Atypical cells in urine sediment: a novel biomarker for early detection of bladder cancer

Yinling Wang; Jun Zheng; Yang Liu; Dongqi Li; Danning Jin; Hong Luan

doi:10.1515/cclm-2024-0650

Atypical cells in urine sediment: a novel biomarker for early detection of bladder cancer

Clin Chem Lab Med. 2024 Sep 23. doi: 10.1515/cclm-2024-0650. Online ahead of print.

Authors

Yinling Wang^{1

2}, Jun Zheng^{1

2}, Yang Liu³, Dongqi Li⁴, Danning Jin^{1

2}, Hong Luan^{1

2}

Affiliations

¹ National Clinical Research Center for Laboratory Medicine, Department of Laboratory Medicine, 159407 The First Hospital of China Medical University , Shenyang, Liaoning, P.R. China.
² Research Unit of Medical Laboratory, Chinese Academy of Medical Sciences, Shenyang, P.R. China.
³ Department of Urology, 159407 The First Hospital of China Medical University , Shenyang, Liaoning, P.R. China.
⁴ Department of Clinical Laboratory Diagnostics, 159407 The First Hospital of China Medical University , Shenyang, Liaoning, P.R. China.

PMID: 39301615
DOI: 10.1515/cclm-2024-0650

Abstract

Objectives: Atypical cells (Atyp.C), as a new parameter determined by an automated urine analyzer, can be suspected of being malignant tumor cells. We evaluated the extent to which the Atyp.C can predict the existence of malignant tumor cells.

Methods: A total of 3,315 patients (1,751 in the training cohort and 1,564 in the testing cohort) were recruited and divided into five groups, namely, primary bladder cancer (BCa), recurrent BCa, post-treatment monitoring of BCa, other urological tumors, and controls. Urine Atyp. C, bacteria, white blood cell, and red blood cell were measured by a Sysmex UF-5000 analyzer. We compared the Atyp.C values across the different groups, sexes, and tumor stages. The diagnostic performance of Atyp.C alone and in combination with other parameters for detecting BCa was evaluated using receiver operating characteristic (ROC) curve analysis.

Results: The Atyp.C value of the primary BCa group was significantly higher than that in the other groups, except recurrent BCa group. The Atyp.C value was closely related to tumor staging. Atyp.C combined with bacteria had the highest diagnostic performance for primary BCa [training cohort AUC: 0.781 (95 % CI: 0.761-0.801); testing cohort AUC: 0.826 (95 % CI: 0.806-0.845)]. The AUC value of diagnosed recurrent BCa by Atyp.C plus bacteria for the training cohort was 0.784 (95 % CI: 0.762-0.804).

Conclusions: Atyp.C was high in primary BCa patients and the combination of bacteria and Atyp.C showed high predictive value for primary BCa, suggesting that Atyp.C may be a useful objective indicator for the early detection of BCa.

Keywords: UF-5000; atypical cell; bacteria; bladder cancer; urinalysis.