The sensitivity of bladder wash flow cytometry, bladder wash cytology, and voided cytology in the detection of bladder carcinoma Journal Article


Authors: Badalament, R. A.; Hermansen, D. K.; Kimmel, M.; Gay, H.; Herr, H. W.; Fair, W. R.; Whitmore, W. F. Jr; Melamed, M. R.
Article Title: The sensitivity of bladder wash flow cytometry, bladder wash cytology, and voided cytology in the detection of bladder carcinoma
Abstract: The sensitivity of voided urinary cytology (VUC), bladder wash cytology (BWC), and bladder wash flow cytometry (BWFCM) in detecting cancer was studied in 70 patients with biopsy‐proven bladder tumors. There were 11 Grade I papillomas, 14 Grade II TA, 18 Grade II‐III TIS, 19 Grade II‐III T1, and eight Grade II‐III T2 carcinomas. One to five VUCs per patient (mean, 2.63) were obtained within the 24 hours preceding biopsy. At endoscopy a bladder wash specimen was obtained and divided for cytologic and flow cytometric examinations. For all tumor categories combined, the sensitivity for one, two, and three voided cytology examinations per patient was 41%, 41%, and 60%, respectively. The sensitivity of a single BWC was 61%, of a single BWFCM, 83%. Thus, one BWFCM is more sensitive than three VUC (binomial test; P = 0.006); one BWC is more sensitive than two VUC (P = 0.01); and one BWFCM is more sensitive than one BWC (P = 0.003). These findings remain significant when papillomas are excluded from the analysis (P ≤ 0.03) and when papillomas and T2 tumors are jointly excluded (P ≤ 0.02). Only four of 70 patients (6%) had their cancers detected by VUC and/or BWC rather than BWFCM. In summary, irrigation cytology specimens are more sensitive than voided urinary cytology, and bladder wash flow cytometry is more sensitive than either in diagnosing bladder cancer. Flow cytometry is more sensitive because of the better sampling of bladder irrigation compared with voided urine and because of the measurement technique itself. Copyright © 1987 American Cancer Society
Keywords: middle aged; major clinical study; comparative study; flow cytometry; methodology; cancer diagnosis; cytology; urinary bladder neoplasms; biopsy; histology; diagnosis; urinary bladder; carcinoma; urine; papilloma; bladder carcinoma; endoscopy; cytological techniques; bladder; irrigation; humans; human; male; female; bladder irrigation
Journal Title: Cancer
Volume: 60
Issue: 7
ISSN: 0008-543X
Publisher: Wiley Blackwell  
Date Published: 1987-10-01
Start Page: 1423
End Page: 1427
Language: English
DOI: 10.1002/1097-0142(19871001)60:7<1423::Aid-cncr2820600702>3.0.Co;2-6
PUBMED: 3304614
PROVIDER: scopus
DOI/URL:
Notes: Article -- Export Date: 5 February 2021 -- Source: Scopus -- Acknowledgement: Dr. Marek Kimmel, a visiting investigator from the Institute of Automation, Silesian Technical University, Poland
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MSK Authors
  1. Harry W Herr
    594 Herr
  2. William R Fair
    342 Fair
  3. Willet F. Whitmore Jr
    139 Whitmore
  4. Myron Melamed
    148 Melamed
  5. Marek Kimmel
    46 Kimmel