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Dynamics in Morbidity Markers and Cytological Observations Made in Urine of Schistosoma haematobium-Infected Children: Pre- and Post-Praziquantel Treatment in an Endemic Setting. Med Sci (Basel) 2022; 10:medsci10010014. [PMID: 35225947 PMCID: PMC8883892 DOI: 10.3390/medsci10010014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 02/04/2022] [Accepted: 02/11/2022] [Indexed: 11/16/2022] Open
Abstract
Background: Schistosomiasis is a neglected tropical disease caused by helminths of the genus Schistosoma. Morbidity markers and cytological observations such as squamous metaplastic cells, inflammatory cells, and hyperkeratotic cells in the urine of S. haematobium-infected children may suggest disease severity. They may also help predict severe forms of clinical presentation, such as bladder cancer in later years, among infected ones who miss out on early detection and treatment. Insights into possible changes in the morbidity markers and cytological observations in the urine of these S. haematobium-infected children before and after treatment would be of high clinical importance. Aim: The aim of this study was to identify changes/dynamics in morbidity markers and cytological abnormalities in the urine deposits of S. haematobium-infected children, pre- and post-praziquantel treatment. Methodology: This was a longitudinal study involving baseline and follow-up sampling among basic school children living in schistosomiasis-endemic communities. Urine samples were collected from 520 children at baseline and examined for S. haematobium ova by microscopy, while urine chemistry analyses were used for the examination of morbidity markers. The cytological analyses involved cytopathological examination of the urine deposits. Children whose urine showed positivity for S. haematobium eggs were treated with a single oral dose of praziquantel (40 mg/kg), after which urine chemistry and cytological analyses were repeated weekly for comparison with baseline, until the eighth week. Results: Morbidity markers such as hematuria, proteinuria, and leukocyturia were detected both at baseline and post-treatment among the infected children (30/520). Hematuria was the predominant parameter (90%, 27/30) detected at baseline, followed by proteinuria (53.3%, 16/30). Leukocyturia was the rarest parameter detected at baseline (13.3%, 4/30). However, almost all these parameters declined gradually post-treatment. Regarding cytological analyses, inflammatory cells were observed most (70.0%, 21/30) at baseline. For hyperkeratotic cells and squamous metaplastic cells, 46.7% and 26.7% were respectively observed at baseline, all of which gradually declined during the weekly follow-ups. Notably, squamous metaplastic cells persisted in all the participants from Week 1 through Week 3 post-treatment, but declined gradually thereafter. Conclusions: Morbidity markers and cytological observations in the children gradually decreased after treatment. Therefore, we continue to recommend routine cytological screening for urogenital schistosomiasis patients at hospitals in S. haematobium-endemic locations using both baseline and follow-up samples to detect these abnormalities early and monitor changes that may be occurring after treatment. Such changes may be useful in assessing treatment progress in infected persons.
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Goutas D, Savvidou K, Vrettou K, Meletis E, Levis P, Constantinides C, Lazaris AC, Mikou P. Comparison of conventional and liquid-based cytology using The Paris System for Reporting Urinary Cytology. Cytopathology 2021; 32:795-801. [PMID: 34289188 DOI: 10.1111/cyt.13040] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 06/23/2021] [Accepted: 07/18/2021] [Indexed: 12/24/2022]
Abstract
BACKGROUND This retrospective study was conducted to compare the conventional cytospin method and ThinPrep liquid-based urinary cytology in diagnosing bladder cancer using The Paris System (TPS) of classification. METHODS We retrieved files for 2020, at the Cytopathology Department of Laiko Hospital, of urinary cases diagnosed according to TPS. Cytospin and ThinPrep slides were separately reviewed and new diagnoses were rendered, then compared with the original diagnosis and histology when available. Risk of high-grade malignancy (ROHM) for each TPS category was assessed, along with accuracy parameters of each method and their combination. RESULTS The study material comprised 100 cases of void urinary cytology classified as 20 high-grade urothelial carcinoma (HGUC = TPS5) cases, 20 of suspicion for HGUC (SHGUC = TPS4), 25 of atypical urothelial cells (AUC = TPS3), and 35 of negative for HGUC (NHGUC = TPS2). A single inadequate (TPS1) case and 4 of low-grade urothelial neoplasm (TPS6) were excluded as small in number. The ROHM was 95% for HGUC, 55% for SHGUC, 28% for AUC and 5.7% for NHGUC. Agreement with the original diagnosis was 86% for cytospin and 82% for ThinPrep. No significant differences were observed among the two techniques or their combination regarding sensitivity and specificity, with a mild advantage for cytospin. Interobserver reproducibility and repeatability were high. CONCLUSION No significant differences were found concerning sensitivity and specificity between cytospin and ThinPrep when applying TPS criteria. TPS is a reliable classification scheme for either conventional/cytospin or liquid-based cytology, or their combination.
