Cytological Atypia of Urine from Patients Receiving Cyclophosphamide

Abstract

This study was carried out in Radiation and Isotope Center Khartoum (RICK) during the period between June to December 2007. The study aimed at assessing the cytological features of urine taken from patients receiving cyclophosphamide. Cytological specimens of urine were taken from 150 individuals, of whom 100 were cancer patients receiving cyclophosphamide (ascertained as cases) and 50 were cancer patients but were not exposed to cyclophosphamide (ascertained as controls). Voided urine specimens were collected and processed by the conventional method for urine cytology and stained by Papanicolaou staining method and examined microscopically. Cytological atypias were detected among 15 (10%) individuals, of whom 14(93%) were from cases and one (7%) from controls. These findings strongly approve the role of cyclophosphamide as a risk factor for developing cytological atypia and this was found to be statistically significant (P<0.02) Inflammatory cells were seen in 70(70%) of cases and 23 (46%) of controls, and Red Blood Cells were seen in 71 (71%) of cases and in 5 (10%) of controls . These indicate that cyclophosphamide is major factor for the presence of the inflammatory cells (P<0.03) and RBCs (P<0.02) in urine smears. In conclusion, cyclophosphamide can cause cytological atypia in urinary cytology. Urine cytology is simple and convenient method in the diagnosis and assessment of pathological conditions of the urinary system. In view of these, we recommend applying urine cytology in screening and assessment of individuals who are at risk of developing bladder cancer.