Performance characteristics of multiple urinary tumor markers and sample collection techniques in the detection of transitional cell carcinoma of the bladder

Bhuiyan, Jalaluddin; Akhter, Javed; O’Kane, Dennis J.

doi:10.1016/s0009-8981(03)00074-3

Cited by 26 publications

(20 citation statements)

References 15 publications

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“…The test strips are also sensitive to hemoglobin and myoglobin, and in the case of female patients, a false-positive test may result from lingering menstrual blood. 16,17 Overall sensitivity values from recent studies using hematuria detection as a test for bladder cancer fall in the range of 47.0%-92.6%, and reported specificity ranges from 51.0%-84.0% 12,[18][19][20][21][22] (Table 1).…”

Section: Hematuriamentioning

confidence: 99%

“…Specificity of the Bladder Cancer Test is reported to be 60.0%-95.0%, and specificity of the NMP22 BladderChek is reportedly in the range of 40.0%-89.8%. 11,[19][20][21][22][23]25,26,32,34,36,37,[39][40][41][42] The NMP22 tests are based on the release of NMPs into the urine following apoptosis of the urothelial cells, a process that can also occur as a result of benign conditions. As is the case with the BTA tests, NMP22 levels are raised in patients with urinary tract infections, concurrent urolithiasis, history of bladder interposition, other malignancies, intravesical therapies and even cystoscopy, all of which may contribute to false-positive results.…”

Section: Nuclear Matrix Protein 22mentioning

confidence: 99%

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Biomarkers for detection and surveillance of bladder cancer

Budman

Kassouf

Steinberg

2013

CUAJ

125

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Introduction: Bladder cancer is the fourth most common cancer in men and the ninth most common cancer in women in Canada. Early detection of tumours is essential for improved prognosis and long-term survival. The standard method for detection and surveillance is cystoscopy together with urine cytology. Cystoscopy is relatively sensitive but is expensive and invasive. Urinary cytology is a noninvasive method that has poor sensitivity but high specificity; it is relied on for the detection of carcinoma in situ. Currently, several urinary based bladder tumour biomarkers with USFDA/Health Canada approval are available commercially, but none have been widely adopted by urologists despite their offering high sensitivity and/or specificity. We present here a review of recent studies evaluating 7 commercial biomarker assays for the detection and/or surveillance of bladder cancer.Results: Sensitivity and specificity ranges, respectively, for each marker were reported as follows: BTA Stat (Polymedco), 52.5%–78.0% and 69.0%–87.1%; BTA Trak (Polymedco), 51%–100% and 73%–92.5%; cytology, 12.1%–84.6% and 78.0%–100%; hematuria dipstick, 47.0%–92.6% and 51.0%–84.0%; NMP22 Bladder Cancer Test (Matritech), 34.6%–100% and 60.0%–95.0%; NMP22 BladderChek (Matritech), 49.5%–65.0% and 40.0%–89.8%;ImmunoCyt/uCyt+ (DiagnoCure), 63.3%–84.9% and 62.0%–78.1%; ImmunoCyt/uCyt+ and cytology, 81.0%–89.3% and 61.0%–77.7%; and UroVysion (Abbott Molecular)/florescence in situ hybridization, 68.6%–100% and 65.0%–96.0%.Conclusion: We find that no currently available bladder cancer urinary marker is sensitive enough to eliminate the need for cystoscopy. In addition, cytology remains integral to the detection of occult cancer. However, owing to their relatively high sensitivities, these markers may be used to extend the period between cystoscopies in the surveillance of patients with transitional cell carcinoma. Further study is required to determine which markers, alone or in panel, would best accomplish this.

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Section: Hematuriamentioning

confidence: 99%

Section: Nuclear Matrix Protein 22mentioning

confidence: 99%

Biomarkers for detection and surveillance of bladder cancer

Budman

Kassouf

Steinberg

2013

CUAJ

125

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“…Another method allows measurement of hTERT mRNA levels by RT-PCR. The sensitivity of these assays is variable: it depends on sample manipulation but also on the presence of inflammatory conditions that can contaminate benign cells with telomerase activity [86][87][88][89][90][91][92][93][94][95][96]. The specificity of both the TRAP assay and hTERT RT-PCR is also variable.…”

