Comparison of TriPath Thin-Layer Technology with Conventional Methods on Nongynecologic Specimens

There is limited literature available comparing SurePath (SP) with conventional cytospins (CS) for urine cytology specimens, especially urothelial carcinoma. In this study, urinary tract cytology cases of high-grade urothelial carcinoma were assessed on SP and CS slides. Also, the morphologic differences of highgrade urothelial carcinoma between SP and CS were evaluated on a total of 35 cases of high-grade urothelial carcinoma. SP showed that the tumor cells tend to present as threedimensional groups and have a smaller cell size than CS. In terms of nuclear features, SP and CS were found to be comparable in morphologic assessment of the tumor cells, with CS providing a slightly better visualization. Diagn. Cytopathol. 2009; 37:16-20. ' 2008 Wiley-Liss, Inc.Key Words: SurePath; cytospin; urine cytology; urothelial carcinoma Urinary bladder cancer is the seventh most common malignancy worldwide.1 In the United States specifically, more than 60,000 new cases of bladder cancer are diagnosed annually, with *13,000 deaths every year.2 The vast majority of these cancers are urothelial carcinomas, the incidence of which has been steadily increasing over the past several years. 3Urothelial carcinoma screening has relied in large part on cytology of the urinary tract. Urinary cytology, however, has its limitations, with a mean sensitivity of only *50% for detecting urothelial carcinoma. 4 It is also hindered by many nondiagnostic samples. This limitation aside, however, urinary cytology detects *80% of aggressive, high-grade urothelial tumors. 4 In view of this, urinary cytology, in conjunction with cystoscopy, has played a large role in the diagnosis and monitoring of individuals with high-grade urothelial carcinoma, including the often clinically silent flat carcinoma in situ.Conventional methods of urine cytology have included cytocentrifugation, millipore filtration, and direct smearing. In the 1990s, liquid-based cytology (LBC) was developed as a replacement for the conventional methods, because of reported higher cell recovery rates and better cell preservation with LBCs. The ThinPrep 1 (Hologic, Marlborough, MA) is a thin-layer, LBC method based on a filtration process and a computer-assisted thin-layer deposition of cells. The SurePath TM (BD-TriPath Imaging, Burlington, NC) is another thin-layer, LBC technique that is based on a sedimentation process. 4 In terms of urine cytological preparations, there have been many studies comparing the ThinPrep method with conventional methods of specimen processing.4-10 However, there have been only a few studies comparing the SurePath TM technique with conventional methods of urinary cytological specimen processing. 9,11,12 In this study, the authors have compared the morphologic features of high-grade urothelial carcinoma on SP and cytospins (CS) slides. Materials and MethodsSince January 2006, all urinary tract cytological specimens at our institution were divided equally for the preparation of 1 CS slide and 1 SP slide. The CS slides were prepared by cytocentrifugation ...

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…9,11,12 In this study, the authors have compared the morphologic features of high-grade urothelial carcinoma on SP and cytospins (CS) slides.…”

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confidence: 99%

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See 3 more Smart Citations

High‐grade urothelial carcinoma: Comparison of SurePath liquid‐based processing with cytospin processing

Nassar

Siddiqui

2008

Use of ThinPrep® monolayer technique and cytospin preparation in urine cytology: A comparative analysis

Nassar

Ali-Fehmi

Madan

2003

We compared the ThinPrep (TP) technique to the cytospin (CS) preparation in the cytological diagnosis of urine by processing 79 specimens by these two techniques. Ten cases were positive for malignancy (six high grade (HG)/carcinoma in situ; four low grade (LG) transitional cell carcinomas (TCC)). Forty-eight cases were within normal limits (59%) and 21 cases had atypical cytological features (19%). The TP technique was better in terms of a cleaner background with fewer obscuring inflammatory cells and blood and with a more even distribution of cells. In general, the cytomorphology was comparable in both techniques. However, in cases with malignancy, CS was relatively superior in the cytomorphologic details; in TP, the diagnostic cells were mostly dispersed as single cells with loss of architectural features and were difficult to find. Artifactual empty spaces and air-drying were more frequently present in TP. In cases contaminated with squamous cells, the urothelial cells were difficult to find in TP. Screening time was comparable for both techniques. In conclusion, to avoid false-negative diagnosis, CS would be complementary to the TP technique in malignant cases and, in particular, those with low cellularity.

Comparison of ThinPrep and TriPath PREP liquid‐based preparations in nongynecologic specimens: A pilot study

Michael

McConnel

Pecott

et al. 2001

ThinPrep (TP) and TriPath PREP (TriP) are two liquid-based cytologic preparations that produce a thin layer of cells. This study compares the diagnostic accuracy and different cytomorphologic alterations produced by these preparations in nongynecologic specimens. Samples from 10 urines (3 urothelial carcinomas and 7 negative), 4 positive serous fluids, and 7 fine-needle aspirates (FNAs) were prepared by both techniques. FNAs represented one each of: Hashimoto's thyroiditis (HT), hyperplastic colloid nodule (HCN), Hodgkin's lymphoma, liposarcoma, chondrosarcoma, squamous-cell carcinoma (SCC) metastatic to the lymph node, and carcinoid tumor. All 5 participants, none of whom had prior knowledge of the clinical history or histologic diagnosis, reviewed and interpreted the slides. Both techniques produced a clean background and were equally accurate in urines, serous fluids, and three FNAs. TriP was slightly more accurate in four FNAs: HCN and HT where colloid and lymphocytes were better represented, SCC where keratin and malignant cells were more readily identified among lymphocytes, and carcinoid which was easier to evaluate on TriP due to less cellular shrinkage and more dispersion of cells between aggregates. TP preparations had more cell shrinkage, and the chromatin was harder to evaluate. Both techniques produced artificial aggregations of lymphocytes, but TriP had a more evenly dispersed single-cell population between aggregates, rendering them easier to evaluate for atypia. TP produced fragmentation of large sheets that were flattened, while TriP contained larger branching sheets in a three-dimensional (3-D) configuration. TP produced a true monolayer of cells that were all spread at the same plane, while in TriP the cells were spread at slightly different planes, requiring frequent focusing of the viewed plane. While both techniques are acceptable for diagnostic purposes, they both introduce new cytomorphologic alterations that pathologists need to recognize. TriP seems superior to TP in FNAs specimens where preservation of architecture and cellular integrity are important considerations.