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Urine by Liquid based cytology

Cancer
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Report in 120Hrs

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At Home

nofastingrequire

No Fasting Required

Details

Detection of urothelial (bladder) cancers and other urinary tract abnormalities.

₹499₹1,500

67% OFF

Urine by Liquid Based Cytology - Comprehensive Medical Test Guide

  • Why is it done?
    • Purpose of the Test: This test examines cells from urine samples using liquid-based cytology techniques to detect abnormalities, malignancies, and infectious agents in the urinary tract. It provides improved cellular preservation and fixation compared to conventional urinary cytology.
    • Primary Indications for Ordering: Suspected bladder cancer or upper urinary tract malignancies; Hematuria (blood in urine) of unknown origin; History of urothelial cancer surveillance; Evaluation of urinary symptoms with concern for malignancy; Assessment of recurrent urinary tract infections; Monitoring patients with prior urologic cancers
    • Typical Timing and Circumstances: Can be performed at any time, though early morning specimens are preferred for higher cellular concentration; Often ordered following abnormal imaging findings; Routinely performed during post-cancer treatment surveillance; May be repeated at regular intervals (every 3-6 months) for high-risk patients; Can be requested as part of comprehensive urologic evaluation
  • Normal Range
    • Reference Values: Negative for malignancy; No atypical cells present; Normal urothelial cells with appropriate maturation; Absence of high-grade dysplasia or carcinoma; Normal background with occasional inflammatory cells may be present
    • Interpretation Categories: Negative/Normal: No evidence of malignancy or significant atypia; Atypical Urothelial Cells (AUC): Borderline findings requiring clinical correlation and possible repeat testing; Low-Grade Urothelial Neoplasia (LGUN): Suspect low-grade urothelial cancer; High-Grade Urothelial Neoplasia (HGUN): Highly suspicious for high-grade urothelial carcinoma; Positive for Malignancy: Diagnostic of urothelial carcinoma or other malignancy
    • What Normal Means: No malignant cells detected; Urinary tract appears free of dysplastic or cancerous changes; Cellular composition is consistent with healthy urothelium; Low risk for current urothelial malignancy; May still require clinical correlation with patient symptoms and imaging findings
    • What Abnormal Means: Presence of atypical or malignant cells; Evidence of dysplastic changes in urothelium; Possible infection with organisms such as BK virus, polyomaviruses, or fungi; Inflammatory changes suggesting active infection or irritation; May indicate need for further investigation with cystoscopy, imaging, or repeat cytology
  • Interpretation
    • Detailed Result Interpretation: Negative Results: Indicates absence of malignancy with high sensitivity for high-grade urothelial carcinoma; Lower sensitivity for detecting low-grade tumors; Clinical correlation essential as negative results do not completely exclude malignancy; Atypical Urothelial Cells: Uncertain significance; Requires repeat sampling or additional imaging; May represent benign atypia, inflammation, or early dysplastic changes; Approximately 10-30% may progress to malignancy; Low-Grade Urothelial Neoplasia: Suggests presence of low-grade urothelial cancer; Associated with approximately 75-90% specificity for low-grade disease; Requires cystoscopic evaluation and possible re-sampling; High-Grade Urothelial Neoplasia: Highly specific for high-grade urothelial carcinoma; Associated with approximately 95-99% specificity; Warrants urgent cystoscopic investigation and urologic consultation; Positive for Malignancy: Diagnostic findings of cancer; Requires immediate urologic referral and treatment planning; May indicate urothelial carcinoma, small cell carcinoma, squamous cell carcinoma, or adenocarcinoma depending on cellular features
    • Factors Affecting Results: Sample quality and cellularity; Specimen adequacy and proper collection method; Recent urologic procedures or catheterization; Active urinary tract infection affecting cellular appearance; Recent radiation therapy or chemotherapy; Hydration status affecting urine concentration; Specimen handling and processing time; Patient age and immune status; Presence of benign epithelial abnormalities; Prior urologic surgeries or interventions
