1172 HEMATURIA: HELPFUL OR MISLEADING FOR THE EARLY DETECTION OF TRANSITIONAL CELL CARCINOMA– RESULTS FROM A COHORT OF 2008 PATIENTS
2010-03-23

You have accessJournal of UrologyBladder Cancer: Detection and Screening1 Apr 20101172 HEMATURIA: HELPFUL OR MISLEADING FOR THE EARLY DETECTION OF TRANSITIONAL CELL CARCINOMA– RESULTS FROM A COHORT OF 2008 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.2010.02.672AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Several non-invasive urine tests are currently available in the diagnosis of transitional cell carcinoma (TCC). However, their accuracy remains limited. Hematuria (HU), a widespread phenomenon in diagnosing TCC, may influence the results. Herein, we evaluate the impact of HU on urine cytology, the UroVysion FISH test (VysisR), the NPM22 ELISA (Matritech) and the uCyt+-test (DiagnoCure). METHODS A cohort of 2008 consecutive patients suspected to have TCC underwent multimarker testing of the 4 mentioned tests followed by cystoscopy and -in case of suspicious findings- transurethral resection. HU was determined by Combur 10 evaluation and urine microscopy, whereby every sign of blood was deemed to be HU. The test results were compared to the HU status by contingency analysis and Chi-square tests separated for patients without evidence of TCC and with histologically proven TCC. RESULTS For the UroVysion test, false positive results occurred in 17.4 and 20.7% of patients without and with HU, respectively (p=0.135). False negative results were seen in 40.0 and 26.9% of patients without and with HU (p=0.104). For the NMP22 test, false positive results occurred in 35.8 and 66.2% of patients without and with HU, respectively (p<0.001). False negative results were noted in 54.1 and 20.7% of patients without and with HU (p<0.001). For the uCyt+ test, false positive results occurred in 11.1 and 25.0% of patients without and with HU, respectively (p=0.0002). False negative results were detected in 55.0 and 20.8% of patients without and with HU (p=0.0027). For cytology, false positive results occurred in 12.9 and 17.8% of patients without and with HU, respectively (p=0.012). False negative results appeared in 37.2 and 17.9% of patients without and with HU (p=0.0002). CONCLUSIONS HU did not influence the diagnostic properties of the UroVysion test. In contrast to that, the results of NMP22 and the uCyt+ test were directly dependent on the HU-status. Therefore, both, false positivity in the absence of TCC, as well as false negativity in the presence of significant TCC may occur. Moreover, urine cytology was found to be similarly influenced by HU. Persistent HU itself may alter the cytological status leading to further invasive measures. These results underline the relevance of the HU-status for the appropriate interpretation of urine tests. Tuebingen, Germany© 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 4SApril 2010Page: e454 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 ...