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Affiliation(s)
- Dimitris Goutas
- First Department of Pathology, School of Medicine, Laiko General Hospital, The National and Kapodistrian University of Athens, Athens, Greece
| | - Kyriaki Savvidou
- Department of Cytopathology, 401 General Military Hospital of Athens, Athens, Greece
| | - Klio Vrettou
- Department of Cytopathology, Laiko General Hospital of Athens, Athens, Greece
| | - Emmanouel Meletis
- Department of Cytopathology, Laiko General Hospital of Athens, Athens, Greece
| | - Panagiotis Levis
- First Urology Department, Laiko General Hospital, The National and Kapodistrian University of Athens, Athens, Greece
| | - Constantine Constantinides
- First Urology Department, Laiko General Hospital, The National and Kapodistrian University of Athens, Athens, Greece
| | - Andreas C Lazaris
- First Department of Pathology, School of Medicine, Laiko General Hospital, The National and Kapodistrian University of Athens, Athens, Greece
| | - Panagiota Mikou
- Department of Cytopathology, Laiko General Hospital of Athens, Athens, Greece
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Alsibai KD, Daste G, Ferlicot S, Fabre M, Steenkeste K, Salleron J, Hammoudi Y, Fontaine-Aupart MP, Eschwege P. Fluorescence Emitted by Papanicolaou-Stained Urothelial Cells Improves Sensitivity of Urinary Conventional Cytology for Detection of Urothelial Tumors. World J Oncol 2020; 11:204-215. [PMID: 33117464 PMCID: PMC7575278 DOI: 10.14740/wjon1305] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Accepted: 08/12/2020] [Indexed: 01/17/2023] Open
Abstract
Background Urinary conventional cytology (UCCy) is easy to perform, but its low sensitivity, especially for low-grade urothelial neoplasms (LGUNs), limits its indications in the management of patients at risk of bladder cancer. The authors aim at obtaining a complementary test that would effectively increase the sensitivity of UCCy on voided urines by analyzing fluorescence of Papanicolaou-stained urothelial cells with no change of method in slide preparation. Methods In this retrospective study of 155 patients, 91 Papanicolaou-stained voided urines were considered satisfactory under fluorescence microscopy (FMi). The results of FMi were compared with UCCy (using transmission microscopy) and correlated to cystoscopy, histology and follow-up data. Results The results are given for all patients and for two groups of them according to the patients’ main complaints (group 1: 33 patients followed up for a previously treated bladder tumor; group 2: 58 patients with persistent urinary symptoms). Overall negative predictive value (NPV) and sensitivity of FMi were 100% vs. 73.7% and 64.3% respectively for UCCy (P = 0.0001). Sensitivity of FMi for LGUN was unexpectedly high with a value of 100% vs. 46.2% for UCCy (P = 0.0002). FMi was significantly superior to UCCy for detecting urothelial tumors in every group of patients and would allow a better characterization of atypical urothelial cells (AUCs) defined by the Paris System for Reporting Urine Cytology (TPS). Conclusions Because of its sensitivity and NPV of 100%, FMi could complement UCCy to screen voided urines allowing a better detection of primary urothelial tumors or early recurrences of previously treated urothelial carcinoma. Moreover, this “dual screening” would allow completing efficiently cystoscopy to detect flat dysplasia, carcinoma in situ (CIS) and extra bladder carcinoma.
