1170 IMPACT OF INSTRUMENTED URINARY SAMPLING ON THE DIAGNOSTIC VALUE OF URINE TESTS (UROVYSIONR, UCYT+R) AND CYTOLOGY FOR TRANSITIONAL CELL CARCINOMA – RESULTS FROM A COHORT OF 2077 PATIENTS
2010-03-23

You have accessJournal of UrologyBladder Cancer: Detection and Screening1 Apr 20101170 IMPACT OF INSTRUMENTED URINARY SAMPLING ON THE DIAGNOSTIC VALUE OF URINE TESTS (UROVYSIONR, UCYT+R) AND CYTOLOGY FOR TRANSITIONAL CELL CARCINOMA – RESULTS FROM A COHORT OF 2077 PATIENTS Christian Schwentner, Joerg Hennenlotter, Ursula Kuehs, Veronika Tews, Daniela Colleselli, Severine Huber, David Schilling, Karl-Dietrich Sievert, and Arnulf Stenzl Christian SchwentnerChristian Schwentner More articles by this author , Joerg HennenlotterJoerg Hennenlotter More articles by this author , Ursula KuehsUrsula Kuehs More articles by this author , Veronika TewsVeronika Tews More articles by this author , Daniela ColleselliDaniela Colleselli More articles by this author , Severine HuberSeverine Huber More articles by this author , David SchillingDavid Schilling More articles by this author , Karl-Dietrich SievertKarl-Dietrich Sievert More articles by this author , and Arnulf StenzlArnulf Stenzl More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.670AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Beside urine cytology, the UroVysion and uCyt+ tests systems are used for early detection of transitional cell carcinoma (TCC). Whereas instrumented urinary sampling (IUS) is an exclusion criterion for several test-kits, there are no specifications for the UroVysion and uCyt+ systems. Given the lack of data there are no recommendations if urinary tract manipulation interferes with these tests. Herein, we evaluate the impact of IUS on urine cytology, the UroVysion FISH test and the uCyt+-test. METHODS 2077 consecutive patients with suspected TCC underwent multimarker testing of the 3 mentioned tests followed by cystoscopy and transurethral resection. All patients were investigated regarding urinary specimen harvesting. IUS was defined as catheterized, irrigated or exprimated urine whereas spontaneous voiding was defined as urine collected without IUS. The test results were compared with regards to the invasiveness of urine collection by contingency analysis and Chi-square tests separately. RESULTS In 65.1% of patients samples were collected after urinary tract instrumentation. In plain cytology, false positive results occurred in 13.4 and 18.1% of patients without and with IUS, respectively (p=0.0097). False negative results appeared in 22.4 and 20.1% of patients without and with IUS (p=0.32). For the UroVysion test, false positive results occurred in 14.1 and 19.4% of patients without and with IUS, respectively (p=0.0246). False negative results were seen in 45.5 and 28.0% of patients without and with IUS (p=0.0374). For the uCyt+ test, false positive results occurred in 13.6 and 24.3% of patients without and with IUS, respectively (p=0.0021). False negative results were detected in 57.1 and 24.8% of patients without and with IUS (p=0.0161). CONCLUSIONS IUS influences the specificity of all investigated tests. The sensitivity of UroVysion and the uCyt+ are particularly deteriorated by IUS. Approximately 50% displayed false-negative tests in the group without IUS. Activated urothelial cells are misinterpreted as tumor cells. These manipulated urothelial cells provoke false positive results due to secondary molecular changes in the UroVysion and the uCyt+ tests. The enormous false negative rate for patients with regular voided specimens underlines the association of mechanical manipulation with molecular changes. These observations stress the outstanding relevance of urinary sampling for the appropriate interpretation of urinary test for the early detection of TCC. Tuebingen, Germany© 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 4SApril 2010Page: e453-e454 Peer Review Report Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.MetricsAuthor Information Christian Schwentner More articles by this author Joerg Hennenlotter More articles by this author Ursula Kuehs More articles by this author Veronika Tews More articles by this author Daniela Colleselli More articles by this author Severine Huber More articles by this author David Schilling More articles by this author Karl-Dietrich Sievert More articles by this author Arnulf Stenzl More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...