This study evaluated the predictive power of Atyp.C (a parameter of UF-5000 flow cytometer) for\npatients with a suspected diagnosis of urothelial carcinoma.\nMethods: We analyzed 163 urine specimens from 128 patients with suspected urothelial carcinoma using a fully\nautomated fluorescence flow cytometry analyzer (UF-5000) and evaluated its performance on identifying atypical/\nmalignant urothelial cells. From January 1, 2019 to April 4, 2019, all consecutive specimens for urinary\ncytopathology were enrolled.\nResults: Of the specimens with urinary cytopathology, 67 specimens (41.1%) revealed abnormal findings in\ncytology analysis. Among them, 20 specimens (12.3%) were diagnosed as atypical urothelial cells, 26 specimens\n(16.0%) as suspicious for malignancy (S-malignancy), and 21 specimens (12.9%) as confirmed malignancy. The UF-\n5000 findings were positive in 59 specimens (36.2%); therefore, the agreement with cytopathology was 73.0%.\nUsing follow-up histologic diagnosis of urothelial carcinoma with or without urinary tract cytology (UTCy) as a\nreference standard (suspicious and confirmed malignancy were the positive criteria for UTCy), the sensitivity was\n59.0%, specificity was 82.1%, positive predictive value was 75.0%, negative predictive value was 68.8%, and the\nagreement was 71.1%.\nConclusions: It is worth knowing and reporting that the Atyp.C assay may be used as an accessory test for patients\nwith suspected urothelial carcinoma, based on its ability to identify high-risk patients who might need closer\nfollow-up or additional medical treatment.
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