Bladder wash flow cytometry in transitional cell carcinoma: useful or misleading?
To evaluate the practical usefulness of flow cytometry (FC) applied to bladder wash specimens for the diagnosis of transitional cell carcinoma (TCC), a study was conducted on a series of 101 cases comprising 60 patients with tumor or with past history of TCC, and a control group of 41 patients undergoing cystoscopy for causes other than TCC in which the absence of tumor was confirmed after 1 year of follow-up. When results of the 33 patients with tumor were compared with those of the control group, FC gave low specificity and positive predictive values (54% and 58%, respectively). Conventional cytologic study was superior to FC in this setting. Although the combination of both techniques increased the sensitivity for low-grade tumors, specificity remained lower than that of cytologic study alone. Otherwise, when considering only the cases with a past history of TCC, results of FC were superior to those of cytologic examination, and the combination of both techniques gave high sensitivity and negative predictive values (94% and 93%, respectively). In conclusion, the use of FC in a general diagnostic setting could be misleading, whereas in the follow-up of patients with a history of TCC it becomes a useful adjunct to cytologic study in order to obtain a high diagnostic performance that could allow cystoscopies to be spaced out in these patients.
Solé
M
M
Department of Pathology, Hospital Clínic i Provincial, University of Barcelona, Spain.
Alós
L
L
Mallofré
C
C
Romero
J A
JA
Muntané
J
J
Cardesa
A
A
D002295:Carcinoma, Transitional Cell / Q000473:pathology*; D003584:Cytological Techniques; D005434:Flow Cytometry / Q000379:methods*; D005500:Follow-Up Studies; D006801:Humans; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D007507:Therapeutic Irrigation; D001743:Urinary Bladder / Q000473:pathology*; D001749:Urinary Bladder Neoplasms / Q000473:pathology*