1173 EARLY DETECTION OF TRANSITIONAL CELL CARCINOMA – PREDICTIVE POWER OF URINE-BASED TUMOR MARKERS WITH REGARD TO TUMOR GRADE AND STAGE
2010-03-23

You have accessJournal of UrologyBladder Cancer: Detection and Screening1 Apr 20101173 EARLY DETECTION OF TRANSITIONAL CELL CARCINOMA – PREDICTIVE POWER OF URINE-BASED TUMOR MARKERS WITH REGARD TO TUMOR GRADE AND STAGE Christian Schwentner, Joerg Hennenlotter, Ursula Kuehs, Henriette Sleiman, 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 , Henriette SleimanHenriette Sleiman 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.2010.02.673AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The number of noninvasive diagnostic tests for transitional cell carcinoma (TCC) has increased tremendously over the last years with a large number of experimental and commercial tests being available. However, their relevance in the diagnostic regimen remains controversial. Routine cytology (Cyt) is nowadays frequently combined with molecular tests. The aim of this study was to comparatively evaluate the predictive value of urine Cyt, the UroVysion FISH test (Vysis), the NPM22 ELISA (Matritech) and the uCyt+ test (DiagnoCure) regarding tumor grade and stage. METHODS Urine Cyt and urine tests uCyt+ (DiagnoCure), UroVysion (Vysis) and NMP22 ELISA (Matritech) were performed in 1274 patients without any history of TCC prior to cystoscopy with or without transurethral resection. Specificity for every marker was determined within the patient cohort with positive histological findings separated into groups of low grade (G1) vs. high grade (G2-3 or CIS) and superficial (Ta+T1) vs. muscle invasive (T≥2) tumors, respectively. RESULTS In 229 patients (18.0%) a TCC was detected histologically. Tumors were low grade in 33.9% and high grade 46.1%. Of those, 75.1% were superficial, while 24.9% were muscle invasive respectively. Sensitivity for low grade tumors was 62.3%, 47.5%, 72.0% and 70.3% whereas it was 90.7%, 83.7%, 89.7% and 75.4% for high grade tumors when either Cyt, the UroVysion, uCyt+ or NPM22 were used. Sensitivity (Cyt, UroVysion, uCyt+ or NPM22) for superficial tumors was 75.0%, 65.5%, 78.3% and 70.1% whereas it was 96.5%, 85.7%, 100.0% and 88.2% for muscle invasive tumors, respectively. CONCLUSIONS Urine Cyt, the UroVysion test as well as the uCyt+ test achieved significantly higher sensitivities in high grade tumors (83-90%). Cyt as well as all other urine-based markers reach higher sensitivities in muscle invasive disease exceeding 80% in all cases. Regarding the detection of low grade tumors and superficial TCCs the uCyt+ tests turned out to be superior to the remaining. The favourable profile of the uCyt+-test indicates that immunocytological tests may be superior because cell morphology is assessed in combination with molecular parameters. Hence, one can also benefit from the advantages of standard Cyt. However, due to the overall predominance of superficial TCCs there is urgent need for further innovation. Tuebingen, Germany© 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 4SApril 2010Page: e454-e455 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 Henriette Sleiman 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 ...