Use of computerized karyometric image analysis for evaluation of human spermatozoa.

The objective of this study was to evaluate a computer image system for its ability to determine morphological and nuclear semen characteristics in an integral and reproducible way. Semen samples from 19 normospermic fertile donors were used to estimate preliminary cutoff values for spermatozoa and to test the reproducibility of the system. Ten aliquots of 1 sample were used to investigate the sensitivity of the system for experimental conditions by exposure to different laboratory variables. Human spermatozoa were stained with Feulgen dye and analyzed with a magnification of 1000x. A panel of 21 parameters was measured for each sperm nucleus using the computerized karyometric image analysis (CKIA) system. Eight parameters were found to be sensitive for differentiating normal or abnormal human spermatozoa, and cutoff values for each parameter were defined for quantitative analysis. These 8 parameters were grouped into 3 categories depending on their descriptive value: morphometry, DNA condensation (stainability), and chromatin texture. Intrapatient and interpatient variabilities were tested by calculating the reliability coefficient for each of the 8 parameters as well as for each category. Reliability coefficients were all >70% (indicative of the suitability of the system to identify differences between spermatozoa). Interpatient variability (SD) was 5%. Although it was not statistically significant, a variation of 10.9% in measurements was found when the effects of experimental conditions were tested. We conclude that an objective description of the human sperm nucleus can be achieved with CKIA, yielding high interpatient and intrapatient reliability coefficients (reproducibility), thereby adding a new tool for the quantification of normal sperm.

UroVysion compared with cytology and quantitative cytology in the surveillance of non-muscle-invasive bladder cancer.

OBJECTIVES: The multitarget fluorescence in situ hybridization probe set Vysis UroVysion, consisting of probes for chromosomes 3, 7, and 17 and for the 9p21 band, was studied to evaluate its value in the follow-up of patients with bladder cancer. The results were compared with conventional cytology and quantitative cytology (Quanticyt). The aim of this study was to evaluate whether UroVysion is a better adjunct to urethrocystoscopy than cytology and quantitative cytology. METHODS: UroVysion, cytology, and quantitative cytology were performed on 113 voided urinary samples of 105 patients under surveillance for non-muscle-invasive bladder cancer. Before urethrocystoscopy or transurethral resection of the bladder, a voided urinary sample was obtained. Results of all tests were compared to evaluate the value of UroVysion. RESULTS: Sixty-four patients had biopsy-proven urothelial cell carcinoma. Sensitivity and specificity were, respectively, 39.1% and 89.7% for UroVysion, 40.6% and 89.7% for cytology, and 42.1% and 67.9% for quantitative cytology. When the UroVysion test and cytology were combined, sensitivity increased to 53.1%, but specificity decreased to 79.5%. Detection of Ta tumours was equal for cytology and UroVysion (26.7%), detection of T1 and T2-T4 samples by UroVysion was 60% and 50%, respectively. Detection of grade 1, 2, and 3 tumours by UroVysion was 21.4%, 36.8%, and 66.7%, respectively. In four cases the UroVysion test was positive, but no abnormalities were seen at cystoscopy. CONCLUSIONS: Our data suggest that the use of UroVysion provides no improvement over cytology or quantitative cytology in the diagnosis of recurrent non-muscle-invasive bladder tumours.

Quantitative cytology on bladder wash versus voided urine: a comparison of results.

OBJECTIVES: Quantitative cytology (Quanticyt) is a valuable marker for the identification of high-risk superficial bladder cancer (SBC) patients and can be used to individualize surveillance of patients. A disadvantage is the necessity to perform an invasive procedure to obtain the required bladder wash sample. This study investigated whether quantitative cytology can be performed on voided urine with reliable results, consistent with the quantitative cytology performed on bladder wash samples. METHODS: Between June 2003 and May 2005, 288 voided urine samples in combination with bladder wash samples were obtained from patients with SBC who visited our urologic outpatient department. Quantitative cytology was performed on all samples. Corresponding clinical pathologic features and washed cytopathology results were collected. Linear regression analyses were performed for comparison of results from both types of samples. RESULTS: Ninety-one percent of the samples fell into the low or intermediate region on bladder wash. A clear deviation in the nuclear shape (MPASS) was seen in the voided urine samples, which led to more low-risk results. The clinical characteristics show that this shift is not the result of under-staging. The nuclear content (2c deviation index [DI]) did not change by performing the analysis on urine. CONCLUSION: When urine is correctly processed after voiding, quantitative cytology can be done on these samples. Voided urine-based quantitative cytology can be implemented in daily practice.