Do liquid-based preparations of urinary cytology perform differently than classically prepared cases?

Rodolfo Laucirica, Joel S. Bentz, Rhona J. Souers, Patricia G. Wasserman, Barbara A. Crothers, Amy C. Clayton, Michael R. Henry, Beth Anne Chmara, Karen M. Clary, Mostafa M. Fraig, Ann T. Moriarty

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Abstract

Context.-The cytomorphology of liquid-based preparations in urine cytology is different than classic slide preparations. Objectives.-To compare the performance of liquidbased preparation specimens to classically prepared urine specimens with a malignant diagnosis in the College of American Pathologists Interlaboratory Comparison Program in Nongynecologic Cytology. Design.-Participant responses between 2000 and 2007 for urine specimens with a reference diagnosis of highgrade urothelial carcinoma/carcinoma in situ/dysplasia (HGUCA), squamous cell carcinoma, or adenocarcinoma were evaluated. ThinPrep and SurePath challenges were compared with classic preparations (smears, cytospins) for discordant responses. Results.-There were 18 288 pathologist, 11 957 cytotechnologist, and 8086 "laboratory" responses available. Classic preparations comprised 90% (n = 34551) of urine challenges; 9% (n = 3295) were ThinPrep and 1% (n = 485) were SurePath. Concordance to the general category of "positive-malignant" was seen in 92% of classic preparations, 96.5% of ThinPrep, 2 and 94.6% of SurePath challenges (P < .001). These results were statistically different for the exact reference interpretation of HGUCA (P < .001) but not for adenocarcinoma (P = .22). Cytotechnologists demonstrate statistically better performance for the general category of "positive-malignant" compared with pathologists for all urinary slide types and for the exact reference interpretation of HGUCA (94% versus 91.1%; P < .001) but not adenocarcinoma (96.3% versus 95.8%; P = .77) or squamous cell carcinoma (93.6% versus 87.7%; P = .07). Conclusions.-Liquid-based preparations performed significantly better in urinary cytology challenges when evaluating malignant categories in the College of American Pathologists interlaboratory comparison program. The liquidbased preparation challenges also performed better for the exact reference interpretation of HGUCA, but no difference was observed for adenocarcinoma challenges. Cytotechnologists perform better than pathologists for all slide types, as well as those demonstrating HGUCA. These results suggest that liquid-based preparations facilitate a more accurate diagnosis than conventional preparations.

Original languageEnglish (US)
Pages (from-to)19-22
Number of pages4
JournalArchives of Pathology and Laboratory Medicine
Volume134
Issue number1
StatePublished - Jan 1 2010

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Cell Biology
Adenocarcinoma
Urine
Squamous Cell Carcinoma
Carcinoma in Situ
Pathologists
Carcinoma

All Science Journal Classification (ASJC) codes

  • Pathology and Forensic Medicine
  • Medical Laboratory Technology

Cite this

Laucirica, R., Bentz, J. S., Souers, R. J., Wasserman, P. G., Crothers, B. A., Clayton, A. C., ... Moriarty, A. T. (2010). Do liquid-based preparations of urinary cytology perform differently than classically prepared cases? Archives of Pathology and Laboratory Medicine, 134(1), 19-22.

Do liquid-based preparations of urinary cytology perform differently than classically prepared cases? / Laucirica, Rodolfo; Bentz, Joel S.; Souers, Rhona J.; Wasserman, Patricia G.; Crothers, Barbara A.; Clayton, Amy C.; Henry, Michael R.; Chmara, Beth Anne; Clary, Karen M.; Fraig, Mostafa M.; Moriarty, Ann T.

In: Archives of Pathology and Laboratory Medicine, Vol. 134, No. 1, 01.01.2010, p. 19-22.

