Liquid technology in the cytological diagnosis of bladder pathology

Objective. To study the effectiveness of liquid cytological diagnosis of bladder cancer and its local relapses using the Cellprep Plus technology as an example.Materials and methods. We analyzed outpatient records of patients with urothelial pathology (n = 806) who underwent a urine cytology exam by the methods of liquid (n = 383) and conventional (n = 423) cytology.Results. The diagnostic sensitivity and specificity of the cytological examination method for diagnosing urothelial carcinoma using the method of liquid cytology have been found to be 93.4 % and 95.4 % respectively, which significantly exceeds the similar indices in the use of the method of conventional cytology – 42.4 % and 93.6 % respectively. The use of the method of liquid cytology considerably increases the accuracy of the cytological examination of bladder pathology and allows obtaining conclusions that coincide with the histological conclusion in 94.0 % of cases. In the use of the method of conventional cytology, the coincidence with histological findings is only 44.6 % (χ2 = 25.08, p < 0.001).Conclusion. The Cellprep Plus liquid technology standardizes the pre-analytical stage and increases the efficiency of the cytological method in the primary diagnosis and monitoring of patients with urothelial pathology. A promising direction of using the method of liquid cytology in the diagnosis of urothelial carcinoma is the development and implementation of the cytological criteria of differential diagnosis between reactive cell atypia and atypia characteristic of a malignant tumor.

How Liquid Based Cytology Surpasses Conventional Cytology - A Review Article

Pap smear is the most widely used test for screening of cervical cancer and precancerous lesions. Liquid-based cytology is a cervical cancer screening technology that inspects cells by dissolving them in liquid and is used as a main screening tool for invasive cervical cancer. The purpose of this article is to demonstrate how fluid-based cytology has surpassed conventional cytology in the interpretation of cervical smear biopsy results in order to identify early cervical lesions in a more efficient and convenient manner, allowing for early diagnosis and treatment of cervical cancer patients and thus improving patient wellbeing.

Is Methionyl-tRNA Synthetase Applicable as a Diagnostic Marker for Lung Cancer in Bronchial Ultrasound-Guided Brushing Cells?

Background and objective: Methionyl-tRNA synthetase (MARS) and A variant of Aminoacyl-tRNA synthetase interacting multifunctional protein 2 (AIMP2) with an exon 2 deletion (AIMP2-DX2) are known to be overexpressed in lung cancer. However, their role as diagnostic markers in lung cancer has not been well established. Thus, we evaluated their diagnostic performance in brushed cells obtained from nodular lung lesions suspected of lung cancer. Methods: Samples obtained by radial endobronchial ultrasound-guided brushing were processed for cytological examination with Papanicolaou (Pap) staining. Then, double IF staining with MARS and AIMP2-DX2 antibodies was measured in the cytology samples for peripheral lung nodules. The diagnostic performance was compared against biomarkers. Results: MARS IF staining was the only independent staining method used for the prediction of malignant cells. The area under the curve (AUC) of conventional cytology, MARS IF, and MARS IF plus cytology was 0.64, 0.68, and 0.69, respectively. The diagnostic accuracy was increased in MARS IF plus conventional cytology compared with cytology alone (71% vs. 47%). Conclusions: The combination of MARS staining with conventional cytology showed increases in the diagnostic accuracy for diagnosing lung nodules suspected of lung cancer on chest-computed tomography scans.

P14.04 Detection of circulating tumor cells in cerebrospinal fluid for patients with suspected breast cancer leptomeningeal metastases. A prospective study

