Impact of different grades of microscopic hematuria on the performance of urine-based markers for the detection of urothelial carcinoma

Todenhöfer, Tilman; Hennenlotter, Joerg; Tews, Veronika; Gakis, Georgios; Aufderklamm, Stefan; Kuehs, Ursula; Stenzl, Arnulf; Schwentner, Christian

doi:10.1016/j.urolonc.2011.10.011

Cited by 30 publications

(26 citation statements)

References 30 publications

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“…Matsuyama et al [16] also used FISH to examine 118 UC patients and found that the absence of 9p21 genes was related to UC recurrence. The results of our study showed that when CSP3/GLPp16-positive patients were compared to CSP3/GLPp16-negative patients in risk groups, no differences in recurrence or progression were observed (p>0.05), which may be related to the low FISH detection sensitivity for low-grade UC (60–70%) [17]. This result may also have occurred because the CSP3/GLPp16 patients rarely exhibit malignant tumor biology and have less infiltration, which is more easily completely surgically resected.…”

Section: Discussionmentioning

confidence: 92%

Utility of Fluorescence In Situ Hybridization (FISH) to Sub-Classify Low-Grade Urothelial Carcinoma for Prognostication

Chen

Peng

et al. 2017

Med Sci Monit

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BackgroundFluorescence in situ hybridization (FISH) is used widely to detect cancer levels, but its value in urothelial carcinoma remains unclear. The aim of this study was to use FISH to examine the urine specimens of low-grade urothelial carcinoma (UC) patients to determine the possibility of sub-classifying the prognosis of UC.Material/MethodsWe diagnosed 107 patients with low-grade UC using a UroVysion kit to detect chromosomes 3, 7, 17, and P16 in the urine. An average 46.6-month follow-up completed in January 2016 combined with the clinical follow-up data were evaluated with Spearman’s correlation analysis to analyze the aberration of chromosomes in relation to the prognostication. Univariate and multivariate analysis using the Mantel-Cox log-rank test for overall, cancer-specific, and disease-free survival were used to determine the prognostic significance of CSP7/CSP17 and CSP3/GLPp16.ResultsIn the 107 samples, 84 showed positive reaction in the FISH test. Furthermore, CSP7/CSP17 was found to be significantly related with age, tumor size, T stage, and tumor numbers, but not in CSP3/GLPp16. In addition, Kaplan-Meier analysis and Cox proportional hazards regression revealed a significant negative correlation between CSP7/CSP17 and survival, while CSP3/GLPp16 showed no significantly differences.ConclusionsCSP7/CSP17 positivity on FISH test appears to play a critical role in low-grade UC and may be considered as a high-risk and prognosis factor.

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Section: Discussionmentioning

confidence: 92%

Utility of Fluorescence In Situ Hybridization (FISH) to Sub-Classify Low-Grade Urothelial Carcinoma for Prognostication

Chen

Peng

et al. 2017

Med Sci Monit

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“…Microscopic hematuria was classified according to Todenhöfer et al into grade 0 (no erythrocytes), grade I (1 erythrocytes/μl < 100), grade II (100 erythrocytes/μl < 250), and grade III (250 erythrocytes/μl). 15 All patients with microscopic hematuria underwent white-light cystoscopy and imaging of the upper urinary tract (computed tomography of the abdomen and pelvis, retrograde pyelogram, ultrasound). Patients with suspicious cystoscopic findings were evaluated by transurethral biopsy and/or resection of suspicious lesions with histological assessment.…”

Section: Methodsmentioning

confidence: 99%

The Clinical Usefulness of Nuclear Matrix Protein-22 in Patients with End-Stage Renal Disease and Microscopic Hematuria

