Citološka preiskava urina in izpirka sečnega mehurja pri ugotavljanju urotelijskega karcinoma

Background. Light microscopic evaluation of cell morphology in preparations from urine or bladder washing containing exfoliated cells is a standard and primary method for the detection of bladder cancer and also malignancy from other parts of the urinary tract. The cytopathologic examination is a valuablemethod to detect an early recurrence of malignancy or new primary carcinoma during the follow-up of patients after the treatment of bladder cancer. Conclusions. Characteristic cellular and nuclear signs of malignancy indicate invasive or in situ urothelial carcinoma or high-grade papillary urothelial carcinoma. However, low sensitivity of the method reflects the unreliable cytopathologic diagnosis of low-grade urothelial neoplasms as cellular and nuclear signs of malignancy in these neoplasms are poorly manifested. Many different markers were developed to improve the diagnosis of bladder carcinoma on urinary samples. UroVysionT test is among the newest and most promising tests. By the method of in situ hybridization one can detect specific cytogenetic changes of urothelial carcinoma

Citodiagnostika netipljivih lezij v dojkah

Izhodišča. Aspiracijska biopsija s tanko iglo (ABTI) je uveljavljena metoda zadiagnostiko sprememb v dojki. V pričujoči študiji smo želeli ugotoviti zanesljivost ultrazvočno (UZ) ali rentgensko (RTG) vodene ABTI za diagnostiko netipljivih lezij v dojki na podlagi cito-histološke korelacije in izračunati občutljivost, specifičnost, napovedno veljavnost pozitivne in negativne diagnoze. Bolniki in metode. V retrospektivno študijo smo vključili 179 žensk,pri katerih je bila v letu 2003 izvršena UZ ali/in RTG vodena ABTI netipljive lezije v dojki, ki je bila kasneje histološko opredeljena na vzorcubiopsije z debelo iglo, vodeni ekscizijski biopsiji ali na kirurškem resektatu. Rezultati. V 66 (36,8%) primerih je bil histološko dokazan karcinom, v 113 (63,1%) primerih pa benigna lezija. Citopatološke diagnoze v skupini karcinomov so bile: karcinom v 41 primerih (62,1%), sumljivo za karcinom v 12 (18,2%), napačno negativna diagnoza v 3 (4,5%), v 10 (15%) primerih pa niso dobili dovolj materiala za diagnozo. Zaključki. V skupini benignih lezij smo iz vzorca ABTI postavili pravilno negativno diagnozo v 55 primerih (48,7%), napačno sumljivo v 18 (15,9%), napačno pozitivno diagnozo v enem primeru (0,88%) in v 39 (34,5%) primerih nismo dobili dovolj materiala zadiagnozo. Občutljivost metode v naši študiji je bila 91%, specifičnost 98%, napovedna veljavnost pozitivne diagnoze 97,6% in napovedna veljavnost negativne diagnoze 94,8 %

Biological markers p16 and Ki-67 for defining cervical intraepithelial neoplasia in biopsy samples of the cervix

Biološka označevalca p16 in Ki-67 sta posredna pokazatelja okužbe s humanimi papiloma virusi z velikim tveganjem (HPV-VT), ki so povezani z nastankom predrakavih sprememb na materničnem vratu. V diagnostično težavnih primerih ju lahko uporabimo za razlikovanje cervikalne intraepitelijske neoplazije od morfološko podobnih neneoplastičnih sprememb. Določamo ju lahko s standardnimi imunohistokemičnimi metodami na tkivnih rezinah bioptičnih vzorcev materničnega vratu. Pri vsakdanjem histopatološkem ocenjevanju bioptičnih vzorcev materničnega vratu z dodatnim imunohistokemičnim barvanjem na p16 in Ki-67 največkrat izključimo cervikalno intraepitelijsko neoplazijo visoke stopnje (CIN2 in CIN3), kar prepreči pretirano zdravljenje sprememb na materničnem vratu. Tak diagnostični pristop je uporaben tudi za histopatološko ocenjevanje intraepitelijskih neoplastičnih sprememb endocervikalnega žleznega epitelija.The biological markers p16 and Ki-67 are indirect indicators of high-risk human papillomavirus infections (HR-HPV) connected to the formation of precancerous changes in the cervix. In diagnostically more challenging cases, they can be used to distinguish between cervical intraepithelial neoplasia and morphologically similar non-neoplastic changes. They can be determined using standard immunohistochemical methods on tissue slices from cervical biopsy samples. In the daily histopathological evaluation of the cervical biopsy samples with additional immunohistochemical staining for p16 and Ki-67, a high-grade cervical intraepithelial neoplasia (CIN2 and CIN3) is usually ruled out, which prevents excessive treatment of changes in the cervix. Such diagnostic approach can also be used in the histopathological evaluation of intraepithelial neoplastic changes of the endocervical glandular epithelium

New Promises of Cytopathologic Diagnostics of Bladder cancer by Using UroVysion™

Cytopathologic examination of the urine and bladder washing is a standard method for the detection of primary bladder cancer in symptomatic patients or in patients with hematuria. The method is also very useful to follow the patients after treatment in order to detect recurrence of bladder cancer which occurs in a significant percentage of patients. Cytopathologic examination is highly accurate for the diagnosis of high grade urothelial carcinoma and carcinoma in situ. However, the method is recognized as being unreliable for the detection of low grade urothelial neoplasms. Obvious cellular and nuclear morphological signs of malignancy can be reliably recognized in high grade papillary, invasive and in situ urothelial carcinoma. Thus, less pronounced cellular atypia pose everyday diagnostic problems and atypia of low grade papillary neoplasms cannot be always reliably differentiated from atypia of some benign and post-treatment reactive changes. In the last decade a number of new urinary markers have been developed to overcome low sensitivity of urinary cytology. Although most of these tests are highly sensitive, they have lower specificity than cytology. The UroVysion test seems the most promising among the new tests. By the method of multitarget fluorescent in situ hybridisation (FISH), the test can detect several cytogenetic changes characteristic for different grades of bladder cancer. Therefore, the UroVysion test is useful for assessing neoplastic nature of cytologically undetermined atypical cells. The most recent reports claim that the UroVysion test can even detect bladder cancer before morphological changes are diagnosed in urine cytology