Utility of HPV test with urine cytology in bladder cancer screening.

Abstract

e16577 Background: Bladder cancer (BC) is a common malignancy with high morbidity and mortality rates, and early detection plays a crucial role in improving patient outcomes. Urine cytology, widely used to screen for BC, has high specificity but lacks sensitivity. Recent studies indicate that HPV is implicated in the pathogenesis of urothelial carcinoma, suggesting that HPV detection in urine could complement traditional cytology for more accurate BC diagnosis. This study evaluates HPV testing in conjunction with urine cytology, highlighting its potential to enhance in BC screenings. Methods: A total of 273 histologically confirmed BC cases met inclusion and exclusion criteria, while 273 normal urine samples were used as the control. After fresh urine samples were collected and preserved, urine liquid cytology processing was conducted. Urine cells were then prepared for staining and underwent an HPV high-risk type hybrid capture assay. Results: Out of 273 total BC cases,172 (63.00%) were HPV positive, compared to only 42 (15.83%) out of 273 cases in the control group. There was a significant correlation between BC and HPV infection (p=0.000). The HPV positive rate was significantly higher in the BC group with high-grade (67/92,72.83%) versus low-grade lesions (105/181.58.01%) (p=0.017). There was no significant difference in positive rates between males and females (p=0.461) or between transitional cell carcinoma and squamous carcinoma/adenocarcinoma cases (p=0.276). Moreover, our study showed a significant in BC detected by cytology in low-grade (28/181, 15.4%) versus high-grade (77/92, 83.7%) BC groups, further confirming that cytology has low sensitivity for low-grade bladder lesions. Conclusions: Our study indicates that HPV infection plays a key role for BC carcinogenesis. As urine cytology lacks sensitivity, especially low-grade BC, a combined approach with HPV testing may offer a promising non-invasive BC screening strategy. HPV and cytology comparison in BC urine cells (N=273) and HPV and BC association (N=273 X2 =546). Tumor Grade Cytology+ Cytology- HPV+ HPV- Cytology+ & HPV + Cytology+ & HPV- Cytology- & HPV + Cytology- & HPV- Low 28/181 (15.47%) 153/181 (84.53%) 105 (58.01%) 76 (41.98%) 11/181 (9.39%) 11/181 (6.08%) 88/181 (48.62%) 65/181 (25.91%) High 77/92 (83.7%) 15/92 (16.3%) 67 (72.8%) 25 (27.17%) 54/92 (58.7%) 23/92 (25.00%) 6/92 (6.52%) 9/92 (9.78%) Cases HPV+ (%) HPV- (%) Fisher's Exact Experimental group 273 172 (63) 101 (36.99) p=0.000 Control Group 273 42(15.39) 231 (84.62) Low-grade 181 10 (58.01) 25 (27.17) p=0.017 High-grade 92 67 (72.83) 77 (35.32) Transitional BC 218 141 (64.67) 77 (35.32) p=0.276 Squamous/Adeno BC 55 (46/9) 31 (56.36),27/4 (49.09/7.27) 24 (43.63), 28/51 (50.91/92.72) Male 237 147 (62.03) 90 (37.97) p=0.461 Female 36 25 (69.45) 11 (30.56)