肾盂及输尿管移行细胞癌尿液细胞学诊断

目的：研究肾盂及输尿管移行细胞癌尿液细胞学诊断的影响因素，探索提高尿检阳性率的方法。方法：收集本院近16年收治的经病理诊断为肾盂、输尿管移行细胞癌，并做尿细胞学检查的66份病例做回顾性研究。结果：肾盂癌阳性率为72．5％（29／40），输尿管癌阳性率为69．2％（18／26）。对比分析表明：肾盂、输尿管癌尿细胞学阳性率与移行细胞癌组织分级、查尿次数及留尿方法有关。连续查尿4次后，阳性率不再升高。结论：尿细胞学阳性率与查尿次数、病理组织学分级及留尿方法有关。尿液细胞学检查应废弃以清晨首次尿作为标本的传统力法。应大量饮水后留尿以保证尿液新鲜有足够的癌细胞，采用适当叩击病变部位及活动体位等方法，以保证有足够的癌细胞脱落是提高尿检阳性率的关键。临床以连续查尿3－4次为宜。

Exfoliate cytological diagnosis of transitional cell carcinoma in pelvis and ureter

Objective To investigate the influential factors on exfoliate cytological diagnosis of transitional cell carcinoma (TCC) in the pelvis and ureter, and the measures taken to increase the positive rate. Methods A retrospective study was underwent to analyze the cytological features in 66 cases of TCC confirmed by pathological examination. Results Positive rates of TCC in the pelvis and ureter were 72.5% (29/40) and 69.2%(18/26) respectively. Comparative study showed that the positive rates were correlated with the grade, sampling time and the quality of specimen. After consecutive tests for four times, no higher positive rate was obtained. Conclusions The positive rates are correlated with the grade of carcinoma, the test time and specimen quality. It is suggested that fresh urine sample should be taken after much drinking for cytological analysis, instead of traditional sampling method that the first urine in the morning should be sent. Tapping of the lesion sites and appropriate physical exercise may be helpful to obtain enough cells to increase the positive rate.