et al. 2012

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Objectives: To evaluate the sensitivity, specificity, and false-positive rate of the nuclear matrix protein-22 (NMP22) test in patients with end-stage renal disease (ESRD) and microscopic hematuria in order to avoid unnecessary follow-up tests for patients with false-positive NMP22 test results. Patients and Methods: Patients with ESRD were screened for microscopic hematuria as part of the pre-transplant workup. Patients with documented microscopic hematuria underwent workup as recommended by the American Urological Association. Results: Between January 2006 and April 2012, 277 patients with ESRD were referred to the Department of Urology for pre-transplant evaluation. Fifty-seven (22.6%) patients were found to have microscopic hematuria and underwent further testing. Nineteen (33.3%) patients demonstrated a positive NMP22 test result and 38 (66.7%) had a negative NMP22 test result. The false-positive rate was 32.7%. The sensitivity and specificity of the NMP22 test in this patient population were 50% and 67%, respectively. The positive predictive value of the test was 52.6% and the negative predictive value 97.3%. Especially noteworthy, the two detected transitional cell cancers of the urinary bladder were both demonstrated during cystoscopy, independent of their NMP22 or urine cytology test result. Conclusions: Our study revealed a significantly increased NMP22 test false-positive rate, low sensitivity, and specificity in the setting of high prevalence of microscopic hematuria, proteinuria, and low glomerular filtration rate in patients with ESRD. Therefore, cystoscopy remains the gold standard for patients with ESRD and microscopic hematuria for pre-transplant evaluation.

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“…10 Many factors affect urine cytology and decrease its sensitivity. [6][7][8] Saline washing, brush biopsy through a retrograde catheter, or ureteroscopy may improve sensitivity and specificity each to approximately 90%. 5,21 However, brush biopsy is associated with higher risk of severe complications.…”

Section: Rt-4mentioning

confidence: 99%

“…[3][4][5][6] However, many factors have been shown to decrease the sensitivity and specificity of urinary cytology, including: low tumour grade, instrumentation, number and methods of collection, background hematuria and inter-pathologist variability. [6][7][8][9][10] The effect of contrast agents has also been investigated with conflicting results; the current urological dogma is to discard contrast washings after retrograde pyelography and obtain washings in saline to maintain the diagnostic accuracy of cytology. 11 To address this issue, we designed a study to assess whether commonly used contrast agents affect cellular morphology or hinder interpretation of urinary cytology specimens.…”

Section: Introductionmentioning

confidence: 99%

Effect of contrast media on urinary cytopathology specimens

Frees

Bidnur

Metcalfe

et al. 2016

CUAJ

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Introduction: Urological dogma dictates that washings collected from the urinary tract for cytological assessment must be performed without interference from contrast agents that may alter cellular integrity and diagnostic interpretation. In practice, the initial contrast used to outline the upper tracts is commonly discarded with subsequent saline washings sent for cytology. We hypothesize that contrast washings do not affect the morphology of urothelial carcinoma cells or the integrity of cytology interpretation. Methods: Samples obtained from (1) human bladder cell lines; (2) urine from a human xenograft bladder cancer model using UC-3 cells; and (3) patients with urothelial carcinoma were subjected to various experimental solutions (water, saline, urine, and dilutions of contrast media) for different exposure times. After exposure to various different solutions, samples underwent cytological analysis to assess morphologic and degenerative changes. Results: No cytological differences were seen when cells were exposed to ionic, hyperosmolar, or non-ionic low-osmolar contrast agents for any exposures up to five minutes. Cells exposed to mixtures of contrast agents and urine also demonstrated no evidence of degenerative change. Cells exposed to water for greater than one minute demonstrated significant hydropic degeneration impacting cytological interpretation. At 40 minutes or later, all reagents caused severe degeneration when evaluating urine samples from the mouse bladder cancer model and from patients undergoing urothelial carcinoma. Conclusions: Commonly used contrast agents have no effect on urinary cytology up to five minutes. Contrast washings of the urinary tract should not be discarded and can be sent for cytological diagnosis if fixed within this time period.

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Impact of different grades of microscopic hematuria on the performance of urine-based markers for the detection of urothelial carcinoma

Cited by 30 publications

References 30 publications

Utility of Fluorescence In Situ Hybridization (FISH) to Sub-Classify Low-Grade Urothelial Carcinoma for Prognostication

Utility of Fluorescence In Situ Hybridization (FISH) to Sub-Classify Low-Grade Urothelial Carcinoma for Prognostication

The Clinical Usefulness of Nuclear Matrix Protein-22 in Patients with End-Stage Renal Disease and Microscopic Hematuria

Effect of contrast media on urinary cytopathology specimens

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