R.N. Molchanov, A.F. Skripnik

The influence of urinary tract infection on quality of bladder tumors cytological diagnosis

Urine cytology (UC) is a highly specific method for diagnosis of bladder tumors (BT), supplementing a cystoscopy. The study and the exclusion of the factors contributing to a decrease in sensitivity of UC can help increase the effectiveness of this method of BT diagnosis. Goal- to estimate the relationship between the effectiveness of cytological diagnosis of bladder tumors and the presence of concomitant urinary tract infection (UTI).

The results of preoperative UC of 150 patients with BT were compared with data of histopathological examination. Assessment of the results was performed using Fisher’s method and the classification tree (QUEST). Among 115 (76.7%) patients with well, moderately and poorly differentiated transitional cell carcinoma (WTCC, MTCC, PTSS respectively)in stage Ta-T3 and 35 (23.3%) with transitional cell papilloma of the bladder (TCP) UTI was detected in 56 (37.3%) cases. Using the UC diagnosis of tumors established in 134 (89.3%) patients, and its’ histological affiliation - in 110 (73.3%). In TCP group a statistically significant association between the presence of infection and the number of errors in diagnosis (p = 0.002) was revealed. The relative risk of misdiagnosis in the presence of UTI was 2.39 with 0.95% confidence interval CI [1.41; 4.09]. The odds ratio for a correct diagnosis in the presence of cytological features MTCC, PTSS, or absence of infection was, 11,05 with 95% CI [4.64; 26,30].

1. There found a statistically significant relation between the presence of UTI on the one hand and the number of errors in the diagnosis of BT according to UC on the other.

2. The most pronounced effect of UTI on the result of the cytological diagnosis was revealed in a group of patients with TCP.

3. The rule to assess the correctness of the diagnosis according to the CIM was built, according to which the chances to form a correct diagnosis under the presence of cytological features UPKR, NPKR or absence of UTI are 11 times higher than the chances to make a mistake.