Immunocytochemical staining for p53 and Ki-67 helps to characterise urothelial cells in urine cytology.
Cytopathology
; 27(6): 456-464, 2016 Dec.
Article
de En
| MEDLINE
| ID: mdl-27873391
ABSTRACT
OBJECTIVE:
The presence of atypical cells in urine cytology is unsatisfactory for both cytologists and clinicians. The objective of this study was to test whether p53 and Ki-67 immunostaining could improve urothelial carcinoma (UC) detection on urinary cytology.METHODS:
A total of 196 urine samples were analysed, 142 from the bladder, 41 from the upper tract and 13 from ileal bladder replacement. Cytology results were expressed as normal (N) (n = 81), atypia cannot exclude low-grade UC (ALG) (n = 25), suspicious for high-grade UC (SHG) (n = 39) and high-grade UC (HG) (n = 51). Actual diagnoses were confirmed by histopathological analysis, cystoscopic examination or follow-up for at least 1 year. Immunocytochemistry performed on CytoSpin™ slides allowed the determination of the percentage of positive cells with p53 and Ki-67.RESULTS:
The median percentage values [first to third quartile] of p53 and Ki-67 were 0 [0-5] and 0 [0-1] for N cytology, 5 [0-40] and 2 [1-10] for ALG, 10 [0-30] and 6 [3-25] for SHG, and 30 [10-80] and 20 [10-30] for HG, respectively. Statistically higher values were observed for both tests (P < 0.001) in positive cytologies (ALG, SHG and HG). The optimal cut-offs were 5% for p53 and 3% for Ki-67. The sensitivity and specificity for the detection of all UC were 86.4% and 76.7% for cytology alone, 81.3% and 93.2% for cytology and p53, 75.7% and 88% for cytology and Ki-67, and 68.9% and 97.5% for cytology, p53 and Ki-67, respectively.CONCLUSION:
Using p53 and/or Ki-67 in addition to cytology increases the specificity without penalising the sensitivity.Mots clés
Texte intégral:
1
Collection:
01-internacional
Base de données:
MEDLINE
Sujet principal:
Tumeurs de la vessie urinaire
/
Carcinomes
/
Carcinome transitionnel
/
Protéine p53 suppresseur de tumeur
/
Antigène KI-67
/
Cytodiagnostic
Limites:
Adolescent
/
Adult
/
Aged
/
Aged80
/
Female
/
Humans
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Male
/
Middle aged
Langue:
En
Journal:
Cytopathology
Sujet du journal:
PATOLOGIA
Année:
2016
Type de document:
Article
Pays d'affiliation:
France