The use of urinary cytology in the detection of upper urinary tract urothelial carcinoma – a single centre experience

Czech version

Authors: Josef Skopal ^1,2; Kseniia Khomenko ³; Michal Michal ^1,2; Milan Hora ³; Tomáš Pitra ³; Kristýna Pivovarčíková ^1,2
Authors‘ workplace: Šiklův ústav patologie LF UK a FN Plzeň ¹; Bioptická laboratoř s. r. o., Plzeň ²; Urologická klinika LF UK a FN Plzeň ³
Published in: Ces Urol 2025; 29(1): 22-28
Category: Original article
doi: https://doi.org/10.48095/cccu2025007

Overview

Introduction: Urine cytology is primarily used for the detection of high-grade urothelial carcinoma (HGUC) in a urine sample. The typical use of urine cytology is the detection of lower urinary tract UC. There is a relatively limited knowledge about the efficacy of urinary cytology in setting of upper urinary tract urothelial carcinoma (UUTUC), i.e., urothelial carcinoma of the renal pelvis and ureter. Material and methods: A total of 68 patients treated at the Department of urology Faculty hospital Pilsen were involved retrospectively (the time period 2017– 2022). All patients had histologic diagnosis UUTUC (based on biopsy) and cytological examination of the urine performed before the biopsy. The results of the urinary cytology were compared to final histology. Results: The study group included 34 patients with voided urine samples, 11 patients with washing samples, 5 patients with both types of urine collection (voided and washing urine cytology), and 18 patients with no available information regarding the method of sample collection. Urinary cytology detected 64% of HG UUTUC and 36% of low-grade (LG) UUTUC. Urinary cytology revealed 50% UC in a voided urine group, 40% UC in a selective washing group, and 55% UC in a group with no specified method of urine collection. The sensitivity of urinary cytology for HG UUTUC detection was 65% and 55% respectively (voided versus instrumented urine). In LG UUTUC, voided samples reached a sensitivity of 40%, and selective washings 20%. Conclusion: The sensitivity of urine cytology for UUTUC is not significantly different from the literature data for lower urinary tract UC; however, the sensitivity of urine cytology in UUTUC detection is in a lower percentage range of reported lower urinary tract sensitivity. Our results relatively favour voided urine samples for cytological detection of UUTUC.

Keywords:

upper urinary tract, urine cytology, urothelial carcinoma, The Paris System for Reporting Urinary Cytology

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