요 세포 검사의 진단적 가치; 액상세포검사와 고식적 방법의 비교

Diagnostic Value of Urine Cytology in 236 cases; a Comparison of Liquid-Based Preparation and Conventional Cytospin Method

  • 이선 (경희대학교 의과대학 병리학 교실) ;
  • 박정희 (경희대학교 의과대학 병리학 교실) ;
  • 도성임 (경희대학교 의과대학 병리학 교실) ;
  • 김윤화 (경희대학교 의과대학 병리학 교실) ;
  • 이주희 (경희대학교 의과대학 병리학 교실) ;
  • 장성구 (경희대학교 의과대학 비뇨기과학 교실) ;
  • 박용구 (경희대학교 의과대학 병리학 교실)
  • Lee, Sun (Department of Pathology, Kyung Hee University College of Medicine) ;
  • Park, Jung-Hee (Department of Pathology, Kyung Hee University College of Medicine) ;
  • Do, Sung-Im (Department of Pathology, Kyung Hee University College of Medicine) ;
  • Kim, Youn-Wha (Department of Pathology, Kyung Hee University College of Medicine) ;
  • Lee, Ju-Hie (Department of Pathology, Kyung Hee University College of Medicine) ;
  • Chang, Sung-Gu (Department of Urology, Kyung Hee University College of Medicine) ;
  • Park, Yong-Koo (Department of Pathology, Kyung Hee University College of Medicine)
  • 발행 : 2007.09.30

초록

Urine cytology is an important screening tool for urinary tract neoplasms. Liquid-based preparation methods, such as $ThinPrep^{(R)}$, have been introduced for non-gynecological samples. We aimed to assess the diagnostic accuracy of liquid-based preparations in urine cytology by comparing the results of the conventional Cytospin preparation method for the same samples. A total of 236 cases subject to urine cytology were enrolled in this study from January 2005 to December 2005. All cases were subjected to cystoscopy and if a malignancy was suspected, a biopsy was performed. Urine cytology slides were made using the $ThinPrep^{(R)}$ preparation method and the conventional Cytospin and/or direct smear method from the individual samples. The results of urine cytology were compared with the final cystoscopic or histological diagnoses. We analyzed the sensitivity, specificity, positive predictive value, negative predictive value and accuracy of both cytology preparation methods. A total of 236 slides made using the liquid based method were satisfactory for slide quality, whereas 5 slides (2.1%) prepared by conventional methods were unsatisfactory because of air-drying, a thick smear, or a bloody or inflammatory background. The $ThinPrep^{(R)}$ method showed 53.1% sensitivity, 92.6% specificity, a 92,6% positive predictive value, a 94.1% negative predictive value and 85,6% accuracy, while the conventional method showed 51% sensitivity, 98.4% specificity, a 92.6% positive predictive value, a 98.4% negative predictive value and 88,6% accuracy. Although the diagnostic values were equivalent between the use of the two methods, the quality of the cytology slides and the time consumed during the microscopic examination for a diagnosis were superior for the $ThinPrep^{(R)}$ method than for the conventional method. In conclusion, our limited studies have shown that the use of the liquid based preparation method is beneficial to improve the quality of slides and reduce the duration for a microscopic examination, but did not show better sensitivity, accuracy and predictive values.

키워드

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