Investigation of Atyp.C using UF-5000 flow cytometer in patients with a suspected diagnosis of urothelial carcinoma: a single-center study

Abstract

Background This study evaluated the predictive power of Atyp.C (a parameter of UF-5000 flow cytometer) for patients with a suspected diagnosis of urothelial carcinoma. Methods We analyzed 163 urine specimens from 128 patients with suspected urothelial carcinoma using a fully automated fluorescence flow cytometry analyzer (UF-5000) and evaluated its performance on identifying atypical/malignant urothelial cells. From January 1, 2019 to April 4, 2019, all consecutive specimens for urinary cytopathology were enrolled. Results Of the specimens with urinary cytopathology, 67 specimens (41.1%) revealed abnormal findings in cytology analysis. Among them, 20 specimens (12.3%) were diagnosed as atypical urothelial cells, 26 specimens (16.0%) as suspicious for malignancy (S-malignancy), and 21 specimens (12.9%) as confirmed malignancy. The UF-5000 findings were positive in 59 specimens (36.2%); therefore, the agreement with cytopathology was 73.0%. Using follow-up histologic diagnosis of urothelial carcinoma with or without urinary tract cytology (UTCy) as a reference standard (suspicious and confirmed malignancy were the positive criteria for UTCy), the sensitivity was 59.0%, specificity was 82.1%, positive predictive value was 75.0%, negative predictive value was 68.8%, and the agreement was 71.1%. Conclusions It is worth knowing and reporting that the Atyp.C assay may be used as an accessory test for patients with suspected urothelial carcinoma, based on its ability to identify high-risk patients who might need closer follow-up or additional medical treatment.

Improving clinical performance of urine sediment analysis by implementation of intelligent verification criteria

“…When the UF-5000 count of pathological casts, RTECs, YLCs, crystals and atypical cells were ≥1/µL, ≥7/µL, ≥10/µL, ≥10/µL and ≥0.1/ μL [16], respectively, the sample was microscopically reviewed by phase-contrast microscopy. Other rules that trigger manual microscopy of the urine sample include samples with a high total count (≥100.000 particles/µL), a RBC/YLC abnormal scattergram flag generated by the analyser, a high test strip total protein count (>3 g/L), and a sperm count ≥1/µL.…”

“…Previous research has shown that automated urine sediment analysers, when compared to urinary cytopathology, can identify abnormal cells in unstained, uncentrifuged urine specimens [16,35,36]. Depending on the patient group studied, the sensitivity and specificity ranges from 50.0 to 75.0% and 83.3 to 100%, respectively.…”

“…The UF-5000, on the other hand, is the third-generation fluorescence flow cytometer analyser for urinalysis and offers the possibility of accurate counting and differentiation of a broad variety of urinary cells. Novel parameters, like renal tubular epithelial cells (RTECs) or atypical cells, became available and have been evaluated [3,15,16].…”

Atypical cells parameter in Sysmex UN automated urine analyzer: feedback from the field

“…The cost effectiveness of the procedure is questioned and criticized for low performance [ 5 ]. Particularly considering urine cytology, using Sysmex UF in aid or even in replace of manual examination may be an option in the future [ 6 ]. Urinalysis testing requires fresh urine samples for chemical and microscopic examinations in which unstained sediment is used in general.…”

Atezolizumab plus platinum-based chemotherapy as first-line therapy for metastatic urothelial cancer: A cost-effectiveness analysis

“…Globally, bladder cancer is the 10th most common cancer, with 573,000 new cases and 213,000 deaths estimated in 2020 ( Sung et al, 2021 ). Urothelial cancer is the most common type of bladder cancer, accounting for 90%–95% of all cases ( Chen et al, 2020 ; Ren et al, 2020 ). Early-stage urothelial cancer is curable, but invasive urothelial cancer with progressive or recurrent disease usually has a poor prognosis ( Lopez-Beltran et al, 2021 ).…”