[Value and limitations of urinary cytology in the diagnosis of bladder tumors].

There were studied 222 patients with bladder tumors, 64 with operated transitional cell carcinoma and 166 with non-malignant diseases from cytologic and histologic point of view. Each patient was investigated by urinary cytology, endoscopy, and during the intervention biopsies were taken, which helped us to establish the histological form, the degree of differentiation and "T" element, using TNM system. All smears were stained by blue polychrome-tannin Dragan method and correlated with histological results which allowed us to appreciate cytodiagnostic as real positives, false negatives, real negatives and false positives. We signalled out some morphological aspects of malignant cells revealed by blue polychrome-tannin Dragan stain, which identified malignant elements in 87% tumors of the bladder G1, in 91.5% in G2 and 93.5% in G3; results were enhanced using washings of the bladder. There was some causes for false negatives results: a calcified tumor in its surface, tumors developed in vesical diverticulum, a limited exfoliation and a wrong interpretation of exfoliated cells. In patients transurethrally operated for tumors of the bladder the urinary cytology identified malignant elements in 22 of them; four presented tumors in the moment of endoscopic examination and 18 were considered as "apparently false-positive"; eleven of them developed tumors in the next 6-24 months from the intervention. In patients with non-malignant diseases false positives results were related specially to urinary lithiasis and chronic renal failure. Results of initial and survey cytodiagnosis allowed us to increase the period between traditional cystoscopies.