Is liquid-based cytology an alternative to conventional cytology for detection of malignant cells in urine of bladder cancer? Eastern Indian prospective observational study

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Objective: Conventional cytology (CC) is a widely employed biomarker for the detection of bladdercancer, but due to its decreased sensitivity, liquid-based cytology (LBC) has been studied. Despiteits improved cell-free background, decreased cell degeneration, and an automated slide preparationtechnique, it shows a variable rate of malignant cells detection. Thus, we did this study to compare thepositivity of LBC with CC in eastern Indian population.Material and methods: A total of 150 patients who underwent a transurethral resection of bladdertumor (June 2017 to December 2018) were enrolled. Pre-operative CC and LBC were processed fromfreshly voided urine samples. The malignant cells detection rate and influential factors were noted andcompared.Results: The detection of malignant cells by LBC was higher compared to CC (37.3% vs. 25.3%;p<0.0001). Among 59 high-grade tumors, 59% and 86% slides were positive for CC and LBC, respec-tively (p<0.0001). Even in the background of hematuria, LBC showed a better detection (43.33% byLBC vs. 23.66% by CC; p<0.0001).Conclusion: The present study concludes that LBC offers a better detection of malignant cells in theurine of patients with bladder tumor as compared to CC. The detection of malignant cells by LBC iseven better in the background of hematuria.