An institutional experience evaluating hTERT immunostaining in 100 consecutive ThinPrep urine specimens

Xing, Juan; Han, Min; Dhir, Rajiv; Pantanowitz, Liron

doi:10.1016/j.jasc.2020.03.003

Cited by 3 publications

(4 citation statements)

References 13 publications

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“…In our study, hTERT nuclear or nonspecific cytoplasmic staining was also identified in benign urothelial cells, such as umbrella cells or parabasal cells, which confused interpretation in as many as 29 cases (29/337, 8.6%). However, the immunoreactivity for hTERT was weaker in benign cells compared with urothelial carcinoma, which is concordant with the findings of previous studies 24,25 . For instance, Xing et al, 25 who performed ICC on ThinPrep slides, recognized hTERT positivity in normal or nonurothelial cells, yet more often a stronger staining pattern in urothelial carcinoma.…”

Section: Discussionsupporting

confidence: 89%

“…Two previously published studies using the SCD‐A7 antibody on urine cytology also demonstrated increased hTERT expression rates in urothelial carcinoma. Allison et al 24 demonstrated that nine of the 11 HGUC samples showed hTERT positivity, while in another study by Xing et al 25 six of the nine SGHUC and HGUC samples showed strong staining with hTERT. These consistent findings support hTERT ICC utility in detecting malignant urine cytology samples.…”

Section: Discussionmentioning

confidence: 97%

“…Two previously published studies using the SCD-A7 antibody on urine cytology also demonstrated increased hTERT expression rates in urothelial carcinoma. Allison et al 24 demonstrated that nine of the 11 HGUC samples showed hTERT positivity, while in another study by Xing et al 25 In the initial application of ICC, however, there was a quality issue related to the immunoreactivity of hTERT. We noticed severe background staining in addition to overstaining of epithelial cells, regardless of several staining protocol alterations, including antibody incubation or retrieval time.…”

Section: Discussionmentioning

confidence: 99%

“…However, the immunoreactivity for hTERT was weaker in benign cells compared with urothelial carcinoma, which is concordant with the findings of previous studies. 24 , 25 For instance, Xing et al, 25 who performed ICC on ThinPrep slides, recognized hTERT positivity in normal or nonurothelial cells, yet more often a stronger staining pattern in urothelial carcinoma. More specifically, whereas 37/60 (62%) of their NHGUC cases showed hTERT immunopositivity, just 8/37 (22%) exhibited a strong signal intensity.…”

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Clinical application of the anti‐human telomerase reverse transcriptase (hTERT) antibody (SCD‐A7) immunocytochemistry in liquid‐based urine cytology: A prospective, single institute study

et al. 2023

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Objectives Urine cytology is the most widely used noninvasive screening tool for urothelial carcinoma diagnosis and surveillance. Although highly specific, urine cytology exhibits suboptimal sensitivity. This study aimed to determine whether hTERT immunocytochemistry (ICC) could be applicable as an ancillary test in routine cytology practice. Methods A total of 561 urinary tract samples were initially screened in this study. All of them were prepared using SurePath liquid‐based cytology (LBC), while additional LBC slides were made and subsequently used for hTERT (SCD‐A7) ICC. Results From the 561 samples screened, 337 were finally analyzed, all having an adequate cellularity and available follow‐up histology. The hTERT ICC‐positive rate was 95.9% (n = 208/217), 96% (n = 24/25), and 100% (n = 4/4) in cytology samples with high‐grade urothelial carcinoma, carcinoma in situ, and low‐grade urothelial carcinoma subsequent histology. Among the 64 atypical cytology cases histologically confirmed as urothelial carcinomas, 92.2% (n = 59/64) were immunoreactive to hTERT, whereas the two histologically benign cases were ICC‐negative. 87/90 (96.7%) of the cytology cases confirmed to be benign in follow‐up were hTERT‐negative. The overall sensitivity and specificity of hTERT ICC were 96.3% and 98.8%, respectively (AUROC = 0.963; 95% CI = 0.960–0.967). Conclusions The hTERT ICC test exhibited consistent and intense staining in malignant urothelial cells, suggesting its value as an ancillary test in liquid‐based urine cytology.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Clinical application of the anti‐human telomerase reverse transcriptase (hTERT) antibody (SCD‐A7) immunocytochemistry in liquid‐based urine cytology: A prospective, single institute study

et al. 2023

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Urine cytology: Updates and challenges in reporting systems, ancillary studies, and artificial intelligence

Xing,

Reynolds,

Liu

et al. 2024

Human Pathology Reports

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Evaluation of a Cytology-Molecular Co-Test in Liquid-Based Cytology-Processed Urine for Defining Indeterminate Categories of the Paris System

Samara,

Thodou,

Apostolopoulou

et al. 2024

Acta Cytologica

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Introduction: Urine cytology using the Paris system (TPS) classification is useful for the detection and monitoring of bladder urothelial carcinoma (UC). However, the categories "Atypical Urothelial Cells” (AUC) and “Suspicious for High-Grade Urothelial Carcinoma” (SHGUC) do not establish a clear diagnosis. This pilot study aimed to investigate whether the presence of mutations in fibroblast growth factor receptor 3 (FGFR3) and telomerase reverse transcriptase (TERT) genes, in urine processed with liquid-based cytology (LBC) could enhance the diagnostic performance of cytology, particularly in defining the indeterminate categories of AUC and SHGUC. Methods: Urine samples from 82 UC patients with primary tumors or under surveillance and 10 healthy individuals were examined. The THIN PREP method was used for cytology followed by DNA isolation from urine sediments. Targeted molecular analysis was achieved in 70 cases (63 patients and 7 controls) for exons 7 and 10 of the FGFR3 gene and the TERT gene promoter (pTERT), using PCR and Sanger sequencing. Molecular results were correlated with TPS cytology categories and validated by histopathological findings following cystoscopy. Results: In healthy subjects, cytology was negative for high-grade urothelial carcinoma (NHGUC) and no mutations were found. No mutations were found in patients with NHGUC cytology, except for one case with equivocal cystoscopy that carried a pTERT mutation. In high-grade urothelial carcinoma cytology (HGUC) (15/20, 75%) of the cases with histologically confirmed UC, molecular analysis revealed the presence of pTERT without FGFR3 mutations. In SHGUC and AUC cytology, FGFR3 and/or pTERT mutations were detected in (3/4, 75%) and 4/4 (100%) histologically confirmed UC cases, respectively. Cytology sensitivity was 85.7% increasing to 100% with the combined cytology-molecular test, whereas specificity remained unchanged at 86.3%. Conclusions: This pilot study suggests that the incorporation of FGFR3/pTERT molecular testing in urine LBC could enhance the diagnostic value of cytology by diagnosing BUC in indeterminate cytology categories.

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An institutional experience evaluating hTERT immunostaining in 100 consecutive ThinPrep urine specimens

Cited by 3 publications

References 13 publications

Clinical application of the anti‐human telomerase reverse transcriptase (hTERT) antibody (SCD‐A7) immunocytochemistry in liquid‐based urine cytology: A prospective, single institute study

Clinical application of the anti‐human telomerase reverse transcriptase (hTERT) antibody (SCD‐A7) immunocytochemistry in liquid‐based urine cytology: A prospective, single institute study

Urine cytology: Updates and challenges in reporting systems, ancillary studies, and artificial intelligence

Evaluation of a Cytology-Molecular Co-Test in Liquid-Based Cytology-Processed Urine for Defining Indeterminate Categories of the Paris System

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