Diagnostic Value of Urine Cytology in 236 cases; a Comparison of Liquid-Based Preparation and Conventional Cytospin Method

Lee, Sun; Park, Jung Hee; Do, Sung Im; Kim, Youn Wha; Lee, Juhie; Chang, Sung Gu; Park, Yong Koo

Abstract

Urine cytology is an important screening tool for urinary tract neoplasms. Liquid-based preparation methods, such as ThinPrep(R), have been introduced for non-gynecological samples. We aimed to assess the diagnostic accuracy of liquid-based preparations in urine cytology by comparing the results of the conventional Cytospin preparation method for the same samples. A total of 236 cases subject to urine cytology were enrolled in this study from January 2005 to December 2005. All cases were subjected to cystoscopy and if a malignancy was suspected, a biopsy was performed. Urine cytology slides were made using the ThinPrep(R) preparation method and the conventional Cytospin and/or direct smear method from the individual samples. The results of urine cytology were compared with the final cystoscopic or histological diagnoses. We analyzed the sensitivity, specificity, positive predictive value, negative predictive value and accuracy of both cytology preparation methods. A total of 236 slides made using the liquid based method were satisfactory for slide quality, whereas 5 slides (2.1%) prepared by conventional methods were unsatisfactory because of air-drying, a thick smear, or a bloody or inflammatory background. The ThinPrep(R) method showed 53.1% sensitivity, 92.6% specificity, a 92.6% positive predictive value, a 94.1% negative predictive value and 85.6% accuracy, while the conventional method showed 51% sensitivity, 98.4% specificity, a 92.6% positive predictive value, a 98.4% negative predictive value and 88.6% accuracy. Although the diagnostic values were equivalent between the use of the two methods, the quality of the cytology slides and the time consumed during the microscopic examination for a diagnosis were superior for the ThinPrep(R) method than for the conventional method. In conclusion, our limited studies have shown that the use of the liquid based preparation method is beneficial to improve the quality of slides and reduce the duration for a microscopic examination, but did not show better sensitivity, accuracy and predictive values.