{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T12:49:58Z","timestamp":1792673398159,"version":"4.5.0"},"reference-count":17,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2017,9,22]],"date-time":"2017-09-22T00:00:00Z","timestamp":1506038400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cytopathology"],"published-print":{"date-parts":[[2017,12]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Urine cytology is the corner\u2010stone for the diagnosis of urothelial neoplasia; however, a substantial proportion of low\u2010grade carcinomas are reported as inconclusive owing to scant cellularity and subtle cytological features. Biomarkers applied on urine sediment smears of such patients are likely to be clinically relevant. Access to Food and Drug Administration approved urinary biomarkers in resource limited setting is poor. Detection of cytokeratin 20 (<jats:styled-content style=\"fixed-case\">CK<\/jats:styled-content>20) in urine sediments, although still a research tool, is a promising marker as immunocytochemistry is performed regularly in several Indian laboratories.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>We tested the clinical utility of <jats:styled-content style=\"fixed-case\">CK<\/jats:styled-content>20 immunocytochemistry as a potential low\u2010cost adjunct to urine cytology in diagnosis of low\u2010grade urothelial carcinoma. One hundred and fifty fresh, voided urine specimens from 42 cases of biopsy proven urothelial neoplasia (14 high grade, 28 combined low\u2010grade [n=26]) and low malignant potential [n=2]), and 20 non\u2010neoplastic lesions were included in the study sample.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Confident diagnosis of malignancy was possible in five (17.8%) low\u2010grade malignancies. Thirteen of 16 (81.3%) low\u2010grade malignancies with inconclusive cytology showed positive <jats:styled-content style=\"fixed-case\">CK<\/jats:styled-content>20 expression. This reduced the proportion of low\u2010grade cases with inconclusive cytology from 57.1% to 10.7% (<jats:italic>P=<\/jats:italic>.021). In addition, we could correctly classify one case of bladder lithiasis with false positive urine cytology. Discrepant <jats:styled-content style=\"fixed-case\">CK<\/jats:styled-content>20 staining (positive) was seen in one patient with acute cystitis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p><jats:styled-content style=\"fixed-case\">CK<\/jats:styled-content>20 expression in non\u2010umbrella cells is a robust marker of urinary bladder carcinoma. It has potential clinical utility for identification of low\u2010grade urothelial malignancy with inconclusive cytological diagnosis.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cyt.12463","type":"journal-article","created":{"date-parts":[[2017,9,22]],"date-time":"2017-09-22T05:06:36Z","timestamp":1506056796000},"page":"531-535","source":"Crossref","is-referenced-by-count":14,"title":["Cytokeratin 20 immunocytochemistry on urine sediments: A potential low\u2010cost adjunct to cytology in the diagnosis of low\u2010grade urothelial carcinoma"],"prefix":"10.1111","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4102-2439","authenticated-orcid":false,"given":"N.","family":"Wadhwa","sequence":"first","affiliation":[{"name":"Department of Pathology University College of Medical Sciences University of Delhi Shahdra Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P.","family":"Diwaker","sequence":"additional","affiliation":[{"name":"Department of Pathology University College of Medical Sciences University of Delhi Shahdra Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N.","family":"Lotha","sequence":"additional","affiliation":[{"name":"Department of Pathology University College of Medical Sciences University of Delhi Shahdra Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V. K.","family":"Arora","sequence":"additional","affiliation":[{"name":"Department of Pathology University College of Medical Sciences University of Delhi Shahdra Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N.","family":"Singh","sequence":"additional","affiliation":[{"name":"Department of Pathology University College of Medical Sciences University of Delhi Shahdra Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,9,22]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21262"},{"key":"e_1_2_7_3_1","unstructured":"Chapter 2: Leading Sites of Cancer.http:\/\/www.ncrpindia.org\/ALL_NCRP_REPORTS\/PBCR_REPORT_2012_2014\/ALL_CONTENT\/PDF_Printed_Version\/Chapter2_Printed.pdf. National Cancer Registry Programme. National Centre of Disease Informatics Indian Council of Medical Research. 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A new histodiagnostic marker detected by monoclonal antibodies","volume":"140","author":"Moll R","year":"1992","journal-title":"Am J Pathol"},{"key":"e_1_2_7_12_1","first-page":"202","article-title":"Cytokeratin 20 as an immunocytochemical marker for detection of urothelial carcinoma in atypical cytology: preliminary retrospective study on archived urine slides","volume":"25","author":"Lin S","year":"2001","journal-title":"Cancer Detect Prev"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2303.2006.00432.x"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1186\/1746-1596-4-20"},{"key":"e_1_2_7_15_1","first-page":"45","article-title":"ImmunoCyt and cytokeratin 20 immunocytochemistry as adjunct markers for urine cytologic detection of bladder cancer: a prospective study","volume":"32","author":"Li HX","year":"2010","journal-title":"Anal Quant Cytol Histol"},{"key":"e_1_2_7_16_1","first-page":"669","article-title":"Value of CK20 immunocytochemistry as an adjuvant to urine liquid\u2010based cytology in detection of urothelial carcinoma","volume":"34","author":"Li M","year":"2012","journal-title":"Zhonghua Zhong Liu Za Zhi"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1464-410X.1996.23511.x"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000478-200108000-00013"}],"container-title":["Cytopathology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fcyt.12463","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/cyt.12463","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,24]],"date-time":"2023-09-24T08:36:37Z","timestamp":1695544597000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/cyt.12463"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,9,22]]},"references-count":17,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2017,12]]}},"alternative-id":["10.1111\/cyt.12463"],"URL":"https:\/\/doi.org\/10.1111\/cyt.12463","archive":["Portico"],"relation":{},"ISSN":["0956-5507","1365-2303"],"issn-type":[{"value":"0956-5507","type":"print"},{"value":"1365-2303","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,9,22]]}}}