The Studies Comparing With Specimen Of Morning Urine Or Fresh Urine Of Cytologic Examination Which One Have The Higher Value To Earlily Diagnose The Urothelial Carcinoma

Objective Through the195suspected patients’morning urine specimen and freshurine specimen with urothelial carcinoma for three days consecutive are collected,The specimens’cytology are analyzed,we compare with two urine specimen whichcan detect the higher positive rate of urothelial carcinoma,which can detect the higherpositive rate at all levels of urothelial carcinoma, we explore the diagnosticperformance of different urine specimen, providing reliable inspection methods andtheoretical basis for clinical early diagnosis of urothelial carcinoma.Methods To collect the QingHai university affiliated hospital urinary surgery inOctober2011-October2013for two years, with having the blood urine of suspectedpatients with urothelial carcinoma,195cases of (male119, female76), aged22to87years old, average (45.26±18.54). Every patients make morning urine specimen andfresh urine specimen for three days consecutive, For surgical removal of tissuesamples or under cystoscope biopsy results of pathological diagnosis as a comparison,dividing into aptitude for low-grade malignant urothelial papillary tumors, low gradeurothelial carcinoma and high grade urothelial carcinoma for3grades.Confirmedafter histopathological diagnosis of urothelial carcinoma in98cases,（male68,female30）,aged25to84years old,average（54.39±14.57),the tendency to low-grademalignant urothelial papillary tumor have11cases, low grade urothelial carcinomahave39cases, high grade urothelial carcinoma have48cases.we compare with twourine specimens which can detect the higher positive rate of urothelial carcinoma anddetect the higher positive rate at all levels of urothelial carcinoma, we explore thediagnostic performance of different urine specimen, We will make test data forstatistical analysis, using X2test for count data, getting P value, detecting havingstatistical significance or not.Results1．Two specimens are compared with cytology for three days:For three days, morning urine group’s positive rates are respective32.65%,31.63%,39.80%, the positive rates of fresh urine group are respective59.18%,57.14%,64.29%, The rates of fresh urine group are higher than the morning urine,The first day the two specimens are made X2test,(X2=13.89, P=0.0002<0.01),havingsignificant differences;The next day,(X2=12.92, P=0.0003<0.01), having significantdifferences;On the third day,(X2=11.77,P=0.0006<0.01),having significant differences, while the morning urine groups’test results are compared with cytology for three days,(X2=2.171,P=0.338>0.05),having no statistical difference.Fresh urine group(X2=5.062, P=0.079>0.05), having no statistical difference.2．Two specimens of urothelial carcinoma are compared at all levels of positive rate:The first day the positive rates of morning urine are respective1.02%,11.22%,20.41%, fresh urine group are respective4.08%,24.49%,30.61%, The positive rate offresh urine group are higher than the morning urine specimen;(X2=15.26, P=0.009<0.01), having significant differences.The second day morning urine are respective0.00%,10.20%,21.43%, fresh urine group are respective2.04%,24.49%and30.61%,(X2=15.81, P=0.007<0.01), having significant differences.On the third day morningurine are respective3.06%,13.27%,23.47%,fresh urine are respective4.08%,27.55%and32.65%,(X2=13.72,P=0.018<0.05), having statistical differences.For three daysmorning urine are compared (X2=6.346,P=0.785>0.05),having no statisticaldifference.fresh urine specimen are compared for three days,(X2=11.12,P=0.348>0.05), having no statistical difference.3．Two specimens’effectiveness of urothelial carcinoma are compared to diagnoseurothelial carcinoma:Morning urine samples, whose values of the sensitivity, specific,false negativerate and false positive rate of urothelial carcinoma are39.80%,36.08%,60.20%,36.08%, Fresh urine specimen,whose four index results are64.29%,60.82%,35.71%,60.82%, two groups of four indicators are compared to get P values <0.01, havingsignificant differences.Conclusion1．The positive predictive value of fresh urine specimens of cytology testto detect urothelial carcinoma are more than morning urine specimen;2．The positive rate of fresh urine samples and morning urine samples duringthree days have no too big fluctuations, Fresh urine samples, whose values of thesensitivity and specialised degrees of urothelial carcinoma are higher than themorning urine specimen, false positive rate and false negative rate are lower than themorning urine specimen;3．The positive rate of fresh urine specimens of cytologic examination at all levelsof urothelial carcinoma are higher than the morning urine specimen;4．The higher the level of urothelial carcinoma are, the higher positive ratemorning urine specimen with fresh urine specimens of cytology test detect, The fresh urine samples at the same time have the higher positive rate detecting all level ofthe sensitivity of urothelial carcinoma than morning urine specimen.5．The value of fresh urine specimens of cytologic examination for the earlydiagnosis of urothelial carcinoma are higher than the morning urine specimens,wecollecte as much as possible the fresh urine samples for detection and diagnosis ofurothelial carcinoma in the clinical practice.