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Comparative study of ProEx C immunocytochemistry and UroVysion fluorescent in-situ hybridization assays on urine cytology specimens.

Chang S, Smith E, Levin M, Rao JY, Moatamed NA - Cytojournal (2015)

Bottom Line: In this study, we compared the utility of ProEx C and UroVysion in urine specimens.Positive predictive value was 88.9% for ProEx C and 66.7% for UroVysion.Negative predictive value was 77.8% and 33.3% for ProEx C and UroVysion, respectively.

View Article: PubMed Central - HTML - PubMed

Affiliation: Address: Department of Pathology and Laboratory Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California, USA.

ABSTRACT

Background: Detection of urothelial carcinoma (UC) by urine cytology can be challenging. Recently, ProEx C has been studied as a marker to improve detection of UC. ProEx C is an assay targeting expression of topoisomerase IIa and minichromosome maintenance protein-2 and is currently utilized to assist in diagnoses of the gynecological specimens. In this study, we compared the utility of ProEx C and UroVysion in urine specimens.

Materials and methods: Twenty-seven urine specimens with UroVysion assay analysis and surgical biopsy follow-up were selected. The smears were stained with ProEx C. ProEx C and UroVysion assay results were separated into two categories based on surgical biopsy follow-up (benign or neoplastic). Surgical biopsy diagnoses were used as the gold standard for comparative evaluation of the two assays. The surgical follow-up was 9 benign, 2 low grade, and 16 high grade UCs.

Results: The sensitivity was 88.9% for ProEx C and 55.6% for UroVysion, while the specificity was 77.8% for ProEx C and 44.4% for UroVysion. Positive predictive value was 88.9% for ProEx C and 66.7% for UroVysion. Negative predictive value was 77.8% and 33.3% for ProEx C and UroVysion, respectively. Using the two-tailed paired t-test, P value of 0.033 was obtained when ProEx C stain was compared with the UroVysion assay.

Conclusion: ProEx C immunocytochemistry has a more favorable performance than fluorescent in-situ hybridization with a significant difference between the two assays using paired two-tail t-test (P = 0.0033).

No MeSH data available.


Related in: MedlinePlus

An example of positive ProEx C staining of malignant urothelial cells (case #27, Table 1). In this case, ProEx C immunohistochemical stain exhibits intense nuclear reaction in >1 cytologically atypical cell (cytology, ×100)
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Figure 3: An example of positive ProEx C staining of malignant urothelial cells (case #27, Table 1). In this case, ProEx C immunohistochemical stain exhibits intense nuclear reaction in >1 cytologically atypical cell (cytology, ×100)

Mentions: ProEx C™ antibody cocktail (BD ProEx C IHC), BD SureDetect detection reagents kit, and BD SureDetect SiHa Cell control slides were obtained from BD Diagnostics-TriPath (Burlington, NC, USA). The staining procedure was performed manually by following the published procedure in the manufacturer product insert. Archived ThinPrep Pap-stained slides were immersed for a week to remove the glass coverslips. Removal of the mounting media was performed under standard protocol using xylene rinses. The slides were then rehydrated with a series of graduated ethanol dilutions. Destaining was then accomplished in 1% hydrochloric acid/70% ethanol for 5 min, and then washed with phosphate-buffered saline solution. Subsequently, the slides were restained with ProEx C using manual IHC technique along with positive and negative controls (SiHa cells). The primary antibody of ProEx C (a cocktail of mouse monoclonal anti-MCM2 and anti-TOP2A) was dispensed onto slides and incubated for 30 min and rinsed off. Minimal artifacts and/or loss of cellularity were encountered due to destaining and restaining. ProEx C scoring was recorded as positive if at least one morphologically AUC displayed positive nuclear staining as described previously.[13] An example of the ProEx C stain in a case of high-grade UC [case #27, Table 1] is shown in Figure 3.


Comparative study of ProEx C immunocytochemistry and UroVysion fluorescent in-situ hybridization assays on urine cytology specimens.

Chang S, Smith E, Levin M, Rao JY, Moatamed NA - Cytojournal (2015)

An example of positive ProEx C staining of malignant urothelial cells (case #27, Table 1). In this case, ProEx C immunohistochemical stain exhibits intense nuclear reaction in >1 cytologically atypical cell (cytology, ×100)
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4325383&req=5

Figure 3: An example of positive ProEx C staining of malignant urothelial cells (case #27, Table 1). In this case, ProEx C immunohistochemical stain exhibits intense nuclear reaction in >1 cytologically atypical cell (cytology, ×100)
Mentions: ProEx C™ antibody cocktail (BD ProEx C IHC), BD SureDetect detection reagents kit, and BD SureDetect SiHa Cell control slides were obtained from BD Diagnostics-TriPath (Burlington, NC, USA). The staining procedure was performed manually by following the published procedure in the manufacturer product insert. Archived ThinPrep Pap-stained slides were immersed for a week to remove the glass coverslips. Removal of the mounting media was performed under standard protocol using xylene rinses. The slides were then rehydrated with a series of graduated ethanol dilutions. Destaining was then accomplished in 1% hydrochloric acid/70% ethanol for 5 min, and then washed with phosphate-buffered saline solution. Subsequently, the slides were restained with ProEx C using manual IHC technique along with positive and negative controls (SiHa cells). The primary antibody of ProEx C (a cocktail of mouse monoclonal anti-MCM2 and anti-TOP2A) was dispensed onto slides and incubated for 30 min and rinsed off. Minimal artifacts and/or loss of cellularity were encountered due to destaining and restaining. ProEx C scoring was recorded as positive if at least one morphologically AUC displayed positive nuclear staining as described previously.[13] An example of the ProEx C stain in a case of high-grade UC [case #27, Table 1] is shown in Figure 3.

Bottom Line: In this study, we compared the utility of ProEx C and UroVysion in urine specimens.Positive predictive value was 88.9% for ProEx C and 66.7% for UroVysion.Negative predictive value was 77.8% and 33.3% for ProEx C and UroVysion, respectively.

View Article: PubMed Central - HTML - PubMed

Affiliation: Address: Department of Pathology and Laboratory Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California, USA.

ABSTRACT

Background: Detection of urothelial carcinoma (UC) by urine cytology can be challenging. Recently, ProEx C has been studied as a marker to improve detection of UC. ProEx C is an assay targeting expression of topoisomerase IIa and minichromosome maintenance protein-2 and is currently utilized to assist in diagnoses of the gynecological specimens. In this study, we compared the utility of ProEx C and UroVysion in urine specimens.

Materials and methods: Twenty-seven urine specimens with UroVysion assay analysis and surgical biopsy follow-up were selected. The smears were stained with ProEx C. ProEx C and UroVysion assay results were separated into two categories based on surgical biopsy follow-up (benign or neoplastic). Surgical biopsy diagnoses were used as the gold standard for comparative evaluation of the two assays. The surgical follow-up was 9 benign, 2 low grade, and 16 high grade UCs.

Results: The sensitivity was 88.9% for ProEx C and 55.6% for UroVysion, while the specificity was 77.8% for ProEx C and 44.4% for UroVysion. Positive predictive value was 88.9% for ProEx C and 66.7% for UroVysion. Negative predictive value was 77.8% and 33.3% for ProEx C and UroVysion, respectively. Using the two-tailed paired t-test, P value of 0.033 was obtained when ProEx C stain was compared with the UroVysion assay.

Conclusion: ProEx C immunocytochemistry has a more favorable performance than fluorescent in-situ hybridization with a significant difference between the two assays using paired two-tail t-test (P = 0.0033).

No MeSH data available.


Related in: MedlinePlus