine is saturated with ammonium sulfide to precipitate proteins and salts. The urine is then filtered. To the resulting filtrate add 20 ml of molten phenol and shake for 20-25 minutes on a universal shaker. The resulting mixture is settled in a separating funnel, where two layers are quickly separated: the upper one is yellow with a brown tint - the phenol layer, the lower one is colorless - the urine layer.

The lower one is removed, 20 ml of sulfuric ether is added to the upper one and shaken vigorously to improve the dissolution of phenol in ether. In this case, phenol passes into the upper, lighter layer, and the ether-insoluble aqueous fraction containing aromatic tryptophan derivatives remains in the lower part of the separating funnel in the form of a dark oily layer with a volume of 0.5-0.7 ml.

This layer is carefully poured into an evaporating dish and dried in a fume hood. The dried extract is dissolved in 0.2 ml of distilled water and applied in an amount of 0.02 ml to chromatographic paper ("Leningrad slow"), pre-washed with a mixture of ether and alcohol in a ratio of 3:1.

After drying, the paper is placed in a chamber pre-saturated with solvents. As a solvent, the following solvent system is used - N-butyl alcohol: glacial acetic acid: water - 4:1:1. Acceleration is carried out at room temperature for 20-24 hours.

After that, the chromatograms are dried and treated with Ehrlich's reagent (12 g of paradimethylaminobenzaldehyde + 20 ml of 6NHCI + 80 ml of ethanol). Immediately after this, yellow-orange spots appear on the chromatograms, which give urea and aromatic derivatives of tryptophan with this reagent, and bluish-lilac spots due to the indole derivatives of the latter.

According to the characteristic color with Ehrlich's reagent, the Rf value and comparison with the standards, the described method makes it possible to identify the following tryptophan metabolites - urea, tryptamine, indican, tryptophan, 3-hydroxykynurenine, kynuranine, 3-hydroxyanthranilic acid. The latter is the most potent endogenous uroepithelial carcinogen, giving a characteristic pinkish-orange stain with Ehrlich's reagent and an Rf value of 0.75-0.8.

Determination of activity | hyaluronidase urine is carried out for the same purpose. But this method makes it possible to differentiate bladder papillomas from invasive cancer and is regarded by most authors as an auxiliary in the diagnosis of bladder epithelial tumors.

The activity of the enzyme in the urine is determined by the conventional phenolphthalein method. For this, urine is collected per day under a thin layer of toluene, which protects it from decomposition; then its total volume is determined, specific gravity, the presence of protein, leukocytes, sugar, and culture for microflora is mandatory.

The latter is necessary due to the fact that various microorganisms, especially Escherichia coli, can be a source of β-hyaluronidase. In cases of infection of the bladder, urine is excluded from further research.

Then, 4-5 ml of urine is taken from each sample, which is centrifuged in a TsNL-2 centrifuge at 8-9 thousand revolutions for 8-10 minutes. Subsequently, according to the number of samples under study, 0.5 ml of 0.1 M acitate buffer is poured into graduated glass centrifuge tubes with a volume of 10 ml, 0.5 ml of 0.05% solution of the femolphthaleinglucuronide substrate (Sigma) is added here, and only at the very end of the test and pre-centrifuged urine.

The addition of alkali made the pH of the mixture equal to 10.2-10.4, i.e., the optimum at which the most intense crimson-red coloration of phenolphthalein separated under the influence of urinary β-hyaluronidase occurs. Further determination is carried out on the SF-4 spectrophotometer at a wavelength of 540 mm

The stained samples are compared with the so-called "empty" baths, which contained the same solutions and in the same concentrations and quantities, but were not subjected to incubation and were prepared immediately before the determination of phenolphthalein in each test sample.

The amount of released phenolphthalein is determined according to a pre-compiled calibration scale, followed by recalculation per 1 ml per 1 hour of incubation.

