Comparison of ImmunoCyt, UroVysion, and urine cytology in detection of recurrent urothelial carcinoma

Abstract

BACKGROUND: ImmunoCyt (uCyt) and UroVysion are ancillary studies that may aid in the detection of urothelial carcinoma in urine specimens. We compared ImmunoCyt and UroVysion to urine cytology in the ability to detect recurrent urothelial carcinoma. METHODS: Single voided urine samples were obtained from 100 patients who had a previous history of bladder cancer. All patients underwent cystoscopy immediately after urine sample collection. Forty‐one cystoscopically suspicious lesions were biopsied. Urine samples were divided and processed blindly and independently in 3 different laboratories for ImmunoCyt, UroVysion, and urine cytology (ThinPrep method). RESULTS: Of the 41 cystoscopically positive cases, most cystoscopy findings showed multiple tumors that were papillary and less than 1 cm. Biopsies showed many low‐grade tumors (54%). Overall sensitivity of cytology for low‐ and high‐grade urothelial cell carcinoma was 15% and 27%, whereas ImmunoCyt was 62% and 91% and UroVysion was 8% and 18%, respectively. Overall specificity of cytology was 97%, whereas ImmunoCyt was 63% and UroVysion was 90%. CONCLUSIONS: ImmunoCyt is more sensitive than either cytology or UroVysion in detecting low‐grade tumors. Both cytology and UroVysion have comparable specificity in cystoscopically negative cases. Whereas ImmunoCyt may improve the cytological detection of recurrent bladder cancer, UroVysion may be used as a confirmatory test for either cytology or ImmunoCyt. Cancer (Cancer Cytopathol) 2009. © 2009 American Cancer Society.

Microdevices for Non-Invasive Detection of Bladder Cancer

“…The aim of promoting early-stage detection would provide clinicians with the flexibility to select for cheaper and less damaging treatment options. Currently, existing monitoring methods are optimized for patients with advanced bladder cancer [22,23,113]. Given that the five-year survival rate of patients whose bladder cancer is confined to the urothelium at diagnosis is over 19 times higher than the rate for patients whose cancer has metastasized [5], screening and diagnostic devices with consistent performance across cancer stages would bring significant benefits to bladder cancer patient care.…”

“…Since low-grade tumors shed few cells [113] and the presence of any circulating tumor cells confers poor prognosis [123], low numbers of exfoliated cells could limit the utility of cell-based tools for early detection. Thus, non-cell based biomarkers such as extracellular vesicles, an agent of cellular communication for budding tumors within the tumor microenvironment [124], may be a promising alternative for detection at earlier stages.…”

Comparative Evaluation of ProEx C and ImmunoCyt/uCyt Assays in Atypical Urine Cytology

“…6,7,26 uCyt Immunofluorescence Staining Slide preparation for uCyt immunofluorescence staining was performed within 7 days of sample collection, according to the procedure published in the manufacturer's instruction sheet. That protocol has also been described in a separate publication by Sullivan et al 17 A positive score was assigned when 1 of the 3 biomarkers (2 for the mucin glycoprotein and 1 for the glycosylated form of carcinoembryonic antigen) was detected in a cell with red or green fluorescence. Both green and red fluorescent cells may be seen in a single positive sample ( Figure 1).…”

“…11,[15][16][17][18] In our institution, uCyt is a commonly used ancillary test. 17 It identifies 3 biomarkers, 2 for the mucin glycoprotein and one for the glycosylated form of carcinoembryonic antigen commonly found in bladder cancer cells.…”

“…11,[15][16][17][18] In our institution, uCyt is a commonly used ancillary test. 17 It identifies 3 biomarkers, 2 for the mucin glycoprotein and one for the glycosylated form of carcinoembryonic antigen commonly found in bladder cancer cells. [19][20][21] Recently, the utility of the ProEx C antibody cocktail in urinary cytology as an ancillary test to aid in the stratification of AUCs was introduced.…”