Is liquid-based cytology an alternative to conventional cytology for detection of malignant cells in urine of bladder cancer? Eastern Indian prospective observational study.

OBJECTIVE

Conventional cytology (CC) is a widely employed biomarker for the detection of bladder cancer, but due to its decreased sensitivity, liquid-based cytology (LBC) has been studied. Despite its improved cell-free background, decreased cell degeneration, and an automated slide preparation technique, it shows a variable rate of malignant cells detection. Thus, we did this study to compare the positivity of LBC with CC in eastern Indian population.

MATERIAL AND METHODS

A total of 150 patients who underwent a transurethral resection of bladder tumor (June 2017 to December 2018) were enrolled. Pre-operative CC and LBC were processed from freshly voided urine samples. The malignant cells detection rate and influential factors were noted and compared.

RESULTS

The detection of malignant cells by LBC was higher compared to CC (37.3% vs. 25.3%; p<0.0001). Among 59 high-grade tumors, 59% and 86% slides were positive for CC and LBC, respectively (p<0.0001). Even in the background of hematuria, LBC showed a better detection (43.33% by LBC vs. 23.66% by CC; p<0.0001).

CONCLUSION

The present study concludes that LBC offers a better detection of malignant cells in the urine of patients with bladder tumor as compared to CC. The detection of malignant cells by LBC is even better in the background of hematuria.