Combined application of cytology and molecular urine markers to improve the detection of urothelial carcinoma

Todenhöfer, Tilman; Hennenlotter, Jörg; Esser, Michael; Mohrhardt, Sarah; Tews, Veronika; Aufderklamm, Stefan; Gakis, Georgios; Kuehs, Ursula; Stenzl, A.; Schwentner, Christian

doi:10.1002/cncy.21247

Cited by 50 publications

(31 citation statements)

References 36 publications

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“…The challenge is to identify adjunct biomarkers that assist with increasing the low sensitivity of VUC while maintaining its high specificity. Previously, the concept of a single marker for the diagnosis of BCa was replaced by the idea to establish multi-marker panels that facilitate higher sensitivities (18,47,48). However, with the combined use of VUC and urinary midkine, the present study was not able to improve the diagnostic performance compared with VUC alone.…”

Section: Discussionmentioning

confidence: 99%

Validation of the diagnostic utility of urinary midkine for the detection of bladder cancer

et al. 2016

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As it has been demonstrated previously that midkine (also known as neurite growth-promoting factor 2) protein levels in urine of bladder cancer (BCa) patients are increased compared to healthy controls, the present study validated the diagnostic utility of midkine in an independent patient cohort and compared the observed values with voided urine cytology (VUC), which is the current reference standard for non-invasive diagnosis of BCa. Voided urine samples were prospectively collected from 92 BCa patients and 70 control subjects. Protein levels of midkine were assessed using a commercially available enzyme-linked immunosorbent assay and normalized to urinary creatinine. The diagnostic performance of urinary midkine was evaluated by receiver operating characteristic curves. The best combinations of sensitivities and specificities were determined by Youden's Index. Midkine concentrations were significantly elevated in urine samples from BCa patients compared to controls (P<0.001; Mann-Whitney U Test). The level of midkine was associated with disease progression, with the highest concentrations in urine specimens of patients with pT1 and ≥pT2a, as well as high-grade tumors (P<0.001; Mann-Whitney U test). Sensitivities of urinary midkine and VUC were 69.7 and 87.6%, respectively. The corresponding specificities for midkine and VUC were 77.9 and 87.7%, respectively. The combined use of VUC and midkine improved the sensitivity to 93.3%, but reduced the specificity to 66.2%. Despite its reduced discriminatory power for low-grade and low-stage BCa, urinary midkine can be utilized for the identification of high-grade pT1 and ≥pT2a tumors. This means that midkine may potentially be suitable for the identification of patients with high risk BCa.

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Section: Discussionmentioning

confidence: 99%

Validation of the diagnostic utility of urinary midkine for the detection of bladder cancer

et al. 2016

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“…Some investigators have studied using a combination of the four available urine tests (CYT, FISH, uCyt+, and NMP22-ELISA) for a large cohort of 808 patients suspected of having UC. [8]…”

Section: Discussionmentioning

confidence: 99%

Diagnostic utility of double immunostaining of a urine cytology preparation for cytokeratin 20/p53 expression in a young woman with micropapillary urothelial carcinoma of the renal pelvis presenting as an unknown primary malignancy

et al. 2016

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Atypical urine cytology (CYT) triggers a cystoscopic or another ancillary investigation that targets urothelial neoplasms. We report a case presenting as an unknown primary malignancy, which illustrated the diagnostic utility of direct double immunostaining for cytokeratin 20 (CK20)/p53 expression in a urine CYT specimen. A 42-year-old woman visited the emergency room for pain in her right lower abdominal quadrant. Computed tomography revealed postrenal obstructive hydronephrosis, and her urine CYT showed malignancy, type undetermined. Atypical cells that are positive for cytoplasmic expression of CK20 and nuclear expression of p53 could facilitate the decision to perform a nephroureterectomy for urothelial carcinoma.

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“…Recentemente, Todenhöfer et al, in una coorte di 808 pazienti e senza precedenti diagnosi di neoplasia vescicale, hanno analizzato la capacità diagnostica di diversi marker da soli e in associazione. La sensibilità e la specificità complessive dell'Im-munoCyt/uCyt+ risultavano del 73.9% e del 76.6% per il test da solo (15). Nel caso di pazienti con microematuria, in una coorte di 189 pazienti, per esempio, solo 8 tumori uroteliali sono stati diagnosticati e 7 su 8 (87%) erano stati diagnosticati dall'ImmunoCyt/Ucyt+ (16).…”

Section: Immunocyt/ucyt+unclassified

“…In particolare, Messing riporta una sensibilità per il carcinoma in situ (cis) del 100%, dato poi confermato da Têtu e Mian (11,12). Il valore predittivo negativo dell'ImmunoCyt/uCyt+ da solo e in combinazione è risultato del 93-95%, nei diversi studi (8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25). Questi risultati, ormai confermati negli anni da numerosi studi sia in Nord America che in Europa, dimostrano la sicurezza della combinazione ImmunoCyt/uCyt+ con la citologia nei protocolli di sorveglianza.…”

Section: Introduzioneunclassified

Clinical Use of the ImmunoCyt/uCyt+ and Fluorescence in Situ Hybridisation (FISH) Tests for Urothelial Carcinomas

Lodde

Mian

2013

Urologia

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Clinical use of the ImmunoCyt/uCyt+ and Fluorescence In Situ Hybridisation (FISH) tests for urothelial carcinomasIn recent years, we have witnessed the propagation and marketing of numerous diagnostic tests capable of detecting, in the urine of patients, the presence of urothelial tumor markers. None of the different markers studied to date , no one has been able to meet all the requirements of the ideal marker. We present and discuss below the results reported in the literature of two tests approved by the Food and Drug Administration [ImmunoCyt/uCyt+ and Fluorescence In Situ Hybridisation (FISH)], which have been commercially available for about 10 years.

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Combined application of cytology and molecular urine markers to improve the detection of urothelial carcinoma

Cited by 50 publications

References 36 publications

Validation of the diagnostic utility of urinary midkine for the detection of bladder cancer

Validation of the diagnostic utility of urinary midkine for the detection of bladder cancer

Diagnostic utility of double immunostaining of a urine cytology preparation for cytokeratin 20/p53 expression in a young woman with micropapillary urothelial carcinoma of the renal pelvis presenting as an unknown primary malignancy

Clinical Use of the ImmunoCyt/uCyt+ and Fluorescence in Situ Hybridisation (FISH) Tests for Urothelial Carcinomas

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