[Comparison of perioperative methylene blue-stained and permanent Papanicolaou-stained urine cytology to detect patients with high-grade urothelial cancer or the urinary bladder. Part 1].
BACKGROUND
The aim of the study was to investigate whether intraoperative methylene blue-stained and permanent Papanicolaou-stained urine cytologies show comparable accuracy in detection of high-grade urothelial carcinoma.


METHODS
The study included 130 patients; 50 patients were without malignancy (25 follow-up, 25 with hematuria). In 80 patients transurethral resection due to urothelial carcinoma was performed. Per patient two cytology specimens were prepared: one immediate methylene blue-stained specimen, which was evaluated by the surgeon, and one Papanicolaou-stained permanent cytology slide, which was blinded and evaluated by one urologist.


RESULTS
Cytology results of all patients without malignancy were unsuspicious irrespective of the staining method. Of 80 patients with urothelial carcinoma, 50 showed a low-grade tumor. Sensitivity of tumor detection was 20 and 30% for methylene blue/Papanicolaou-stained slides, respectively. Among 30 patients with high-grade carcinoma, 10 were detected by methylene blue cytology and 30 by Papanicolaou-stained slides, corresponding to a sensitivity of 40 and 100%, respectively.


CONCLUSIONS
The results of standard Papanicolaou-stained urine cytology in the detection of clinically relevant high-grade urothelial carcinoma are excellent. The quality of cytological tumor detection by methylene blue-stained cytology made by different evaluators is insufficient in our opinion.
Klinik und Poliklinik für Urologie, Universitätsklinikum Essen, Hufelandstrasse 55, 45122 Essen.
R
R
Rossi
T
T
Jaeger
C
C
Börgermann
C
C
Furtkamp
R
R
Moos Stahl
H
H
Rübben
F
F
vom Dorp
D002295:Carcinoma, Transitional Cell / Q000473:pathology* / Q000601:surgery; D003558:Cystoscopy; D003581:Cytodiagnosis / Q000379:methods*; D006801:Humans; D008751:Methylene Blue; D012680:Sensitivity and Specificity; D013194:Staining and Labeling; D001749:Urinary Bladder Neoplasms / Q000473:pathology* / Q000601:surgery; D014556:Urine / Q000166:cytology*; D019459:Urothelium / Q000473:pathology
D008751:Methylene Blue