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Affiliation(s)
- Kinan Drak Alsibai
- Service d'Anatomie Pathologique, Centre des Ressources Biologiques, Centre Hospitalier de Cayenne, 97306 Cayenne Cedex, France.,These authors should be considered joint first authors
| | - Ghislaine Daste
- Centre de Pathologie Cellulaire et Moleculaire (CPCM-Labs), 31750 Escalquens, France.,These authors should be considered joint first authors
| | - Sophie Ferlicot
- Service d'Anatomo-Pathologie, Universite Paris-Sud, Hopital Bicetre, Assistance Publique-Hopitaux de Paris, 94276 Le Kremlin-Bicetre Cedex, France
| | - Monique Fabre
- Service d'Anatomie Pathologique, Universite Paris-Descartes, Hopital Universitaire Necker-Enfants Malades, Assistance Publique-Hopitaux de Paris, 75743 Paris Cedex, France
| | - Karine Steenkeste
- Institut des Sciences Moleculaires d'Orsay (ISMO), CNRS, Universite et Paris-Saclay, 91405 Orsay Cedex, France
| | - Julia Salleron
- Service de Biostatistiques, Institut de Cancerologie de Lorraine, 54519 Vandoeuvre-les-Nancy Cedex, France
| | - Yacine Hammoudi
- Service d'Urologie, Universite Paris-Sud, Hopital Bicetre, Assistance Publique-Hopitaux de Paris, 94276 Le Kremlin-Bicetre Cedex, France
| | | | - Pascal Eschwege
- Service d'Urologie, Universite de Lorraine, CNRS UMR 7039 CRAN, Centre Hospitalier Regional Universitaire, 54035 Nancy Cedex, France
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Cytological and Wet Mount Microscopic Observations Made in Urine of Schistosoma haematobium-Infected Children: Hint of the Implication in Bladder Cancer. CANADIAN JOURNAL OF INFECTIOUS DISEASES & MEDICAL MICROBIOLOGY 2019; 2019:7912186. [PMID: 31565106 PMCID: PMC6745107 DOI: 10.1155/2019/7912186] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Revised: 07/23/2019] [Accepted: 08/17/2019] [Indexed: 12/03/2022]
Abstract
Background Schistosomiasis is the second major human parasitic disease next to malaria, in terms of socioeconomic and public health consequences, especially in sub-Saharan Africa. Schistosoma haematobium (S. haematobium) is a trematode and one of the species of Schistosoma that cause urogenital schistosomiasis (urinary schistosomiasis). Although the knowledge of this disease has improved over the years, there are still endemic areas, with most of the reported cases in Africa, including Ghana. Not much has been done in Ghana to investigate cytological abnormalities in individuals within endemic communities, although there are epidemiologic evidences linking S. haematobium infection with carcinoma of the bladder. Aim The aim of this study was to identify microscopic and cytological abnormalities in the urine deposits of S. haematobium-infected children. Methodology Three hundred and sixty-seven (367) urine samples were collected from school children in Zenu and Weija communities. All the samples were examined microscopically for the presence of S. haematobium eggs, after which the infected samples and controls were processed for cytological investigation. Results S. haematobium ova were present in 66 (18.0%) out of the 367 urine samples. Inflammatory cells (82%, 54/66), hyperkeratosis (47%, 31/66), and squamous cell metaplasia (24%, 16/66) were the main observations made during the cytological examination of the S. haematobium-infected urine samples. Conclusion Cytological abnormalities in S. haematobium-infected children may play an important role in the severity of the disease, leading to the possible development of bladder cancer in later years, if early attention is not given. Therefore, routine cytological screening for urogenital schistosomiasis patients (especially children) at hospitals in S. haematobium-endemic locations is recommended.
