Urine cytology is the examination of urothelial cells under the microscope. This allows assessing the cellular nature of the urothelial cells. We study the nuclear and cytoplasmic features which may suggest a urothelial malignancy. Voided urinary cytology is recommended in all patients who have risk factors for urothelial carcinoma. The sensitivity of voided urine cytology for detection of urothelial neoplasm ranges from 18% to 76% and is dependent on factors such as tumor grade, the number of specimens examined, and the expertise of the cytopathologist. Specificity of urine cytology specimens has been reported to be as high as 93%.
Pathologists will categorise their observations and findings and report the likely diagnosis. The Paris system for urine cytology is used to better classify the findings and communicate clinical recommendations to the clinicians and patients.
Urine tests for tumor markers: Newer tests also look for certain substances in urine that might be a sign of bladder cancer. These include:
- UroVysion™: This test looks for chromosome changes that are often seen in bladder cancer cells.
- BTA tests: These tests look for a substance called bladder tumor-associated antigen (BTA), also known as CFHrp, in the urine.
- ImmunoCyt™: This test looks at cells in the urine for the presence of substances such as mucin and carcinoembryonic antigen (CEA), which are often found on cancer cells.