    • Clinical Significance: High-Grade Results: Strongly suggest malignancy requiring immediate intervention; Associated with aggressive disease behavior; Necessitates urgent cystoscopy with biopsies; May indicate need for staging studies (CT, MRI) and treatment planning; Intermediate Results: Require careful clinical correlation with imaging and symptoms; May necessitate repeat cytology in 1-3 months; Cystoscopy may be indicated depending on clinical presentation; Low-Grade Results: Suggest lower-grade malignancy with better prognosis; Still require cystoscopic surveillance; May be managed more conservatively initially; Require long-term follow-up given recurrence potential; Negative Results in High-Risk Patients: Do not exclude malignancy despite negative cytology; Sensitivity decreases in cases of low-grade tumors; May warrant repeat testing or alternative diagnostic approaches; Clinical judgment and additional imaging remain critical
  • Associated Organs
    • Primary Organ Systems Involved: Urinary Bladder: Primary site of urothelial cancer; Most common source of abnormal cells in urine; Target organ for malignancy detection; Upper Urinary Tract: Includes ureters and renal pelvis; Can shed malignant cells into urine; Important for detecting upper tract tumors; Urethra: May contribute cellular material to urine; Can be site of primary or secondary malignancy; Prostate Gland: In males, cellular contribution to urine; Can have primary malignancy affecting urinary cytology; Kidneys: Contribute renal tubular cells and may shed cancer cells; Important in detecting renal cell carcinoma in some cases
    • Medical Conditions Associated with Abnormal Results: Urothelial Carcinoma (Bladder Cancer): Most common primary malignancy detected; Can be low-grade or high-grade; Accounts for majority of positive findings; Upper Urinary Tract Urothelial Carcinoma: Tumors of renal pelvis or ureters; Higher mortality due to late detection; Important cause of abnormal urinary cytology; Non-urothelial Bladder Cancers: Squamous cell carcinoma; Small cell carcinoma; Adenocarcinoma of bladder; Secondary Malignancies: Metastatic cancers involving urinary tract; Primary malignancies from adjacent organs; Systemic cancers affecting urinary epithelium; Benign Conditions: Urinary tract infections; Bladder inflammation (cystitis); Urinary calculi (stones); Recent urologic procedures or trauma; Radiation cystitis following cancer treatment
    • Diseases This Test Helps Diagnose or Monitor: Bladder Carcinoma: Initial detection and surveillance; Urothelial Cancer Recurrence: Post-treatment monitoring; Upper Tract Malignancies: Detection of renal pelvis and ureteral tumors; Atypical Cystitis: Differentiating inflammatory conditions from malignancy; Polyomavirus Nephropathy: In transplant patients; Tuberculosis: Granulomatous infection of urinary tract; Schistosomiasis-Associated Malignancy: In endemic regions; Immunosuppression-Related Conditions: In HIV-positive or transplant patients
    • Potential Complications and Risks Associated with Abnormal Results: Advanced Cancer: Delays in diagnosis may allow disease progression; Late-stage presentation associated with worse prognosis; Metastatic Disease: High-grade malignancies may have already spread; Requires staging and multimodal therapy; Loss of Bladder Function: Advanced tumors may necessitate cystectomy; Significant impact on quality of life; Systemic Toxicity: Treatment-related complications from chemotherapy or radiation; Mortality Risk: High-grade urothelial carcinoma carries significant mortality; 5-year survival depends on stage at diagnosis and grade; Recurrence: Even after initial treatment, malignancy can recur; Requires lifelong surveillance and potential repeat interventions; Psychological Impact: Cancer diagnosis and ongoing surveillance requirements; Treatment morbidity affecting patient well-being
  • Follow-up Tests
    • Recommended Tests Based on Results: For Atypical or Positive Results: Cystoscopy with Biopsy - Direct visualization and tissue confirmation of any lesions; Transurethral Resection of Bladder Tumor (TURBT) - Both diagnostic and therapeutic when malignancy identified; Upper Tract Imaging - CT urography or retrograde pyelography to exclude upper tract pathology; Urinary Flow Cytometry - May detect additional abnormalities; Urine Culture - Rule out infection as cause of atypia; Repeat Urinary Cytology - At 1-3 month intervals for atypical or borderline results