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Kapoor K, Datta C, Pal DK. Is liquid-based cytology an alternative to conventional cytology for detection of malignant cells in urine of bladder cancer? Eastern Indian prospective observational study. Turk J Urol 2019; 45:351-356. [PMID: 31509507 DOI: 10.5152/tud.2019.19040] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Accepted: 07/23/2019] [Indexed: 12/13/2022]
Abstract
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.
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Affiliation(s)
- Kunal Kapoor
- Department of Urology, Institute of Post Graduate Medical Education & Research (IPGMER&R), Kolkata, India
| | - Chhanda Datta
- Department of Pathology, Institute of Post Graduate Medical Education & Research (IPGMER&R), Kolkata, India
| | - Dilip Kumar Pal
- Department of Urology, Institute of Post Graduate Medical Education & Research (IPGMER&R), Kolkata, India
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Granados R, Butrón M, Santonja C, Rodríguez JM, Martín A, Duarte J, Camarmo E, Corrales T, Aramburu JA. Increased risk of malignancy for non-atypical urothelial cell groups compared to negative cytology in voided urine. Morphological changes with LBC. Diagn Cytopathol 2016; 44:582-90. [DOI: 10.1002/dc.23489] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2015] [Revised: 02/26/2016] [Accepted: 03/30/2016] [Indexed: 01/18/2023]
Affiliation(s)
| | | | - Carlos Santonja
- Pathology Department; University Hospital Fundación Jiménez Díaz; Av Reyes Católicos 2. 28040 Madrid
| | | | - Ana Martín
- Pathology Department; University Hospital of Getafe
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Straccia P, Bizzarro T, Fadda G, Pierconti F. Comparison between cytospin and liquid-based cytology in urine specimens classified according to the Paris System for Reporting Urinary Cytology. Cancer Cytopathol 2016; 124:519-23. [DOI: 10.1002/cncy.21709] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2015] [Revised: 02/09/2016] [Accepted: 02/09/2016] [Indexed: 12/19/2022]
Affiliation(s)
- Patrizia Straccia
- Division of Anatomic Pathology and Histology, “Agostino Gemelli” School of Medicine; Catholic University; Rome Italy
| | - Tommaso Bizzarro
- Division of Anatomic Pathology and Histology, “Agostino Gemelli” School of Medicine; Catholic University; Rome Italy
| | - Guido Fadda
- Division of Anatomic Pathology and Histology, “Agostino Gemelli” School of Medicine; Catholic University; Rome Italy
| | - Francesco Pierconti
- Division of Anatomic Pathology and Histology, “Agostino Gemelli” School of Medicine; Catholic University; Rome Italy
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Magiorkinis E, Diamantis A. The fascinating story of urine examination: From uroscopy to the era of microscopy and beyond. Diagn Cytopathol 2015; 43:1020-36. [DOI: 10.1002/dc.23370] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2014] [Revised: 06/27/2015] [Accepted: 09/02/2015] [Indexed: 12/26/2022]
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Luo Y, She DL, Xiong H, Yang L, Fu SJ. Diagnostic Value of Liquid-Based Cytology in Urothelial Carcinoma Diagnosis: A Systematic Review and Meta-Analysis. PLoS One 2015; 10:e0134940. [PMID: 26241896 PMCID: PMC4524610 DOI: 10.1371/journal.pone.0134940] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2014] [Accepted: 07/15/2015] [Indexed: 01/22/2023] Open
Abstract
