Utility of a Flowcytometry Based Urine Analyser in Screening of Urothelial Malignancies EC17-EC20
Dr. Lalit Kumar,
Department of Pathology, Rajiv Gandhi Super Speciality Hospital, Tahirpur, Delhi, India.
Introduction: Urothelial malignancies are one of the most prevalent carcinomas. In clinical practice, all patients undergo routine urine examination. If urine examination is used as a screening test to detect malignancies, it will indeed be of great help in early detection and initiation of treatment, leading to better patient care and disease outcome. There is a paucity of literature on detection of urothelial carcinomas based on flowcytometric urine analysers.
Aim: To establish flowcytometry based screening criteria which could assist in detecting urothelial carcinomas on routine urine examination.
Materials and Methods: The prospective study was conducted in the Department of Pathology, Rajiv Gandhi Super Speciality Hospital, Tahirpur, Delhi, India. All the samples which were sent for urine cytology from July 2017 to June 2018 were included in the study. The samples underwent cytological examination using Giemsa and Papanicolaou stain after being analysed in Sysmex UX 2000. The statistical analysis was performed using Microsoft Excel 2010 and SPSS statistical program (Version 24).
Results: Total of 160 patients were included in the study. The male to female ratio in the present study was 5.67:1. Around 22% (35) cases turned out malignant, with 31 (88.6%) men and 4 (11.4%) women. The mean age for malignant cases was 60.2±5.2 years compared to 48.9±33.4 years for non-malignant cases. Multiple parameters were evaluated; only Red Blood Cell (RBC), White Blood Cells (WBC), Small Round Cells (SRC), and Epithelial Cells (EC) were statistically significant. Cut-off value for RBC was established at 52.9 cells/μL with high sensitivity, specificity and Negative Predictive Value (NPV); whereas WBC, SRC and epithelial cells showed increased NPV only.
Conclusion: Automated urine analysers, with established cut-off values for detection of urothelial malignancies, could help in screening of the routine samples for early detection of urothelial malignancies.