Assessment of intercentre reproducibility in detection of bladder epithelial cells using a novel cell harvesting device


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Bensita .M.V Thottakam (1), Ghulam Nabi (2), Satchi Swami (3), Linda Gordon (4), Mary McKean (5), Alex Wilson (6), Sian Chilcott (7)
Cytosystems Ltd, Aberdeen, United Kingdom (1), University Of Dundee, Dundee, United Kingdom (2), NHS Grampian, Aberdeen, United Kingdom (3), NHS Grampian, Aberdeen, United Kingdom (4), NHS Grampian, Aberdeen, United Kingdom (5), Robert Gordon University, Aberdeen, United Kingdom (6), Addenbrookes Hospital NHS Trust, Cambridge, United Kingdom (7)

Background

Urinary cytology for the early detection of bladder cancer is associated with high inter-observer variations between centres. The objective of this study was to investigate the transferability of slides prepared using a novel cell harvesting device (CHD) and centrifugation (CF)  between two centres and to determine the accuracy and reproducibility of cell counting between devices and centrifugation.  

Method

50 ml of urine was collected from 34 patients presenting to Urology outpatient clinics for investigation of bladder cancer at two different locations, Aberdeen Royal Infirmary (19 patients) and Addenbrookes Hospital, Cambridge (15 patients). All urine samples were collected, processed and prepared in the same way within 4 hours of void.  Each sample was split into 2x 25ml aliquots, one aliquot was subjected to routine centrifugation at 2500 rpm for 10 minutes in each centre, and the other half passed through an identical novel cell harvesting device x 6 minutes in each centre. Thinprep slides were prepared using a Thinprep 2000 processor and PAP stain applied at each centre for CF specimens, while all CHD urines were prepared and stained in Aberdeen.   Total cell counts on each slide from both centres were undertaken using a standardised high power field microscope and an expert independent cytopathologist based in Aberdeen. 

Results

There were no significant differences in total cell counts within or between the two centres (p-Value= 0.931) either using a CHD or routine centrifugation.  There was consistent evidence of less cellular debris in slides prepared using the CHD.

Conclusion

The early application of a CHD in a routine Cytopathology laboratory at two centres has confirmed the translational ability of the equipment. Further work is ongoing to establish its place in a laboratory setting for central processing.