The level of enzyme activity in the analysis of urine healthy individuals ranged from 0.4 to 1.1 and averaged 1.0 units. Fishman at 1 ml/hour. With papillomas of the bladder, an increase in enzyme activity by 1.2-1.4 times is noted. Moreover, this increase is constant and does not depend on ongoing therapeutic measures. In bladder cancer, the activity of β-hyaluronidase in the urine is increased by at least 2-3, and sometimes more times, reaching 5 Fishman units.

When determining the activity of this enzyme, one should take into account, firstly, comorbidities in patients. This applies, first of all, to hepatitis and pancreatitis, which in themselves give a sharp increase in its activity in the urine. Secondly, it should be emphasized that even performing cystoscopy alone, not to mention more complex surgical interventions, immediately leads to an increase in the level of enzyme activity in the urine compared to the initial data, and only after 8-10 days the activity of β-lucuronidase returns to the original numbers.

According to M.N. Vlasova et al., which we present here, there are no differences in the increase or decrease in enzyme activity depending on the age and sex of patients, as well as chemotherapy or radiation treatments.

The authors use this method as an auxiliary method for diagnosing epithelial tumors in the bladder. It can also be recommended when carrying out measures for the biochemical prevention of bladder cancer, aimed at reducing the activity of β-lucuronidase in the urine to control this activity.

Naturally, due to laboriousness and complexity, the method cannot be used as a screening method, but in risk groups its use is fully justified in order to identify individuals who have an important endogenous risk factor and, therefore, need appropriate preventive measures.

Pryanichnikova M.B.

A cytological study of urine, or analysis of urine for atypical cells, is a study of the structure of the elements of this biological fluid under a microscope. The evaluation of the material is carried out to establish the presence or absence of signs of malignant degeneration and other pathological processes in the cells. The method allows timely detection or control of diseases of the urinary system.

Purpose of the study

Urine for cytology is given under such conditions:

suspicion of a neoplasm in the bladder, as well as the kidneys, ureters, urethra, prostate gland (prostate). The indication is hematuria - the presence in the urine of blood cells - erythrocytes. In some cases, the analysis is prescribed for violation of urination;
control of possible recurrence of urinary tract cancer;
the inability to use colposcopy and other methods to study the state of the reproductive system in women (in virgins, during menstruation, with extensive inflammation). In this case, urine cells are examined.

Laboratory cytological examination is carried out to diagnose oncological diseases of the urogenital area

Urine sediment cytology cannot diagnose such benign bladder tumors as lipoma, fibroma, leiomyoma, neurofibromatosis, as well as pathological tissue growth - endometriosis. However, the method allows you to detect papillomas in time, preventing their degeneration, as well as detect cancer cells.

How to prepare for a urinalysis

The study does not require special preparation. Before the procedure, it is desirable to carry out the hygiene of the genital organs, and then collect the urine in a sterile container, hermetically sealed with a lid.

It is desirable to deliver the sample to the laboratory within two hours.

The time of fluid sampling depends on the direction of the study:

To analyze hormonal changes during a woman's menstrual cycle, the first portion of morning urine is required, which contains the most cellular elements, although sometimes material taken at another time of day is used.
To detect atypical cells, on the contrary, it is not recommended to study morning urine, it is better to wait 3 hours after the first urination and urinate into a container, collecting all the excreted fluid.
The most accurate results for tumors of the bladder are obtained with the cytology of urine isolated by aspiration through a catheter - when the liquid is sucked out of the organ cavity with a syringe.

This method evaluates the human microflora

What will the cytological test tell about

for abnormal cells

Diagnosis of neoplasms of the urinary tract is based on the desquamation of the cells of these tumors and their entry into the urine:

In a benign process, individual cells or entire layers of transitional epithelium (the layer lining the inner surface of the bladder) are detected in the material, the structure of which resembles the normal epithelium of the organ. The shape of these elements is often spindle-shaped, together with them, the presence of erythrocytes is recorded in the urine.
In bladder cancer, transitional epithelial cells have pronounced signs of atypia - their structure differs even from each other. At the same time, erythrocytes in large numbers and necrotic masses are present in the sample.