BACKGROUND Breast cancer (BC) is the most frequent cause of leptomeningeal metastases (LM). LM diagnosis is confirmed by the detection of tumor cells in the cerebrospinal fluid (CSF) using conventional cytology (gold standard). However, even with optimal CSF sample volume and time to the analysis, the sensitivity of this technique is low, demanding repeated samples. Here, we aimed to evaluate the value of circulating tumor cell (CTC) detection in CSF using the CellSearch® system for LM diagnosis. MATERIAL AND METHODS This prospective, monocentric study included adult BC patients with suspected LM (clinical and/or radiological signs). CSF samples from 1–3 lumbar puncture(s) were analyzed: protein level, conventional cytology (60 drops), and CTC detection with the CellSearch® system (60 drops, first lumbar puncture only). Sensitivity (Se) and specificity (Sp) were calculated, using the results of the conventional cytology as the gold-standard. RESULTS Forty-nine eligible patients were included (Jan 2017-Jan 2020): median age 51.8, 95.9% women, 20.4% HER2+ BC, 93.8% previously diagnosed with metastatic BC, 89.8% with clinical symptoms. Among them, 40 were evaluable (CTC detection failure: n=8, eligibility criteria failure: n=1). Median sample volume was 3.0 mL for conventional cytology samples (median time to analysis: 22min) and 3.3 mL for CTC samples. Of the 40 evaluable patients, 18 had a positive cytology (on CSF sample n=°1/n°2: n=16/n=2) and were therefore diagnosed with LM using the gold-standard method. Protein level was elevated in 88.2% of these patients, compared with 45.1% of patients with negative CSF cytology (p=0.005). CTCs were detected in these 18 patients (median 5824 CTCs, range 93-45052). CTCs were also detected in 5/22 patients with a negative cytology (median 2 CTCs, range 1–44). Among them, one patient (44 CTCs) was diagnosed with a cytologically-proven LM 9 months later, while there was no further argument for LM in the other 4 patients’ history (1–3 CTC), who died of the extra-cerebral disease after a median time of 5.2 months (range 0.9–25.9). The detection of at least one CTC in CSF was associated with a Se of 100.0% (IC95% 82.4–100) and a Spe of 77.3% (IC95% 64.3–90.3) for the diagnosis of LM. CONCLUSION CTCs were detected with the CellSearch® system in all patients diagnosed with a cytologically-proven LM, as well as in a few patients without a cytological confirmation of LM. The prognosis of these patients with CSF cytology-/CTCs+ needs to be further investigated in a larger cohort.

EVALUATION OF CELL BLOCK TECHNIQUE VERSUS CONVENTIONAL CYTOLOGY ON BRONCHOSCOPY GUIDED NEEDLE ASPIRATION/ BRUSH CYTOLOGY FOR DIAGNOSIS OF LUNG CANCER

INTRODUCTION: Bronchoscopy is a safe and effective method for diagnosing lung carcinomas with a variation in the diagnostic yield with different bronchoscopy guided procedures. Cell block technique has shown an addition cases positivity in diagnosing carcinomas as compared to the conventional method. AIM: The present study was aimed to evaluate the diagnostic utility of cell block technique on Bronchoscopy guided needle aspiration/ Brush and also to compare cytological preparation with cell block. MATERIAL AND METHODS: A total of 50 cases were included in the study that was suspected to be having lung carcinoma. These patients went under bronchoscope guided aspirations (TBNA, EBNA, and Brush). Smears were immediately made for conventional cytology study and well as in another aliquot samples were collected to prepare cell blocks following which H&E staining was done. RESULTS: Out of 50 cases, 8 cases came out to be negative on conventional smears and when compared with cell block technique 4 additional cases came out to be positive who were negative on conventional smears. The diagnosis were compared with histopathology biopsies keeping it as a gold standard and results on cell block techniques were conrmed to be true. CONCLUSION: Out of 50 cases, an additional 4 more cases were diagnosed malignant by using the cell blocks technique but there were few drawbacks with cell block technique. In few of the cases on cell block, cellularity was very less, cells morphology was also not very clear and some showed cells entrapped in a clusters. The conclusion made out of this study is that cell block technique is more accurate than the cytological smears and when used in combination diagnostic efcacy will be improved.

Diagnostic Efficacy of DNA Ploidy in Liquid Based Cervical Cytology using DNA Cytometry

Worldwide cervical cancer is the fourth most common cancer in women and high incidence is reported from India. Liquid Based Cytology (LBC) provides good morphology for detection of cellular abnormalities. We, therefore, reviewed diagnostic efficacy of conventional Pap staining, flow cytometry and Human Papilloma Virus (HPV) testing in cervical pre cancer and cancer. Narrative review of cervical pre cancer and cancer candidate biomarkers including Pap staining, HPV and flow cytometry from cervical cytology fluids, is based on a detailed review of the literature. Based on the so far conducted studies, a promising conclusion can be drawn, that cytometry when coupled with HPV DNA typing or the conventional cytology gives better results as compared to that of conventional cytology or DNA cytometry alone. Liquid cytology provides a good and stable source of cervical cells to carry out ploidy studies using DNA cytometry. The procedure should be used in conjunction with LBC and HPV detection.