Role of urinary cytology and urinary deoxyribonucleic acid flow cytometry in the diagnosis of bladder cancer.

In order to determine the diagnostic efficiencies of urinary cytology and urinary deoxyribonucleic acid (DNA) flow cytometry (FCM) in the detection of bladder cancer, 92 patients were studied from March 1991 to the end of July 1992. Thirty cases had previously undergone operation for bladder cancer and 62 cases were suspected as bladder cancer. One to three fresh voided urine samples from the same patient were sent for conventional urinary cytology and urinary DNA FCM analysis. Each patient underwent cystoscopic examination or surgical histopathologic examination to verify the presence of bladder tumor. From December 1991 to the end of July 1992, 52 cases were analyzed and reported separately due to improved FCM techniques. Urinary DNA FCM showed a higher sensitivity than cytology in both the total (p < 0.05) and the second half time period (p < 0.01). Cytology showed a statistically superior specificity against FCM in the total period (p < 0.05) but not in the second half time period (p > 0.1). Combining sensitivity and specificity, FCM's overall accuracy rate was better than cytology in the second half time period (p < 0.05). To clarify the specific features of bladder tumors in which FCM showed superior sensitivity than cytology, we analysed the detection rates for various features of bladder tumor in the second half time period. FCM was better than cytology in detecting multiple tumors, small tumors and papillary tumors. No statistical differences were obtained if tumors were single, larger than 3 cm or flat in outer surface. To our knowledge, no previous similar analysis has been reported in the literature.(ABSTRACT TRUNCATED AT 250 WORDS)