OBJECTIVE To evaluate the value of liquid-based cytology (LBC) in the diagnosis of urothelial carcinoma. METHOD Diagnostic studies were searched for the diagnostic value of LBC in urothelial carcinoma in PubMed, Embase, Cochrane Library, Web of Science, CBM and CNKI. The latest retrieval date was September 2014. The data were extracted and the quality of the included studies was independently assessed by 2 reviewers. Stata 13 software was used to perform the statistical analysis. The research was conducted in compliance with the PRISMA statement. RESULT Nineteen studies, which included 8293 patients, were evaluated. The results of the meta-analysis showed that the pooled sensitivity and specificity of LBC were 0.58 (0.51-0.65) and 0.96 (0.93-0.98), respectively. The diagnostic odds ratio (DOR) was 31 (18-56) and the area under the curve (AUC) of summary receiver operating characteristic (SROC) was 0.83 (0.80-0.86). The post-test probability was 80% when a positive diagnosis was made. Compared with high grade urothelial carcinoma (HGUC), the sensitivity of detecting low-grade urothelial carcinoma (LGUC) was significantly lower, risk ratio of sensitivity was 0.54 (0.43-0.66), P<0.001. However, no significant sensitivity improvement was observed with LBC when compared with traditional cytospin cytology, risk ratio was 1.03 (0.94-1.14), P = 0.524. CONCLUSION Despite LBC having a pooled 58% positive rate for urothelial carcinoma diagnosis in our meta-analysis, no significant improvement in sensitivity was observed based on the studies evaluated. Further research is needed to validate these findings.
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Affiliation(s)
- You Luo
- Gansu Nephro-Urological Clinical Center, Institute of Urology, Department of Urology, Key Laboratory of Urological Disease of Gansu Province, Lanzhou University Second Hospital, Lanzhou 730000, China
| | - Dong-Li She
- Gansu Nephro-Urological Clinical Center, Institute of Urology, Department of Urology, Key Laboratory of Urological Disease of Gansu Province, Lanzhou University Second Hospital, Lanzhou 730000, China
| | - Hu Xiong
- Gansu Nephro-Urological Clinical Center, Institute of Urology, Department of Urology, Key Laboratory of Urological Disease of Gansu Province, Lanzhou University Second Hospital, Lanzhou 730000, China
| | - Li Yang
- Gansu Nephro-Urological Clinical Center, Institute of Urology, Department of Urology, Key Laboratory of Urological Disease of Gansu Province, Lanzhou University Second Hospital, Lanzhou 730000, China
| | - Sheng-Jun Fu
- Gansu Nephro-Urological Clinical Center, Institute of Urology, Department of Urology, Key Laboratory of Urological Disease of Gansu Province, Lanzhou University Second Hospital, Lanzhou 730000, China
- * E-mail:
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Muralidaran C, Dey P, Nijhawan R, Kakkar N. Artificial neural network in diagnosis of urothelial cell carcinoma in urine cytology. Diagn Cytopathol 2015; 43:443-9. [PMID: 25605418 DOI: 10.1002/dc.23244] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
AIMS AND OBJECTIVE To build up an artificial neural network (ANN) model in the diagnosis of urothelial cell carcinoma (UCC) in urine cytology smears. MATERIAL AND METHODS We randomly selected a total of 115 urine cytology samples, out of which 59 were histopathology proven UCC cases and remaining 56 were benign cases from routine cytology samples. All the carcinoma cases were proven on histopathology. Image morphometric analysis was performed on Papanicolaou's stained smears to study nuclear area, diameter, perimeter, standard deviation of nuclear area, and integrated gray density. Detailed cytological features were also studied in each case by two independent observers and were semi-quantitatively graded. The back propagation ANN model was designed as 17-11-3 with the help of heuristic search. The cases were randomly partitioned as training, validation, and testing sets by the program. There were 79 cases for training set, 18 cases for validation set and 18 cases for test set. RESULT In the training set, ANN was able to diagnose all the malignant and benign cases. In the test set, all the benign and malignant cases were diagnosed correctly. However, one of the low grade cases was diagnosed as high grade UCC by ANN model. CONCLUSIONS We successfully built an ANN model in urine from the visual and morphometric data to identify the benign and malignant cases. In addition, the system can also identify the low grade and high grade UCC cases.
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