Korean J Urol.  2014 Jun;55(6):390-394. 10.4111/kju.2014.55.6.390.

A Comparison Between ThinPrep Monolayer and Cytospin Cytology for the Detection of Bladder Cancer

• Kim JY
• Kim HJ

• KMID: 1885617
• DOI: http://doi.org/10.4111/kju.2014.55.6.390

Abstract

PURPOSE
The sensitivity of urine cytology is higher for carcinoma in situ and poorly differentiated tumors in bladder cancer, while being fairly low for low-grade or well-differentiated tumors. Development of a sensitive diagnostic test to detect bladder carcinoma would significantly facilitate patient management and allow earlier treatment of this disease. This study compared ThinPrep urine cytology (Cytyc Co.) and conventional Cytospin urine cytology (Shandon Scientific Ltd.) in the diagnosis of bladder cancer.
MATERIALS AND METHODS
From January 2002 to December 2010, ThinPrep cytology and conventional urine Cytospin cytologic examination of bladder washings were performed in 3,085 subjects suspected of having bladder cancer and in 379 patients with follow-up after transurethral resection of bladder tumor (TUR-BT). The sensitivity and specificity of the urine ThinPrep test was compared with that of conventional Cytospin cytology according to tumor number, size, pathological stage, grade, and recurrence.
RESULTS
Of 3,085 subjects, bladder cancer was confirmed by TUR-BT in 379 subjects. The overall sensitivity of ThinPrep and Cytospin cytology was 60.9% and 59.9% in patients suspected of having bladder cancer, respectively. The overall specificity of ThinPrep and Cytospin cytology was 94.8% and 95.3% in patients suspected of having bladder cancer, respectively. The sensitivity of ThinPrep and Cytospin cytology was increased with increasing number, size, pathological stage, and grade, but there was no significant difference between the two tests.
CONCLUSIONS
These results suggest that ThinPrep cytology has no advantage in the diagnosis of bladder cancer of a low grade or low stage.

Keyword

Cytospin cytology; ThinPrep; Urinary bladder neoplasm

MeSH Terms

Carcinoma in Situ
Diagnosis
Diagnostic Tests, Routine
Follow-Up Studies
Humans
Recurrence
Sensitivity and Specificity
Urinary Bladder
Urinary Bladder Neoplasms*

Reference

1. Siegel R, Naishadham D, Jemal A. Cancer statistics, 2012. CA Cancer J Clin. 2012; 62:10–29.

2. Heney NM, Ahmed S, Flanagan MJ, Frable W, Corder MP, Hafermann MD, et al. Superficial bladder cancer: progression and recurrence. J Urol. 1983; 130:1083–1086.

3. Thrasher JB, Crawford ED. Current management of invasive and metastatic transitional cell carcinoma of the bladder. J Urol. 1993; 149:957–972.

4. Papanicolaou GN, Marshall VF. Urine sediment smears as a diagnostic procedure in cancers of the urinary tract. Science. 1945; 101:519–520.

5. Piaton E, Hutin K, Faynel J, Ranchin MC, Cottier M. Cost efficiency analysis of modern cytocentrifugation methods versus liquid based (Cytyc Thinprep) processing of urinary samples. J Clin Pathol. 2004; 57:1208–1212.

6. Linder J. Recent advances in thin-layer cytology. Diagn Cytopathol. 1998; 18:24–32.

7. Dodd LG, Sneige N, Villarreal Y, Fanning CV, Staerkel GA, Caraway NP, et al. Quality-assurance study of simultaneously sampled, non-correlating cervical cytology and biopsies. Diagn Cytopathol. 1993; 9:138–144.

8. Lokeshwar VB, Soloway MS. Current bladder tumor tests: does their projected utility fulfill clinical necessity? J Urol. 2001; 165:1067–1077.

9. Leyh H, Marberger M, Conort P, Sternberg C, Pansadoro V, Pagano F, et al. Comparison of the BTA stat test with voided urine cytology and bladder wash cytology in the diagnosis and monitoring of bladder cancer. Eur Urol. 1999; 35:52–56.

10. Takashi M, Schenck U, Kissel K, Leyh H, Treiber U. Use of diagnostic categories in urinary cytology in comparison with the bladder tumour antigen (BTA) test in bladder cancer patients. Int Urol Nephrol. 1999; 31:189–196.

11. Pode D, Shapiro A, Wald M, Nativ O, Laufer M, Kaver I. Noninvasive detection of bladder cancer with the BTA stat test. J Urol. 1999; 161:443–446.

12. Wiener HG, Vooijs GP, van't Hof-Grootenboer B. Accuracy of urinary cytology in the diagnosis of primary and recurrent bladder cancer. Acta Cytol. 1993; 37:163–169.

13. Lamm DL, Griffith G, Pettit LL, Nseyo UO. Current perspectives on diagnosis and treatment of superficial bladder cancer. Urology. 1992; 39:301–308.

14. Wiener HG, Mian C, Haitel A, Pycha A, Schatzl G, Marberger M. Can urine bound diagnostic tests replace cystoscopy in the management of bladder cancer? J Urol. 1998; 159:1876–1880.

15. Konety BR, Metro MJ, Melham MF, Salup RR. Diagnostic value of voided urine and bladder barbotage cytology in detecting transitional cell carcinoma of the urinary tract. Urol Int. 1999; 62:26–30.

16. Koss LG, Deitch D, Ramanathan R, Sherman AB. Diagnostic value of cytology of voided urine. Acta Cytol. 1985; 29:810–816.

17. Zein T, Wajsman Z, Englander LS, Gamarra M, Lopez C, Huben RP, et al. Evaluation of bladder washings and urine cytology in the diagnosis of bladder cancer and its correlation with selected biopsies of the bladder mucosa. J Urol. 1984; 132:670–671.

18. Lee KR, Ashfaq R, Birdsong GG, Corkill ME, McIntosh KM, Inhorn SL. Comparison of conventional Papanicolaou smears and a fluid-based, thin-layer system for cervical cancer screening. Obstet Gynecol. 1997; 90:278–284.

19. Cheung AN, Szeto EF, Leung BS, Khoo US, Ng AW. Liquid-based cytology and conventional cervical smears: a comparison study in an Asian screening population. Cancer. 2003; 99:331–335.

20. Negri G, Menia E, Egarter-Vigl E, Vittadello F, Mian C. ThinPrep versus conventional Papanicolaou smear in the cytologic follow-up of women with equivocal cervical smears. Cancer. 2003; 99:342–345.

21. Shin BK, Lee YS, Jeong H, Lee SH, Kim H, Kim A, et al. Detecting malignant urothelial cells by morphometric analysis of ThinPrep (R) liquid-based urine cytology specimens. Korean J Cytopathol. 2008; 19:136–143.