Multidimensional slit‐scan detection of bladder cancer preliminary clinical results

Abstract

A multidimensional slit‐scan flow system was developed for the automated recognition of abnormal cells derived from cancer of the uterine cervix and its precursors. It provides great sensitivity in both its ability to recognize cellular abnormality and to deal with the myriad potential causes of false alarms in an automated flow system. While its initial application was the automated recognition of the spectrum of neoplasia in gynecologic cytology samples, a preliminary study was carried out using specimens obtained from the urinary bladder. Cellular material was collected by bladder irrigation and stained with the fluorochrome acridine orange. One hundred fifty‐three bladder irrigation specimens, including 115 abnormal specimens containing cells derived from neoplastic lesions of the bladder epithelium, were analyzed. For the purposes of this study, abnormal specimens from the urinary bladder included specimens containing cells derived from the following lesions of the urothelium: dysplasia (atypical hyperplasia), carcinoma‐in‐situ, and transitional cell carcinoma, grades 1–3. Approximately 50,000 cells were analyzed for most specimens. Of the 38 presumed normal specimens (specimens containing only normal urothelial components), four were instrument classified abnormal. For the 69 specimens containing cells derived from transitional cell carcinoma, grade 1, 1–2, 2, 66 were correctly classified as abnormal while three were classified as normal. There were no false negatives in the 17 specimens containing cells derived from transitional cell carcinoma, grade 2–3, 3, or in the two specimens containing cells derived from carcinoma‐in‐situ. Of the eight specimens containing cells derived from dysplasia (atypical hyperplasia), seven were instrument classified abnormal. This system has demonstrated utility in the study and recognition of the cellular components of urothelial cancer and its precursors present in the urinary bladder.