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Medical Forum / Diseases and Disorders / Prostatitis / July 2004Urine Analysis vs. Urine Cytology
I know a Urine Cytology is ordered to look for cancer cells. They accidently ordered one on me and thank God there were no cancer cells however it did show some inflammatory cells, however they also ordered a UA which showed NO WBC. So, how is this possible????? A Mistake on their part? Mak Different tests done using different techniques. Don't think standard urinalysis is anywhere near as accurate as cytology. I'm sure if one searches hard enough on the web, one can find the exact techniques used. But it would probably be akin to comparing a CBC vs. blood cytology. The CBC is done using a machine to "count" the #'s of RBC, WBC, etc. while a cytology has a human looking at the cells under a microscope. Larry E. > I know a Urine Cytology is ordered to look for cancer cells. They accidently > ordered one on me and thank God there were no cancer cells however it did show [quoted text clipped - 4 lines] > > Mak > Different tests done using different techniques. Don't think standard > urinalysis is anywhere near as accurate as cytology. I'm sure if one [quoted text clipped - 13 lines] > > > > Mak i dont know, i dont get it. i would think there is a processing error. A UA done using a microscope should be the same thing, they are looking for cells. The only difference can be if one is spun and the other isnt, however, if thats the case, UA's are point less because one can miss WBCs that are only showing in cytologies when the urine is spun. mak No ... they're just different tests with different accuracies. Kinda like doing an x-ray vs. doing an MRI in looking for the reason why your back hurts. An MRI is a much more accurate exam. Same for UA vs. Cytology. A UA is likely done using automated equipment (not a human), while a Cytology means that cells are examined by a human under a microscope. Another difference ... Cytology provide more of a qualitative result. Larry E. >>Different tests done using different techniques. Don't think standard >>urinalysis is anywhere near as accurate as cytology. I'm sure if one [quoted text clipped - 22 lines] > > mak > I know a Urine Cytology is ordered to look for cancer cells. They accidently > ordered one on me and thank God there were no cancer cells however it did show [quoted text clipped - 4 lines] > > Mak Hey Mak, It depends on how the UA was done. There is a test for white cells on a test strip that they dip into the urine. Sometimes that is all they do and don't even look at the urine under the microscope. Depending on the type of microscope they use, all urines is not stained but unstained and you have to see through all the sh.t that is there as well. They also look for other things not just WBC. Urine cytology is a washed specimen and the cells are stained and looked at under the microscope. You also look at numbers in which case cytology can not do that and keep in mind that White cells are not macrophages in which both are inflammatory cells. You can have a lot of macrophages consistent with chronic inflammation and not have a lot of white cells consistent with NO WBC and Inflammatory cells present. White cells are included as inflammatory cells which is why cytology always uses the term Inflammatory cells to include All types of inflammatory cells in which there are many, many different types through out the body. Glial cells are inflammatory cells found in the brain. etc................. Hope it helps. > > I know a Urine Cytology is ordered to look for cancer cells. They > accidently [quoted text clipped - 12 lines] > strip that they dip into the urine. Sometimes that is all they do and don't > even look at the urine under the microscope. It was a Microscopic UA. They do look at it under a microscope. > Depending on the type of microscope they use, all urines is not stained but > unstained and you have to see through all the sh.t that is there as well. > They also look for other things not just WBC. They do in a UA too. I wouldnt know what kind of microscope they used. > Urine cytology is a washed specimen and the cells are stained and looked at > under the microscope. I dont know what you mean by stained???? > You also look at numbers in which case cytology can not do that and keep in > mind that White cells are not macrophages in which both are inflammatory > cells. You can have a lot of macrophages consistent with chronic > inflammation and not have a lot of white cells consistent with NO WBC and > Inflammatory cells present. Huh? Over my head. > White cells are included as inflammatory cells which is why cytology always > uses the term Inflammatory cells to include All types of inflammatory cells > in which there are many, many different types through out the body. Glial > cells are inflammatory cells found in the brain. etc................. > Hope it helps. Thanks for your input Robert, I appreciate it, but the last 2 paragraphs are over my head. > > I know a Urine Cytology is ordered to look for cancer cells. They > accidently [quoted text clipped - 12 lines] > strip that they dip into the urine. Sometimes that is all they do and don't > even look at the urine under the microscope. It was a Microscopic UA. They do look at it under a microscope. > Depending on the type of microscope they use, all urines is not stained but > unstained and you have to see through all the sh.t that is there as well. > They also look for other things not just WBC. They do in a UA too. I wouldnt know what kind of microscope they used. > Urine cytology is a washed specimen and the cells are stained and looked at > under the microscope. I dont know what you mean by stained???? > You also look at numbers in which case cytology can not do that and keep in > mind that White cells are not macrophages in which both are inflammatory > cells. You can have a lot of macrophages consistent with chronic > inflammation and not have a lot of white cells consistent with NO WBC and > Inflammatory cells present. Huh? Over my head. > White cells are included as inflammatory cells which is why cytology always > uses the term Inflammatory cells to include All types of inflammatory cells > in which there are many, many different types through out the body. Glial > cells are inflammatory cells found in the brain. etc................. > Hope it helps. Thanks for your input Robert, I appreciate it, but the last 2 paragraphs are over my head. > > I know a Urine Cytology is ordered to look for cancer cells. They > accidently [quoted text clipped - 5 lines] > > > > A Mistake on their part? This is a response I recieved from a Doctor online: by Sheldon_Marks_MD, on 7/3/2004 7:38:49 AM NEW! These and all laboratory tests are very good but far from perfect. When one introduces the human factor, the accuracy declines even more. If there are no signs of cancer, this is the message you should be looking for. Cytology specimens look at just a few cells concentrated from a specimen, where the simple urine analysis looks at a single microdrop from the specimen. If there are any questions, you should have the tests repeated. Many doctorsare moving away from simple cytology specimens to get more detailed DNA analysis of the cells, such as using the NMP 22 and BTA stat tests, as well as more advanced tests available through speciality labs. ASk your doctor if these may be necessary. This is for the next person who comes up with the same question. > > > I know a Urine Cytology is ordered to look for cancer cells. They > > accidently [quoted text clipped - 15 lines] > looking for. Cytology specimens look at just a few cells concentrated > from a specimen, Looks at cells from a lot of urine. where the simple urine analysis looks at a single > microdrop from the specimen. It is only a fraction of a drop and certainly not the whole drop. It's like get getting a hand bucket and tossing it in the ocean and looking for fish. After several buckets you say you have an average of 0 fish. If you go on a boat and use a one mile net and count the fish and get an average of 10 per net catch. How do you explain the descrepancy? If there are any questions, you should > have the tests repeated. Mak, you don't need retesting as the dipstick chemistry strip has a test for white cells. It is the leukocyte esterase. If it is positive then it is compatible with clinically significant number of white cells present in the urine. In your case it should be negative indicating very little number of white cells. It is extremely rare to have a negative Leukocyte esterase and have more than 5 WBC's / HPF. That is the clinical cutt-off for white cells. Many doctorsare moving away from simple > cytology specimens to get more detailed DNA analysis of the cells, > such as using the NMP 22 and BTA stat tests, as well as more advanced > tests available through speciality labs. ASk your doctor if these may > be necessary. > > This is for the next person who comes up with the same question. On 7/3/04 1:38 PM, in article 10edvcp9pjvclc9@corp.supernews.com, "Robert" >> "Robert" <Robert@hotmail.com> wrote in message > news:<10e0qe8p3lga64b@corp.supernews.com>... [quoted text clipped - 46 lines] >> >> This is for the next person who comes up with the same question. IMO cytology is good for just one thing, finding high grade bladder/ureter cancer. It does a OK job doing this, getting above 90% for one type of high cancer called CIS. Other than this I do not think it is very good by its self, having very high false neg rates. I have seen peoples bladder just full of low grade tumor with a "normal" cytology. It also works into some algorithms in following up small amounts of blood in peoples urine after a negative workup (IVP and cysto). Some of the more "high tec" cytology type tests are coming out with to goal of trying to get rid of the frequent cystoscopy that needs to be done to follow people with bladder cancer. Someday they will probably do this, but right now they are not ready for prime time. ME > On 7/3/04 1:38 PM, in article 10edvcp9pjvclc9@corp.supernews.com, "Robert" > [quoted text clipped - 64 lines] > > ME The original question pertained to a wrong test order of cytology when the diagnostic workup was for prostatitis. Mak was questioning the disparate result of the UA stating 0 WBC/HPF vs the comment on the wrongly ordered cytology report that said inflammatory cells were present. The numbers are not important in cytology compared to a uniform counting method of the UA. The third method is a urethral swab in which WBC may be present in NSU or NGU and the other two methods. > > On 7/3/04 1:38 PM, in article 10edvcp9pjvclc9@corp.supernews.com, "Robert" > > [quoted text clipped - 13 lines] > > >>>> > > >> This is a response I recieved from a Doctor online: So does normal urine usually have some WBC in it, just not enough to be clinically significant? > > > On 7/3/04 1:38 PM, in article 10edvcp9pjvclc9@corp.supernews.com, "Robert" > > > [quoted text clipped - 16 lines] > So does normal urine usually have some WBC in it, just not enough to > be clinically significant? Normal urine has < 2 WBC/HPF. 2-5 is borderline and more than 5 is usually clinically significant depending on the situation as some are not collected properly(contaminated not clean catch). The older one gets the more WBC's ones sees in the urine. Other conditions not directly related to the urinary system can cause elevations as well such as the colon. Once abnormal it carries the same significance as 10 /HPF is the same as 100/HPF. One is not worse than the other in terms of extent or severity of disease. It is not only the number of white cells under some situations but the type of white cell also that is important. Drug induced renal failure is a good example in which to check the type of white cells in the urine. |
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