Research output: Contribution to journalArticle

Laucirica, R, Bentz, JS, Souers, RJ, Wasserman, PG, Crothers, BA, Clayton, AC, Henry, MR, Chmara, BA, Clary, KM, Fraig, MM & Moriarty, AT 2010, 'Do liquid-based preparations of urinary cytology perform differently than classically prepared cases?', Archives of Pathology and Laboratory Medicine, vol. 134, no. 1, pp. 19-22.
Laucirica, Rodolfo ; Bentz, Joel S. ; Souers, Rhona J. ; Wasserman, Patricia G. ; Crothers, Barbara A. ; Clayton, Amy C. ; Henry, Michael R. ; Chmara, Beth Anne ; Clary, Karen M. ; Fraig, Mostafa M. ; Moriarty, Ann T. / Do liquid-based preparations of urinary cytology perform differently than classically prepared cases?. In: Archives of Pathology and Laboratory Medicine. 2010 ; Vol. 134, No. 1. pp. 19-22.
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abstract = "Context.-The cytomorphology of liquid-based preparations in urine cytology is different than classic slide preparations. Objectives.-To compare the performance of liquidbased preparation specimens to classically prepared urine specimens with a malignant diagnosis in the College of American Pathologists Interlaboratory Comparison Program in Nongynecologic Cytology. Design.-Participant responses between 2000 and 2007 for urine specimens with a reference diagnosis of highgrade urothelial carcinoma/carcinoma in situ/dysplasia (HGUCA), squamous cell carcinoma, or adenocarcinoma were evaluated. ThinPrep and SurePath challenges were compared with classic preparations (smears, cytospins) for discordant responses. Results.-There were 18 288 pathologist, 11 957 cytotechnologist, and 8086 {"}laboratory{"} responses available. Classic preparations comprised 90{\%} (n = 34551) of urine challenges; 9{\%} (n = 3295) were ThinPrep and 1{\%} (n = 485) were SurePath. Concordance to the general category of {"}positive-malignant{"} was seen in 92{\%} of classic preparations, 96.5{\%} of ThinPrep, 2 and 94.6{\%} of SurePath challenges (P < .001). These results were statistically different for the exact reference interpretation of HGUCA (P < .001) but not for adenocarcinoma (P = .22). Cytotechnologists demonstrate statistically better performance for the general category of {"}positive-malignant{"} compared with pathologists for all urinary slide types and for the exact reference interpretation of HGUCA (94{\%} versus 91.1{\%}; P < .001) but not adenocarcinoma (96.3{\%} versus 95.8{\%}; P = .77) or squamous cell carcinoma (93.6{\%} versus 87.7{\%}; P = .07). Conclusions.-Liquid-based preparations performed significantly better in urinary cytology challenges when evaluating malignant categories in the College of American Pathologists interlaboratory comparison program. The liquidbased preparation challenges also performed better for the exact reference interpretation of HGUCA, but no difference was observed for adenocarcinoma challenges. Cytotechnologists perform better than pathologists for all slide types, as well as those demonstrating HGUCA. These results suggest that liquid-based preparations facilitate a more accurate diagnosis than conventional preparations.",
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AU - Bentz, Joel S.

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AU - Wasserman, Patricia G.

AU - Crothers, Barbara A.

AU - Clayton, Amy C.

AU - Henry, Michael R.

AU - Chmara, Beth Anne

AU - Clary, Karen M.

AU - Fraig, Mostafa M.

AU - Moriarty, Ann T.

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N2 - Context.-The cytomorphology of liquid-based preparations in urine cytology is different than classic slide preparations. Objectives.-To compare the performance of liquidbased preparation specimens to classically prepared urine specimens with a malignant diagnosis in the College of American Pathologists Interlaboratory Comparison Program in Nongynecologic Cytology. Design.-Participant responses between 2000 and 2007 for urine specimens with a reference diagnosis of highgrade urothelial carcinoma/carcinoma in situ/dysplasia (HGUCA), squamous cell carcinoma, or adenocarcinoma were evaluated. ThinPrep and SurePath challenges were compared with classic preparations (smears, cytospins) for discordant responses. Results.-There were 18 288 pathologist, 11 957 cytotechnologist, and 8086 "laboratory" responses available. Classic preparations comprised 90% (n = 34551) of urine challenges; 9% (n = 3295) were ThinPrep and 1% (n = 485) were SurePath. Concordance to the general category of "positive-malignant" was seen in 92% of classic preparations, 96.5% of ThinPrep, 2 and 94.6% of SurePath challenges (P < .001). These results were statistically different for the exact reference interpretation of HGUCA (P < .001) but not for adenocarcinoma (P = .22). Cytotechnologists demonstrate statistically better performance for the general category of "positive-malignant" compared with pathologists for all urinary slide types and for the exact reference interpretation of HGUCA (94% versus 91.1%; P < .001) but not adenocarcinoma (96.3% versus 95.8%; P = .77) or squamous cell carcinoma (93.6% versus 87.7%; P = .07). Conclusions.-Liquid-based preparations performed significantly better in urinary cytology challenges when evaluating malignant categories in the College of American Pathologists interlaboratory comparison program. The liquidbased preparation challenges also performed better for the exact reference interpretation of HGUCA, but no difference was observed for adenocarcinoma challenges. Cytotechnologists perform better than pathologists for all slide types, as well as those demonstrating HGUCA. These results suggest that liquid-based preparations facilitate a more accurate diagnosis than conventional preparations.

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