Title: Role of CK20 immunocytochemistry as an adjuvant to urine cytology in the detection of urothelial malignancy
Authors: Dr Kanwalpreet Kaur, Dr Karuna Gupta
DOI: https://dx.doi.org/10.18535/jmscr/v12i11.07
Abstract
Introduction: Urine cytology has been a non-invasive method of choice for detecting urothelial carcinomas but it has several drawbacks including low sensitivity for low grade urothelial lesions, morphology being easily affected by infection, instrumentation, surgery, chemo or immune therapy. Additional screening tests with high sensitivity and specificity for urothelial tumours of all grades are indicated to help improve the diagnostic ability of urine cytology as well as to reduce the need for frequent cystoscopies, especially in those with low-risk disease.
Objective: We studied the role of CK20 immunocytochemistry (CK20 ICC) and compare the results with efficacy of cytology in detecting urothelial carcinomas.
Material and Methods: We studied 160 cytospin centrifuged smears of urine cytology stained with hematoxylin and eosin and were reported according to the Paris system. Cell blocks were prepared in each case and stained with CK 20 monoclonal antibodies.
Results: Sensitivity, specificity, positive predictive value and negative predictive value of urine cytology was 78.72%, 98.05%, 94.87% and 91.15% respectively while that of CK20 ICC was 85.11%, 94.29%, 86.96% and 93.40% respectively.
Conclusion: CK20 ICC is more sensitive than urine cytology for detection of all grades and stages of bladder cancer. It is recommended as useful adjuvant to urine cytology in controversial cases.
Keywords: voided urine cytology, The Paris System, CK 20 immunocytochemistry.
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