DIAGNOSTIC-ACCURACY AND KEY CYTOLOGIC FEATURES OF HIGH-GRADE TRANSITIONAL-CELL CARCINOMA IN THE UPPER URINARY-TRACT

This study examined the diagnostic accuracy of upper urinary tract cyt ology and defined key cytologic criteria by logistic regression analys is for the diagnosis of high-grade transitional cell carcinoma (TCC). The upper urinary tract cytologic diagnosis was retrospectively review ed for 153 patients, and diagnostic accuracy was calculated. Cases wer e scored for the presence or absence of 32 cytomorphologic criteria, a nd key features to distinguish high-grade TCC from benign lesions were assessed. There were two false-positive and four false-negative diagn oses of TCC. Likelihood ratios for the diagnoses of benign, atypical, suspicious, and TCC were 0.2, 1.4, 3.9, and 32.8, respectively. Regres sion analysis showed that the cytologic features of anisonucleosis, hi gh nuclear/cytoplasmic ratio, and nuclear overlapping were important i n the separation of high-grade TCC from benign lesions. We conclude th at by using these criteria, the accuracy of diagnosis of high-grade TC C could be improved.