Comparison of the Clinical Usefulness of Different Urinary Tests for the Initial Detection of Bladder Cancer: a Systematic Review

Overview

Journal Curr Urol

Specialty Urology

Date 2021 Jun 4

PMID 34084118

Citations 9

Authors

Alessandro Sciarra

Giovanni Di Lascio

Francesco Del Giudice

Pier Paolo Leoncini

Stefano Salciccia

Alessandro Gentilucci

Angelo Porreca

Benjamin I Chung

Giovanni Di Pierro

Gian Maria Busetto

Ettore De Berardinis

Martina Maggi

Affiliations

Soon will be listed here.

Abstract

Objectives: The standard initial approach in patients with hematuria or other symptoms suggestive of bladder cancer (BC) is a combination of cystoscopy and urine cytology (UC); however, UC has low sensitivity particularly in low-grade tumors. The aim of the present review was to critically analyze and compare results in the literature of promising molecular urinary tests for the initial diagnosis of BC.

Methods: We searched in the Medline and Cochrane Library databases for literature from January 2009 to January 2019, following the PRISMAguidelines.

Results: In terms of sensitivity, ImmunoCyt showed the highest mean and median value, higher than UC. All tests analyses showed higher mean and median sensitivity when compared with UC. In terms of specificity, only UroVysion and Microsatellite analyses showed mean and median values similar to those of UC, whereas for all other tests, the specificity was lower than UC. It is evident that the sensitivity of UC is particularly low in low grade BC. Urinary tests mainly had improved sensitivity when compared to UC, and ImmunoCyt and UroVysion had the highest improvement in low grade tumors.

Conclusions: Most of the proposed molecular markers were able to improve the sensitivity with similar or lower specificity when compared to UC. However, variability of results among the different studies was strong. Thus, as of now, none of these markers presented evidences so as to be accepted by international guidelines for diagnosis of BC.

Citing Articles

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