Urinary immunocytology—Promise or nonseller? A review with an opinion

Abstract

Urine cytology is considered a valid diagnostic method of urological and nephrological diagnosis and follow-up, whereas immunohistochemistry is an indispensable adjunct to histopathology. The combination of both--urinary immunocytology--has, so far, only attained a marginal role. This review gives a state-of-the-art update of urinary markers and relevant epitopes, elucidates some methodological pitfalls, and gives an outlook on the promise of urinary immunocytology today. It suggests that morphological urine cytology should be amended by immunology in a mutual quest of urologists and pathologists to improve the diagnostic power of urine cytology. The cost-effectiveness of the method is considered. This review also sheds light on the age-old dispute among pathologists about the nature of urothelial carcinoma that is reflected in the frequent and controversial reclassifications of the disease.

Evaluation of double immunocytochemical staining for CK20 and P53 as a potential adjunct to cytology for urothelial cancer diagnosis

“…Mutation of the p53 gene results in a longer half‐life of the protein which is reflected in p53 accumulation in the nucleus, detectable by immunohistochemistry. P53 is involved in the oncogenesis of urothelial carcinomas and correlates with tumour progression for carcinoma in situ and tumour recurrence …”

“…Although modern pathology tends to the application of molecular techniques for the identification of p53 mutations or CK20 gene, the use of immunostaining has certain advantages related to simplicity, cost and preservation of morphology . Moreover, as cytology material has the specific disadvantage of unknown cellularity of the reprocessed sample, the idea of simultaneous staining of two antibodies is rather appealing .…”

Current prospects of urine cytology in diagnosis and follow-up urinary tract malignancies - the short review

“…Evidence-based knowledge suggests that urinary immunocytology -combination of 2 approaches: cytology and immunohistochemistry as an adjunct, may attain potential role. This approach seems to bear the potential to fortify the diagnostic power of urine cytology in the screening and surveillance of urothelial carcinoma [13,14]. Böhm et al [14] mentioned that some immunohistochemical markers have already been used in urinary immunocytology.…”

“…This approach seems to bear the potential to fortify the diagnostic power of urine cytology in the screening and surveillance of urothelial carcinoma [13,14]. Böhm et al [14] mentioned that some immunohistochemical markers have already been used in urinary immunocytology. Including cytokeratin stains (cytokeratin-20 and cytokeratin fragments), Ki-67, fibroblast growth factor (FGF) and its receptor (FGFR), p53 and nuclear matrix proteins were enumerated [13][14][15][16].…”

“…Böhm et al [14] mentioned that some immunohistochemical markers have already been used in urinary immunocytology. Including cytokeratin stains (cytokeratin-20 and cytokeratin fragments), Ki-67, fibroblast growth factor (FGF) and its receptor (FGFR), p53 and nuclear matrix proteins were enumerated [13][14][15][16]. We focused on nuclear matrix protein 22 (NMP-22) and cytokeratin -20 (CK-20).…”