Study On The Diagnostic Value Of A Novel Urine Cytology Test For Urothelial Carcinoma

Objective:To evaluate the application value of the novel urine cytology test for the diagnosis of urothelial carcinoma by using the TCT method as a control.Methods:The study included 100 patients who were suspected to have urothelial cancer due to imaging results or painless gross hematuria,admitted to the Eastern Theater General Hospital from June 2018 to October 2019.After removing 9 samples without pathological control we got a total of 91 samples.The patients included 71 men and 20 women with a mean age of(65.3 ± 11.3)years.All patients underwent the new urine shedding cytology test and TCT.All patients had no indwelling catheterization,and urine samples were placed before cystoscopy.The experimental group used the new urine cytology test method: We collected all urine from each patient from the first urination in the morning to the time before the test,with a urine volume of not less than 250 ml.Urine samples were pretreated by standing,centrifuging,pickling,washing,etc.,and then sealed with 10% formaldehyde solution.We centrifuged the test tube until the cells are aggregated into clumps at the bottom of the slide.The samples with obvious epithelial tissues or cell clumps were filtered through filter paper and the lower sediment was directly put into the embedding box,dehydrated,transparent,and embedded in wax.Samples with a small amount of cells or cells that are difficult to aggregate are first embedded in agar gel and then embedded in paraffin.The remaining steps are the same as before.The remaining steps were the same as before.Five wax blocks were sliced for the first time.After dewaxing,hematoxylin-eosin staining was performed and the slides were sealed.When the result was negative after reading,we used the continuous sectioning method to slice all the wax blocks.The rest of the steps were the same as before.The control group used the TCT method: We collected the second mid-urinary urine specimen(about 50ml).The urine specimens were allowed to stand,centrifuged,and washed with washing solution,and then the TCT preservation solution was added.After being left to stand,the slides were made with T5000 automatic liquid-based thin-layer cell preparation machine,and the sections were mounted after hematoxylin-eosin staining.After reviewing the pathological section,compared with the final postoperative pathological results,the correct rate,the sensitivity and specificity of the experimental group and the control group in terms of the overall sample,different types,different levels,gender,tumor location,and the film production were compared,and statistics were used.We made scientific analysis to verify the conclusion.Results:Of the 91 patients,there were 52 cases of bladder tumors(50 urothelial carcinoma,1 renal-derived adenoma,and 1 mucinous adenocarcinoma),24 cases of ureteral or renal pelvic cancer,1 case of postoperative pathology showed atypical hyperplasia of the epithelium,3 cases of glandular cystitis,1 case of bladder stones,5cases of renal cell carcinoma,and 5 cases of BPH or prostate cancer and 1 case of lymphoma.Of the 74 cases diagnosed with urothelial carcinoma,54 cases were high-grade urothelial carcinoma and 20 were low-grade urothelial carcinoma.There were 44 cases of muscular invasive urothelial carcinoma and 30 cases of non-muscular invasive urothelial carcinoma.Of these,63 patients were first episodes and 11 patients had relapses.The sensitivity of the experimental group and the control group were 64.9% and 45.9%(P <0.05).The specificity were 88.2% and82.4%(P>0.05).The correct rates were 69.2% and 52.7%(P< 0.05).The sensitivity of the experimental group method used in high-grade and low-grade urothelial cancer were 77.8% and 30.0%(P <0.05);In low-grade urothelial carcinoma,the sensitivity of the experimental group and control group were 30.0% and 10%(P> 0.05);In high-grade urine the sensitivity of the two were 77.8% and 59.3% in pathologically carcinoma(P< 0.05).The sensitivity of the experimental group method in muscular infiltrating and non-muscularly infiltrating urothelial carcinoma were 93.2% and23.3%(P <0.05);In muscle-invasive urothelial carcinoma,the sensitivity of the experimental group and control group were 93.2% and 65.9%(P <0.05);In non-muscle-invasive urothelial carcinoma,the sensitivity of the two were 23.3% and16.7% respectively(P> 0.05).The sensitivity of the experimental group method were65.0% and 64.8% in female and male patients(P> 0.05).The sensitivity in first episode and relapse patients were 63.5% and 72.7%(P> 0.05);the sensitivity of the experimental group method in upper urinary urothelial carcinoma and bladder urothelial carcinoma were respectively 62.5% and 60.0%(P> 0.05).The sensitivity and accuracy of the new urinary shedding cytology test is obviously superior to that of TCT,and the specificity are not significantly different.The sensitivity of the new method to high-grade urothelial cancer is significantly higher than that of low-grade urothelial cancer.The new method is more sensitive in the diagnosis of high-grade urothelial cancer than TCT,and shows no difference in low-grade tumors.The sensitivity of the new method to myometrial invasive urothelial cancer is significantly higher than that of non-muscular invasive urothelial cancer,which shows an advantage in the diagnosis of myometrial urothelial cancer compared with TCT method.There was no significant difference in the diagnosis of non-muscle-invasive urothelial carcinoma.Their sensitivity did not show statistical differences in the detection of different genders,first episodes and recurrences,upper urinary urothelial carcinoma and bladder urothelial carcinoma.The novel urine cytology test is excellent in the quality of pathological section.Conclusions:Under the guarantee of high specificity,the novel urine cytology test has more advantages than the TCT method and has higher application value.