    • Further Investigations: Imaging Studies: CT Scan of Abdomen and Pelvis - For staging and detecting metastatic disease; MRI Pelvis - Alternative for patients with contrast allergies or renal insufficiency; Chest X-ray or CT Chest - Screening for pulmonary metastases; Bone Scan - If clinically indicated for high-grade malignancies; Laboratory Tests: Serum Creatinine and BUN - Assess renal function before treatment; Liver Function Tests - Baseline assessment if chemotherapy planned; Urinalysis and Culture - Rule out infection; Urine Biomarkers - Including NMP22, BTA, or FDP tests as adjunctive tools; Molecular Testing: Fluorescence In Situ Hybridization (FISH) - May improve detection of low-grade tumors; Next-Generation Sequencing - In selected cases to guide targeted therapy
    • Monitoring Frequency for Ongoing Conditions: Post-TURBT Surveillance: Cytology every 3 months for first 2 years; Then every 6 months for years 2-5; Then annually thereafter depending on grade and recurrence; Cystoscopy: Every 3 months for first year; Every 6 months for second year; Then annually based on findings; High-Grade Urothelial Carcinoma: More intensive monitoring; May require cytology every 1-3 months initially; Cystoscopy every 1-3 months depending on treatment response; Low-Grade Tumors: Less intensive initial monitoring; Cytology every 3-6 months; Annual cystoscopy often sufficient; Post-Chemotherapy or Radiation: Closer surveillance given treatment-related changes; Repeat cytology at 3 months post-treatment; Regular cystoscopy to assess treatment response
    • Complementary Information Tests: Urinary Markers: NMP22 (Nuclear Mitotic Apparatus protein 22) - High sensitivity for high-grade tumors; BTA STAT and BTA TRAK - For detection of recurrent disease; Immunocytochemistry: P53 and Ki-67 - May provide prognostic information; CK20 and CK7 - Help confirm urothelial origin; Molecular Markers: FGFR3 mutations - Particularly in low-grade tumors; TP53 mutations - Associated with high-grade disease; HRAS mutations - Found in some low-grade tumors; Telomerase Activity - Prognostic indicator in some cases; Flow Cytometry: DNA Ploidy Analysis - Provides additional prognostic information; Helps identify polyploid or aneuploid cells
  • Fasting Required?
    • Fasting Requirement: No - Fasting is NOT required for urine cytology collection
    • Special Patient Preparation Requirements: Optimal Collection Timing: Collect early morning first-void specimen when urine is most concentrated; This maximizes cellular yield and diagnostic sensitivity; Avoid specimens from later in the day when urine is dilute; Hydration: Patient should maintain normal hydration status; Excessive hydration may dilute specimen; Dehydration improves cellular concentration; Specimen Collection Instructions: Discard initial portion of urine stream (first 10-15 mL); Collect midstream portion directly into sterile container; Collect at least 40-60 mL for adequate sampling; Do not use preservatives unless specifically requested; Timing Considerations: Avoid collection immediately after cystoscopy or catheterization; Wait at least 3 days after urologic procedures; Do not collect during menstruation if female; Avoid collection during active urinary tract infection if possible
    • Medications to Avoid: No specific medications require discontinuation for urine cytology; Some medications may affect specimen appearance: Diuretics - May cause urine dilution; Continue as prescribed unless otherwise instructed; Anticoagulants - May increase presence of red blood cells; Continue as clinically indicated; Antibiotics - May alter cellular appearance if active infection being treated; Should be noted on requisition form; Phenolphthalein or other laxatives - May discolor urine; May interfere with microscopic examination
    • Specimen Handling and Processing: Temperature: Transport specimen at room temperature; Do not refrigerate unless transport will exceed 2 hours; Do not freeze specimen; Time Sensitivity: Process specimen within 2 hours of collection for optimal results; Delayed processing may degrade cellular material; Longer delays reduce diagnostic accuracy; Container Requirements: Use sterile, leak-proof containers; No formaldehyde or fixatives unless specified; Some laboratories may provide special containers with preservatives; Clinical Information: Provide relevant clinical history on requisition; Include current symptoms, hematuria, prior cancer history; Note any recent procedures or treatments; Indicate if repeat specimen or surveillance cytology; Multiple Specimens: For surveillance cases, separate specimen from each collection; Do not mix multiple days' specimens; Label clearly with date and time of collection

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