Cost efficiency analysis of modern cytocentrifugation methods versus liquid based (Cytyc Thinprep®) processing of urinary samples

Abstract

Background/Aims: Liquid based cytology (LBC) was developed as a replacement for cytocentrifugation in the treatment of cell suspensions. Because accurate data comparing the quality and total cost of modern cytocentrifugation methods versus LBC in non-gynaecological samples are not available, this study was designed to investigate these issues. Methods: The study comprised 224 urine samples treated with the Thermo Shandon CytospinH 4 using reusable TPXH chambers, disposable CytofunnelsH for samples up to 0.5 ml, and disposable MegafunnelsH for samples up to 6 ml. Each method was compared with the Cytyc ThinprepH processing of a paired sample. Quality was assessed by scoring cellularity, fixation, red blood cells, leucocytes, abnormalities of urothelial cells, and suitability for molecular studies. Wage costs, investment, and consumables allowed a ''total cost'' to be calculated on the basis of 200 specimens/month. Total cost and quality combined were used to calculate an index of total quality (ITQ). Results: Cytocentrifugation with disposable chambers resulted in a global quality superior to that of Cytyc Thinprep LBC. Preparation and screening times were 2.25 and 1.33-2 times greater when using LBC compared with cytocentrifugation. The total cost each month reached 1960.23 $ to 2833.43 $ for cytocentrifugation methods and 5464.95 $ for Cytyc Thinprep LBC (92.8-178.8% increased cost). ITQ of cytocentrifugation with disposable chambers surpassed that of Cytyc Thinprep LBC (37.25/32.08 and 9.98, respectively). Conclusion: Cytyc Thinprep LBC and cytocentrifugation are both appropriate methods for cytology based molecular studies, but cytocentrifugation remains the quality standard for current treatment of urinary samples because of its lower cost.

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

“…13 Since the early 1990s, after the onset of marketing of ThinPrep for use in evaluating nongynecological specimens, there have been many studies comparing ThinPrep with more conventional processing techniques (e.g., cytocentrifugation, direct smear, filtration) for urine cytology. [4][5][6][7][8][9][10] These studies have produced conflicting conclusions. Elsheikh et al 5 preferred ThinPrep over conventional CS in the majority of nongynecologic, including urinary cytology cases.…”

“…However, other studies have concluded that conventional methods, such as cytocentrifugation, are more appropriate HIGH-GRADE UROTHELIAL CARCINOMA Diagnostic Cytopathology, Vol 37, No 1 than ThinPrep for the treatment of urine cytology samples and that in cases of malignancy, CS is superior in terms of interpreting the cytomorphologic details. 4,7,8 There have been only a few documented reports comparing SP with conventional preparations for the evaluation of urine cytology specimens. 9,11,12 These studies have shown mixed results.…”

“…4 In terms of urine cytological preparations, there have been many studies comparing the ThinPrep method with conventional methods of specimen processing. [4][5][6][7][8][9][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.…”

p53 immunodetection of liquid-based processed urinary samples helps to identify bladder tumours with a higher risk of progression

“…In the urine, the use of the Thinprep s 2000 (Cytyc Corp., Boxborough, MA, USA) processor results in increased cellularity and marked reduction of debris, erythrocytes and crystals (Anagnostopoulou et al, 2000;Wright and Halford 2001;Piaton et al, 2002Piaton et al, , 2004. Additionally, complementary techniques such as immunocytochemistry, DNA, RNA and protein molecular analysis can be successfully applied to Thinprep sprocessed samples, thus allowing the impact of biomarkers in a variety of human malignancies to be studied (Tisserand et al, 2003).…”

Detecting Malignant Urothelial Cells by Morphometric Analysis of ThinPrep® Liquid-based Urine Cytology Specimens

“…3,4 Therefore, urinary cytology is another important approach for making the diagnosis and follow-up of bladder cancer. This procedure is noninvasive and quite sensitive for high grade urothelial lesions irrespective of their location in the urinary tract.…”