Comparative evaluation of the BTAstat test, NMP22, and voided urine cytology in the detection of primary and recurrent bladder tumors

Giannopoulos, Aris; Μανούσακας, Θεόδωρος; Mitropoulos, Dionisios; Botsoli-Stergiou, Efi; Constantinides, Constantinos; Giannopoulou, Myrto; Choremi-Papadopoulou, H

doi:10.1016/s0090-4295(00)00489-1

Cited by 49 publications

(28 citation statements)

References 16 publications

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“…There are several studies that have found a greater likelihood of recurrence in patients with a positive fluorescence in situ hybridization (FISH) assay compared to those with negative assays in the absence of a visualized tumor [34,35,36]. This has also been reported for NMP22 and ImmunoCyt/uCyt, albeit in a small number of patients [12,37,38]. In summary, the issue of specificity is the major limitation in use of these urine markers.…”

Section: Urine-based Markersmentioning

confidence: 87%

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Molecular Markers for Bladder Cancer Screening, Early Diagnosis, and Surveillance: The WHO/ICUD Consensus

et al. 2014

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Due to the lack of disease-specific symptoms, diagnosis and follow-up of bladder cancer has remained a challenge to the urologic community. Cystoscopy, commonly accepted as a gold standard for the detection of bladder cancer, is invasive and relatively expensive, while urine cytology is of limited value specifically in low-grade disease. Over the last decades, numerous molecular assays for the diagnosis of urothelial cancer have been developed and investigated with regard to their clinical use. However, although all of these assays have been shown to have superior sensitivity as compared to urine cytology, none of them has been included in clinical guidelines. The key reason for this situation is that none of the assays has been included into clinical decision-making so far. We reviewed the current status and performance of modern molecular urine tests following systematic analysis of the value and limitations of commercially available assays. Despite considerable advances in recent years, the authors feel that at this stage the added value of molecular markers for the diagnosis of urothelial tumors has not yet been identified. Current data suggest that some of these markers may have the potential to play a role in screening and surveillance of bladder cancer. Well-designed protocols and prospective, controlled trials will be needed to provide the basis to determine whether integration of molecular markers into clinical decision-making will be of value in the future.

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Section: Urine-based Markersmentioning

confidence: 87%

“…BTA stat is a qualitative test, while BTA TRAK is quantitative. Both have been performed on fresh, refrigerated, or frozen urine obtained as voided or catheterized specimens [29,31,33,37,43,46,48,49,50,51,52,53,54,55,56,57,58,59,60,61]. …”

Section: Urine-based Markersmentioning

confidence: 99%

Molecular Markers for Bladder Cancer Screening, Early Diagnosis, and Surveillance: The WHO/ICUD Consensus

et al. 2014

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“…18 Our study concurs with several others and confirms marked improvement of sensitivity by incorporating ImmunoCyt/uCytt with cytology. Most studies reported results comparable or better 44-74% (65%) 57-90% (72%) BTA trak 21,26,30À32 58-78% (67%) 63-84% (75%) NMP22 21,22,27,28,31,33 53-74% (64%) 55-80% (70%) Telomerase 4,17,22 65-70% (68%) 89-99% (94%) Microsatellites 16 -(74%) -(82%) FISH 17 -(81%) -(96%) ImmunoCyt/ uCytt 6,7,11,13À15,18,20,21 53-100% (90%) 64-95% (74%)…”

Section: Discussionmentioning

confidence: 97%

ImmunoCyt/uCyt+™ improves the sensitivity of urine cytology in patients followed for urothelial carcinoma

et al. 2005

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ImmunoCyt/uCytt is a fluorescent test combining three monoclonal antibodies. In this study, it has been tested as a complement to cytology in the detection of urothelial carcinoma in urine. It has been performed simultaneously with standard cytology and cystoscopy on 870 urine analyses from one hospital. In 136 cases, one or more bladder tumors were found. Overall sensitivity of cytology, ImmunoCyt/uCytt and combined analyses reached 29, 74 and 84%, respectively, and overall specificity was 98, 62 and 61%. The negative predictive value of cytology, ImmunoCyt/uCytt and both analyses was 88, 93 and 95%, respectively, and the positive predictive value was 70, 26 and 29%. The sensitivity of cytology for low malignant potential neoplasms, low-and high-grade papillary carcinomas was 6, 18 and 53%, while it reached 71, 79 and 93% when combined with ImmunoCyt/uCytt. The sensitivity of cytology for stages Ta, T1, T2 and over and Tis tumors was12, 67, 47 and 50%, while it reached 78, 83, 79 and 100% when combined with ImmunoCyt/uCytt. In the absence of tumor on cystoscopy but with positive ImmunoCyt/uCytt, 18% of patients developed a tumor, 2-6 months later. Of the 109 cases diagnosed as suspicious for malignancy by cytology, a tumor was present in 30 cases and ImmunoCyt/uCytt was positive in 22 (73%) of them. In conclusion, ImmunoCyt/uCytt may be used to postpone cystoscopies in patients followed for bladder cancer and may help to save cytologist and pathologist screening Keywords: urothelial carcinoma; cytology; ImmunoCyt/uCytt; immunofluorescence; urinary bladder; recurrence Superficial bladder cancers are defined as tumors limited to the mucosa (Tis, Ta) or invading into the lamina propria (T1), without muscle invasion. 1 They represent more than 80% of urothelial carcinomas and more than 50% will recur. 1-3 Patients with bladder cancer are followed with regular cytologies and cystoscopies. Cytology is very specific but this test is limited by its low sensitivity ranging from 16 to 60%. 4 Cytology is most useful at detecting highgrade (HG) cancer, whereas its sensitivity for lowgrade (LG) urothelial tumors is low and merely reaches 17%. 4 Furthermore, criteria used in urinary cytology to detect tumor cells are largely subjective and the ability to detect cancer cells is dependent on the experience of cytologists or pathologists. For instance, atypical cells and papillary aggregates may be found in either reactive or neoplastic conditions. 5 Furthermore, LG urothelial carcinomas do not always exfoliate in aggregates and the cell characteristics are often so subtle that they might not be recognizable even by an experienced cytologist. 5 Standard practice in the follow-up of patients with bladder cancer requires cystoscopies at regular intervals, but this technique is invasive, costly and causes discomfort to the patient. It is thus estimated that by improving the sensitivity of cytology, fewer follow-up cystoscopies would be needed. Furthermore, improved sensitivity would help cytologists and pathologists to save time c...

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“…However, only a prolonged follow–up of patients can determine whether any of these represent sub–clinical disease, as is seen with urinary cytology. Recently, Giannopoulos et al [18]in a mean follow–up of 13.2 months, detected recurrences on follow–up in 57% of the patients with elevated NMP22 levels. A prolonged follow–up may hence be required before labelling the test as false positive.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the Clinical Value of Urinary NMP22 as a Marker in the Screening and Surveillance of Transitional Cell Carcinoma of the Urinary Bladder

et al. 2001

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Comparative evaluation of the BTAstat test, NMP22, and voided urine cytology in the detection of primary and recurrent bladder tumors

Cited by 49 publications

References 16 publications

Molecular Markers for Bladder Cancer Screening, Early Diagnosis, and Surveillance: The WHO/ICUD Consensus

Molecular Markers for Bladder Cancer Screening, Early Diagnosis, and Surveillance: The WHO/ICUD Consensus

ImmunoCyt/uCyt+™ improves the sensitivity of urine cytology in patients followed for urothelial carcinoma

Evaluation of the Clinical Value of Urinary NMP22 as a Marker in the Screening and Surveillance of Transitional Cell Carcinoma of the Urinary Bladder

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