Noninvasive Detection of Bladder Cancer by the UBC Rapid Test, Ultrasonography and Cytology

摘要

Background: At presentation, 75% of patients (pts) have superficial tumors confined to the mucosa (Ta) or the lamina propria (Tl). After transurethral resection (TUR), 50% of pts will have recurrence within 2y. Therefore, a close follow-up is mandatory. Cystoscopy is invasive, so, there is need for non-invasive methods. Study Aims: to assess sensitivity (sens) and specificity (spec) of 3 noninvasive methods to detect primary and recurrent Bladder Cancer- the UBC Rapid, Ultrasonography (US) and Cytology. Materials and Methods: 89 pts following resection of Bladder tumors and pts evaluated for hematuria, provided urine for the UBC Rapid and cytopathological examination. Each pt had US and cystoscopy. And biopsies, if needed. The Sens. and Spec. of the 3 noninvasive methods, were compared to cystoscopy. Results: No tumor in 54 pts, Bladder tumor- found in 35 pts. Overall Sens. of the UBC Rapid test was 68.8% and Spec. was 79.6%. Sens. of US was 68.8% and Spec. was 98%. Sens. of Cytology was 56.7% and Spec. was 97.9%. The combination of all 3 methods had a Sens, of 94.3 and a Spec. of 71.1%. At least 1 of the tests was positive in 33 / 35 tumors. The combination of UBC Rapid and US had a Sens. of 91.4% (95% CI= 76.9% to 98.2%) and a Spec .of 76%. The combination of UBC Rapid and Cytology had a Sens. of 87.5% (95% CI= 71% to 96.5%) and a Spec. of 75%. The combination of US and Cytology had a Sens. of 82.4% (95% CI= 65.5% to 93.2%) and a Spec. of 95.5%. Conclusions: The combination of UBC Rapid, US and cytology has very high Sens., can decrease the frequency of cystoscopies and should be used as a routine noninvasive surveillance test.