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Diagnosis of urinary bladder urothelial carcinoma by immunocytology with p53, MCM 5, MCM 2 and Ki‐67 antibodies using cell blocks derived from urine
Author(s) -
Brisuda Antonín,
Háček Jaromír,
Čechová Marcela,
Škapa Petr,
Babjuk Marek
Publication year - 2019
Publication title -
cytopathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.512
H-Index - 48
eISSN - 1365-2303
pISSN - 0956-5507
DOI - 10.1111/cyt.12698
Subject(s) - cytology , medicine , immunocytochemistry , urine , urology , antibody , ki 67 , urothelial carcinoma , carcinoma , pathology , urinary system , urine cytology , urothelial cell , urinary bladder , gastroenterology , bladder cancer , immunohistochemistry , cancer , urothelium , immunology , cystoscopy
Objective Immunocytochemistry has attained a marginal role in urology so far. Combining the morphological and immunophenotypical changes of the urothelial cells retrieved from urine is a logical approach. The study aimed to analyse the diagnostic potential of immunocytological staining in the detection of high‐grade and low‐grade urothelial carcinoma. Methods Freshly voided urine was collected from 152 consecutive individuals, cytology classes were determined and cell blocks produced. A total of 77 patients were diagnosed with urothelial carcinoma and 75 patients had various benign urological conditions. Immunocytochemistry was performed using four antibodies: p53, MCM 2, MCM 5 and Ki‐67. A diagnostic power to detect low grade and high‐grade urothelial carcinoma was analysed for each antibody and their combinations with cytology. Results There were no significant differences between patients with low‐grade tumours and control group. Antibodies p53 and Ki‐67 slightly improved the sensitivity of urinary cytology while maintaining its specificity. The best negative predictive value was demonstrated in combinations of cytology and MCM 5 (88.9%) and cytology, p53 and MCM 5 (90.6%). In the diagnosis of high‐grade tumours, all antibodies apart from MCM 2 yielded better sensitivity and specificity than cytology alone (receiver operating characteristic curves: p53 = 0.853, MCM 5 = 0.931, and Ki‐67 = 0.895). Combined with cytology, the sensitivities went even higher for the cost of lower specificity. The best diagnostic performance was observed in the combination of MCM 5 and Ki‐67 (sensitivity = 96.2%; specificity = 80%). Conclusions Immunocytochemistry with p53, MCM 5 and Ki‐67 antibodies can improve the diagnostic power of urinary cytology in the detection and follow‐up of urinary bladder urothelial carcinoma.