Anticipatory Positive Urine Tests for Bladder Cancer

Gopalakrishna, Ajay; Fantony, Joseph J.; Longo, Thomas A.; Owusu, Richmond; Foo, Wen Chi; Dash, Rajesh; Denton, Brian T.; Inman, Brant A.

doi:10.1245/s10434-016-5763-5

Cited by 26 publications

(16 citation statements)

References 21 publications

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“…A larger series may suggest a small benefit for urinary cytology in patients with a normal cystoscopy and imaging, as previously reported by others [13,14]. We acknowledge that urinary cytology may test positive because of a cancer anticipatory effect [31]. While we do not have long-term follow-up data for patients where cytology was positive with a normal cystoscopy and imaging, these patients were followed up till discharged from urology care.…”

Section: Discussionmentioning

confidence: 75%

Does urinary cytology have a role in haematuria investigations?

et al. 2018

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Urine cytology will miss a significant number of muscle-invasive bladder cancer and high-risk disease. Our results suggest that urine cytology should not be routinely performed as part of haematuria investigations. The role of urine cytology in select cases should be considered in the context of the impact of a false positive result leading to further potentially invasive tests conducted under general anaesthesia.

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Section: Discussionmentioning

confidence: 75%

Does urinary cytology have a role in haematuria investigations?

et al. 2018

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“…Limitations of the present study are those inherent to its single‐visit design, similar to most diagnostic biomarker studies. Because a negative test does not exclude future recurrences, future studies should focus on longitudinal assessment of changes in the Bladder EpiScore as these may give insight into the risk of development of urothelial cancer in patients with subclinical disease . Indeed, a movement toward risk‐based counselling and decision‐making holds the promise of personalizing medicine in a highly heterogeneous, complex clinical entity such as NMIBC.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic accuracy, clinical utility and influence on decision‐making of a methylation urine biomarker test in the surveillance of non‐muscle‐invasive bladder cancer

et al. 2019

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ObjectivesTo investigate prospectively the clinical utility and influence on decision-making of Bladder EpiCheck TM , a non-invasive urine test, in the surveillance of non-muscle-invasive bladder cancer (NMIBC). Materials and MethodsUrine samples from 440 patients undergoing surveillance for NMIBC were prospectively collected at five centres and evaluated using the Bladder EpiCheck test (NCT02647112). A multivariable nomogram and decision-curve analysis (DCA) were used to evaluate the impact of Bladder EpiCheck on decision-making when used in routine clinical practice. The test was designed to exclude recurrent disease. ResultsData from 357 patients were available for analysis. The test had a specificity of 88% (95% confidence interval [CI] 84-91), a negative predictive value (NPV) of 94.4% (95% CI 91-97) for the detection of any cancer and an NPV of 99.3% for the detection of high-grade cancer. In multivariable analysis, positive Bladder EpiCheck results were independently associated with any and high-grade disease recurrence (odds ratio [OR] 18.1, 95% CI 8.7-40.2; P < 0.001 and OR 78.3, 95% CI 19.2-547; P < 0.001). The addition of Bladder EpiCheck to standard variables improved its predictive ability for any and high-grade disease recurrence by a difference of 16% and 22%, respectively (area under the curve 85.9% and 96.1% for any and high-grade cancer, respectively). DCA showed an improvement in the net benefit relative to cystoscopy over a large threshold of probability, resulting in a significant reduction in unnecessary investigations. These results were similar in subgroups assessing the impact of specific clinical features. ConclusionsBladder EpiCheck is a robust high-performing diagnostic test in patients with NMIBC undergoing surveillance that can potentially reduce the number of unnecessary investigations.

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“…Some of these tests presented values of sensitivity and specificity higher than urinary cytology and achieved FDA approval for bladder cancer diagnosis. Despite high sensitivities and specificities, all these molecular assays present inconvenient rates of false-positive results (Hajdinjak, 2008;Dimashkieh et al, 2013;Gopalakrishna et al, 2017;Springer et al, 2018). False-positive rates could result from several factors, including the presence of benign conditions as hematuria, cystitis, lithiasis, urinary tract infections, and hotspot mutations are the most frequent somatic alterations in BC and constitute the most reliable biomarkers for BC.…”

Section: Introductionmentioning

confidence: 99%

Validation of a Novel, Sensitive, and Specific Urine-Based Test for Recurrence Surveillance of Patients With Non-Muscle-Invasive Bladder Cancer in a Comprehensive Multicenter Study

et al. 2019

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Bladder cancer (BC), the most frequent malignancy of the urinary system, is ranked the sixth most prevalent cancer worldwide. Of all newly diagnosed patients with BC, 70-75% will present disease confined to the mucosa or submucosa, the non-muscle-invasive BC (NMIBC) subtype. Of those, approximately 70% will recur after transurethral resection (TUR). Due to high rate of recurrence, patients are submitted to an intensive follow-up program maintained throughout many years, or even throughout life, resulting in an expensive follow-up, with cystoscopy being the most cost-effective procedure for NMIBC screening. Currently, the gold standard procedure for detection and follow-up of NMIBC is based on the association of cystoscopy and urine cytology. As cystoscopy is a very invasive approach, over the years, many different noninvasive assays (both based in serum and urine samples) have been developed in order to search genetic and protein alterations related to the development, progression, and recurrence of BC. TERT promoter mutations and FGFR3

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Anticipatory Positive Urine Tests for Bladder Cancer

Cited by 26 publications

References 21 publications

Does urinary cytology have a role in haematuria investigations?

Does urinary cytology have a role in haematuria investigations?

Diagnostic accuracy, clinical utility and influence on decision‐making of a methylation urine biomarker test in the surveillance of non‐muscle‐invasive bladder cancer

Validation of a Novel, Sensitive, and Specific Urine-Based Test for Recurrence Surveillance of Patients With Non-Muscle-Invasive Bladder Cancer in a Comprehensive Multicenter Study

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