In the laboratory, native (unchanged) and specially stained smears are prepared from the sediment of the material. Then, under a microscope, the morphological composition of the cells is studied. In addition to the presence of a benign or malignant tumor, cytological analysis helps to detect other lesions of the urinary tract, for example, an inflammatory process.

In addition, cytology is done for those patients who are at the final stage of treatment of the disease.

The results of a study on atypical cells can be as follows:

Unsatisfactory sample - collected urine not suitable for research (contains an insufficient number of cells or impurities that should not be in the material). It is necessary to repeat the diagnosis.
The analysis is negative - there are no cancer cells in the urine.
Atypical urine cytology - some changes are found in the cells of the sample, but without malignant signs.
Suspicious cytology - cellular material is not normal, cancer is possible.
A positive analysis - there are malignant tumor cells in the urine.

The sensitivity of the method is about 90%. However, the study may have errors, this is affected by infectious lesions of the urinary tract, insufficient number of cells, stones in the bladder or kidneys, intravesical instillations (infusion of medications). If the analysis turns out to be positive, to confirm the diagnosis, they resort to cystoscopy - a biopsy (pinching off) of the tissues of the bladder, followed by microscopic examination.

The advantage of this analysis is that the cytological test, compared to other studies, does not require much time.

To hormonal fluctuations

In this case, native and stained smears are also studied, and then the number of cells in them is counted. different types, among which:

basal;
intermediate;
basophilic (keratinizing);
acidophilic (keratinized);
non-nuclear acidophilic.

Particular attention is paid to the latter - the number of these elements in different days cycle is 2-20% and indicates the release of adrenal hormones (more than the ovaries).

Other indicators

Microscopy of the urine sediment is part of the general analysis of urine and can reveal other pathologies. For example, when the level of leukocytes is above the norm, they speak of an inflammatory process, and the detection of bacteria or fungi indicates infections of the urinary tract.

Women are often exposed to diseases of the urinary system, which are infectious or inflammatory. This is due to the anatomical features of the structure of the female pelvis. Not always a visual examination using a cystoscope is sufficient to make an accurate diagnosis, so it is advisable to conduct cytological studies.

Cytology of the bladder is a diagnostic measure that allows you to check the bladder in women for cancer.

This study is prescribed in a situation where there is a suspicion of the presence of a malignant formation in the organs of the urinary system. Often, patients who have a high probability of detecting cancer cells resort to this method.

Indications for cytological examination

Cytology of the bladder is prescribed for those patients who:

malignancy has already been identified. tumor organs of the urinary system, cytological studies in this case allow you to track how the disease proceeds;
there is a suspicion of malignant tumors, diagnostics reveals cancer;
present blood in the urine, this serves as a signal of the presence of pathology, so the doctor without fail prescribes a cytological diagnosis;
treatment of the disease is completed, timely diagnosis allows assessing the course of treatment and avoiding relapse illness.

What is studied through cytology

Cytological examination of the bladder is a study using a microscope of the sediment of a urine sample obtained after centrifugation of the biomaterial. Such a study is carried out by a specialist histologist in the laboratory.

The purpose of cytology is to detect altered cells that can be excreted in the urine. Diagnostics allows to identify with high accuracy the presence of a malignant process in the organs of the urinary system.

However, if you receive an unsatisfactory, atypical or suspicious result, you should resort to passing repeated and additional tests.

Preparation for the procedure

To take a urine sample for analysis, you should follow such general rules as personal hygiene and the use of a sterile container designed to collect biomaterial.

A significant difference in the preparation for cytology lies in the time of collection and the amount of material collected.

Urine collection is carried out in the morning, but not immediately after waking up. Biomaterial for analysis is collected approximately 2 hours after the bladder has been emptied by fluid accumulated during the night. If the morning rise is carried out at 7 o'clock, then it is better to immediately visit the toilet and defecate.

You should not drink a lot of liquid, as it can dilute the urine. It is recommended to immediately take the sample to the laboratory in order to obtain a more accurate test result.