Section: Telomerasementioning

confidence: 99%

Bladder Cancer Markers and Recent Innovations

Viola-Magni¹,

Cataldi²,

Marocco³

2017

Bladder Cancer - Management of NMI and Muscle-Invasive Cancer

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Bladder cancer (urothelial carcinoma) is the most common tumor of the urinary tract. It occurs more frequently among men about 65 years old on average. Two forms of the tumor are known: a non-muscle-invasive one and a muscle-invasive one. The latter turns out to be very aggressive with a survival of 5 years average. The non-muscle-invasive form frequently recurs (60-70%) and in 15% of cases, it progresses into the invasive form. The diagnosis is made mainly by cystoscopy and urine cytology. A high number of researches were dedicated in order to find a simple test using voided urine to frequently monitor possible tumor recurrence. During the last 10 years, many tests were proposed concerning either special proteins of which the most common are the bladder tumor antigen (BTA) and the nuclear matrix protein 22 (NMP22) or the presence of genetic mutations [most frequently, fibroblasts growth factor receptor 3 (FGFR3) and TP53], alteration of DNA methylation, chromatin structure and, more recently, the presence of specific micro-RNA. Recently the analysis of lipids present in voided urine showed a difference in fatty acids between healthy individuals and those affected by non-invasive forms. These markers appear to have a high specificity and sensitivity: a deepening of these results could lead to the development of a test that avoids invasive treatment and the cost of cystoscopy.

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“…Despite high false positive results (4 -34%), the BTA test is promising as an adjunct to the detection of early urothelial neoplasms. 1,4,6 Nuclear matrix proteins (NMPs) are involved in DNA configuration, structure, and function regulating the replication and transcription of various genes. The NMP-22 test measures a nuclear matrix protein in urine that is believed to be released in much higher amounts in patients with urothelial carcinoma.…”

mentioning

confidence: 99%

“…It is still not clear whether the marginal improvement in sensitivity it offers is worth the cost and time. 1,4,6 Telomerase is a ribonucleoprotein enzyme found in immortal cells, including most tumor cells. Tests for telomerase activity using the PCR-based telomere repeat amplification protocol (TRAP) assay have been positive in most urothelial carcinomas.…”

mentioning

confidence: 99%

FISHing and beyond in urinary cytology

Dahmoush

Cohen

2004

Diagnostic Cytopathology

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Voided urine and bladder washings are amongst the most common non-gynecologic specimens received in cytology laboratories. Whereas light microscopic examination has been the mainstay of screening and diagnosis for decades, problems with sensitivity for detecting low-grade urothelial neoplasms have always been a major source of limitation and frustration to cytopathologists as well as urologists. Recently, new ancillary techniques have been flooding the literature and scientific meetings, all promising a magic answer and leading one to believe that the days of morphologic urinary cytology are numbered. So are we there yet? Should we give up on urinary cytology and advise our urology colleagues to send their specimens for ancillary testing? This editorial is an overview of the salient problems of urinary cytology and a critical appraisal of the status of its challengers.Urinary bladder cancer is the second most common urological malignancy and the eighth most common cancer in the United States. About 75% of urothelial carcinomas are "superficial" at the time of diagnosis, and of these 50 -70% will recur and 10 -20% will progress to muscle invasive disease. Because the clinical behavior of so-called "superficial" bladder cancer is difficult to predict, there is necessarily frequent surveillance of these patients. 1 Cytologic examination of urothelial cells (from voided urine, urinary bladder washings, and upper urinary tract brushings) coupled with cystoscopic examination is the gold standard for detecting recurrent urothelial neoplasms. Whereas urinary cytology has excellent sensitivity and specificity for the diagnosis of high-grade carcinomas, both approaching 100%, the cytologic diagnosis of low-grade carcinomas is significantly less sensitive. This reduced sensitivity is partly due to sampling issues but largely due to difficulty in interpretation, which is markedly influenced by the experience of the cytopathologist. 2 The limitations of cytology and the invasive nature of cystoscopy have fueled the search for urinary tumor biomarkers that could detect clinically significant (recurrent) neoplasms with high sensitivity and specificity. The focus of this effort is to reduce the cost and morbidity of cystoscopic surveillance, and to institute prompt surgical intervention before tumors progress to muscle invasive disease. 1 An increasing number of urinary tumor markers are currently under investigation. Most of these markers appear to have better sensitivity than urinary cytology, particularly for detecting low-grade urothelial tumors. However, they tend to be less specific, yielding more false positive results, particularly in patients with concurrent cystitis or other non-neoplastic bladder conditions. [3][4][5] The Bard tumor antigen test is a FDA-approved latex agglutination test designed to detect bladder cancer in voided urine. The earliest test was designed to detect basement membrane complexes released into the urine of bladder cancer patients as the tumor invades the bladder wall. Two newer versions of th...

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Performance characteristics of multiple urinary tumor markers and sample collection techniques in the detection of transitional cell carcinoma of the bladder

Cited by 26 publications

References 15 publications

Biomarkers for detection and surveillance of bladder cancer

Biomarkers for detection and surveillance of bladder cancer

Bladder Cancer Markers and Recent Innovations

FISHing and beyond in urinary cytology

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