Atypical urothelial cells investigation with automated urinalysis and expert review of microscopic sediment as early parameter for suspected bladder cancer patients.

INTRODUCTION AND

OBJECTIVES

Automated urinalysis offers rapid and efficient evaluation of urine sediment; however, most systems do not routinely report epithelial cell atypia. This study aimed to evaluate the clinical relevance of the atypical cell (Atyp.C) parameter generated by the Sysmex UF-4000 analyzer as an early indicator of suspected urothelial carcinoma.

MATERIALS AND

METHODS

A prospective study was conducted using the UF-4000 analyzer to detect Atyp.C in urine specimens from high-risk patients. Atyp.C results were collected simultaneously for all samples. Specimens with positive Atyp.C findings underwent urinary tract cytology, which was independently reviewed by board-certified cytopathologists and categorized into four diagnostic groups. Statistical analyses were performed using IBM SPSS version 21.

RESULTS

Among 332 specimens, 20 samples (6.02%) showed Atyp.C values > 0.0/μL. The mean Atyp.C value was 0.6/μL (95% CI 0.064-1.135) in males and 1.20/μL (95% CI 0.608- 1.791) in females, with no significant difference between sexes (p = 0.2549). Of the 20 Atyp.C-positive samples, 5 (25%) demonstrated abnormal cytology, including 2 cases of atypical urothelial cells, 1 case suspicious for high-grade malignancy, and 2 cases of confirmed high-grade urothelial carcinoma. Atyp.C values were significantly higher in abnormal compared with benign cytology (p < 0.01).

CONCLUSIONS

The Atyp.C parameter may have potential as an adjunctive screening marker for urothelial abnormalities; however, further validation studies are required.