If the biomaterial needs to be taken from people who lead a recumbent lifestyle or are seriously ill, then a catheter is provided for such situations. A number of hygiene procedures should be carried out: wash the perineum, wipe it with a towel, install a catheter and collect a urine sample.

Deciphering the results of a cytological study

In each laboratory, the result of the study is expressed in terms and units of measurement that are different from those obtained in other laboratories. It depends on the equipment that is used to conduct the study.

The results of the diagnosis are provided to the attending physician, who examines them and makes a diagnosis. However, there are generally accepted medical terms that are used in all clinics and laboratories, and have an unambiguous interpretation, accessible even for self-understanding.

An unsatisfactory result indicates that the study did not reveal the number of abnormal cells that would allow an accurate conclusion, so you should retake the tests.

An atypical result indicates that cells of an atypical shape were detected in the samples presented, however, such data do not carry accurate information about whether there are cancers in the organs of the urinary system. Additional tests are required.

Suspicious result serves first alarm signal. This suggests that suspicious cells were found, but such neoplasms can also be benign.

A positive result indicates that cancer cells have been detected. It is possible to identify which organ of the urinary system has undergone cancer with the help of diagnostics of a narrow specialty. In the future, special treatment is prescribed.

A negative result indicates that the presence of cancer cells in the patient's body has not been identified.

To diagnose bladder cancer, it is necessary to conduct not only a urine test, but also a study of the whole organism as a whole. Then, having all the collected tests in hand, the attending physician diagnoses the patient and selects the appropriate treatment.

The positive point of cytological diagnosis is that, unlike other studies, it is carried out quickly (3-5 days), and the results obtained make it possible to start timely treatment. Often, the doctor may prescribe several such studies in order to make an accurate diagnosis and establish the fact of oncology.

urine cytology- this is special study urine with a microscope. The purpose of this analysis is to detect atypical or cancerous cells. As a rule, the doctor prescribes a similar analysis if a tumor of the urinary tract is suspected.

Cytology is most often given if bladder cancer is suspected, although the results can be used to suspect oncological diseases of the kidney, ureters and urethra, and prostate cancer.

Your doctor will definitely order tests if you have had episodes of blood in the urine. Urine cytology is also obligatory in patients suffering from oncology of the bladder. Monitoring allows timely detection of recurrence of the disease.

urine cytology may fail to diagnose small and benign urinary tract tumors, but usually easily diagnose large cancers.

There are some risks in interpreting the result of the analysis. They are usually associated with violations of the analysis collection method. Be sure to collect urine in a clean container, one serving is enough. If urine is collected using a catheter, there may be deviations in the results due to the risk of urinary tract infection.

How to pass a urine cytology?

The first morning urination is not suitable for analysis, since the cells remained in the bladder all night, could be destroyed and this will cause difficulties in diagnosis. In the morning, urinate, take a shower, then you will need to collect urine for the test. A sterile container is best for collection and storage. The doctor may prescribe a collection of urine samples for a whole week. Examination of a large number of samples increases the accuracy of urine cytology results.

In the laboratory, a specialist histologist or pathologist will analyze all the cells of the sample and describe their types, identify changes that indicate pathology.

Each laboratory describes the results of urine cytology in its own way, but there are general terms that appear in almost every result:

Unsatisfactory sample - means that you need to repeat the analysis, because an insufficient number of cells or the wrong types of cells were found in the analysis sample.
Negative urine cytology - there are no cancer cells in the urine sample.
Atypical urine cytology - small changes were found in the cells of the sample. The cells were not normal, but at the same time they did not look like cancer cells.
suspicious urine cytology– the cells in the sample were not normal and could possibly be cancerous.
Positive urine cytology - the urine sample is stained with malignant cells.

When diagnosing oncology of the urinary tract, not only urine cytology analysis is used, but only the initial stage of the examination. If abnormalities were found during cytological studies, the doctor prescribes cystoscopy to examine the bladder and urinary tract.