尿細胞診の臨床的検討 --膀胱腫瘍を中心に--

Abstract

悪性腫瘍を疑われて当科へ入院した160例の尿細胞診を臨床的に検討した.各疾患別の尿細胞診陽性率は腎盂尿管癌(8例)62.5%, 膀胱癌(90例)56.7%, 前立腺癌(18例)22.2%, 腎癌(15例)13.3%であった.膀胱癌のstage AとB, C, D間に陽性率の有意差を認めたが, stage B, C, D間には差がなかった.Low grade (1・2)群に比し, high grade (3・4)群に陽性率が有意に高く, 腫瘍の大きさにより陽性率に差を認めた.膀胱腫瘍初発例と再発例とを比較すると, 初発例に陽性率が高かった.検査回数との関係では, 1回目の検査で膀胱腫瘍の尿細胞診陽性は88.3%, 3回目までに96.1%が陽性であったことから, 少なくとも3回は検査を要することが示された.前立腺癌では前立腺性酸フォスファターゼが高値なもの, あるいは骨転移を有するもののみに尿細胞診陽性であった

During the last 66 months, 482 urinary cytologic examinations were performed on 160 inpatients suspected of having genitourinary cancer at our University Hospital. Cytologic diagnosis was done according to the Papanicolaou's classification. The cytologic findings were compared by size, shape, numbers of the tumor and the histologic findings. The positive rate (classes IV and V) was 56.7% (90 patients) in bladder cancer, 22.2% (18 patients) in prostatic cancer, 13.3% (15 patients) in renal cancer and 62.5% (8 patients) in renal pelvic or ureteral cancer. There was no false positive case for benign disease. The positive rate of cytologic examinations for stage A bladder cancer was statistically lower than that for stage B, C and D cancers. There were no statistically significant differences among the stage B, C and D groups. The positive rate in the low grade (grade I and II) bladder cancer was statistically lower than that of high grade (grade III and IV) cancer. In the small tumor less than thumbtip -sized, cytological diagnosis was positive in 40.0%, while in the large tumor larger than this size, the positive rate was 73.3%. The difference between these two groups was statistically significant. The positive rate in the non-recurrent cases of the bladder cancer was 64.5%, while that in the recurrent cancer cases was 39.3%. The difference between these two groups was statistically significant. The positive rate of urinary cytology did not correspond to the shape or number of tumors. It is desirable to perform cytology more than 3 times on the same patient.(ABSTRACT TRUNCATED AT 250 WORDS)