p16/Ki‐67 dual labeling and urinary cytology results according to the New Paris System for Reporting Urinary Cytology: Impact of extended follow‐up

Abstract

BACKGROUND: Overexpression of p16INK4a has been identified in urothelial malignancies both cytologically and histologi- was significantly shorter for dual-labeled cases versus cases with negative dual labeling (P < .0001). The same tendency was observed in patients with histologically proven LGUN (P < .0001). As for specificity in patients with negative cystoscopy and cytology combined, prolonged follow-up showed 90% overall survival at 24 months. CONCLUSIONS: A longterm evaluation of p16/Ki-67 dual labeling may identify HGUC and progression in cases with negative/low-grade urinary cytology results, and there are potential implications for the clinical management of patients after the conservative treatment of non-muscle-invasive urothelial carcinoma.

One year of experience using the Paris System for Reporting Urinary Cytology

“…We did not observe such a difference (Table ). As reported by Piaton et al, the categories of SHGUC and HGUC can be considered as positive because they are very indicative of HGUC on histology.…”

“…Ancillary tests may be of help in such cases. Piaton et al recently reported interest in dual labeling using p16 and Ki‐67 for AUC and LGUN for the prediction of outcome in patients with urothelial carcinomas. Such a test is easy to perform and could be used daily to help characterize such cytologies.…”

SOX10/keratin dual‐color immunohistochemistry: An effective first‐line test for the workup of epithelioid malignant neoplasms in FNA and small biopsy specimens

“…The use of multiplexed IHC stains in cytology specimens has grown dramatically in the past 5 to 7 years (Table ) . Studies have shown the usefulness of these stains in triaging patients with abnormal cervical cytology, evaluating malignant effusions, identifying high‐grade urothelial carcinomas, detecting malignancy in biliary brushings, and the subtyping of non‐small cell lung carcinoma . The last example especially highlights the need to preserve limited diagnostic material for ancillary studies such as fluorescence in situ hybridization (FISH) for ALK and ROS1 rearrangements, next‐generation sequencing (NGS), and PD‐L1 testing, all of which have become standard practice for the management of lung adenocarcinomas.…”

“…Dual‐color immunohistochemistry (IHC) has been established as an adjunct test for the evaluation of invasive carcinoma in both the breast and prostate, and has had ever‐more increasing use in the evaluation of cytology specimens including the subtyping of non‐small cell lung cancer, triaging abnormal cervical scrapings, the detection of high‐grade urothelial carcinoma, identifying malignant cells in biliary brushings, and the evaluation of malignant effusions . The simultaneous detection of one nuclear marker and one cytoplasmic marker with dual‐color staining dramatically enhances the visibility of small foci of invasive tumor cells, a few tumor cells in a reactive background, and/or distinct expression patterns in different settings …”

The combined application of urinary liquid‐based cytology with fluorescence in situ hybridization and p16/Ki‐67 dual immunostaining is valuable for improving the early diagnosis of upper tract urothelial carcinomas

“…NHGUC and AUC cases were considered negative for carcinoma. Both HGUC and SHGUC were treated as HGUC in LBC …”