Drapier Eric, Renaudin Karine, Maillet Frédéric, Braud Guillaume, Laboisse Christian, Bouchot Olivier
Service d'Urologie, Hôtel Dieu, 1, place Alexis Ricordeau, 44093 Nantes, France.
Prog Urol. 2003 Apr;13(2):222-6.
Superficial bladder tumours are common tumours that frequently relapse, generally with deterioration of the grade. Cystoscopic surveillance is unpleasant for the patient and is associated with considerable morbidity, while urine cytology, although very easy to poor, has a low sensitivity. According to the literature, the uCyt+ test is very effective for the detection of urothelial tumours. This immunofluorescent technique detects desquamated tumour cells previously labelled by specific antibodies.
This prospective study was conducted in 92 patients undergoing screening or follow-up cystoscopy. Voided urine was collected prior to cystoscopy to perform standard cytology and a uCyt+ test. These examinations were interpreted independently under blinded conditions.
The sensitivity and specificity of uCyt+ were 68.7% and 81.7%, versus 40.6% and 96.7% for cytology. The sensitivity of uCyt+ was higher for low-grade tumours (87.5%), in contrast with cytology (37.5%). The results of uCyt+ were comparable to those of cytology for high-grade tumours (80%).
The uCyt+ test presented better performances than standard cytology. It would allow less frequent surveillance cystoscopy examinations, especially in patients with low-grade lesions.
浅表性膀胱肿瘤是常见肿瘤,常易复发,且通常伴有分级恶化。膀胱镜监测对患者来说很不舒服,且伴有相当高的发病率,而尿液细胞学检查尽管操作简便但敏感性较低。根据文献,uCyt+检测对尿路上皮肿瘤的检测非常有效。这种免疫荧光技术可检测先前被特异性抗体标记的脱落肿瘤细胞。
本前瞻性研究纳入了92例接受筛查或随访膀胱镜检查的患者。在膀胱镜检查前收集晨尿,以进行标准细胞学检查和uCyt+检测。这些检查在盲法条件下独立解读。
uCyt+的敏感性和特异性分别为68.7%和81.7%,而细胞学检查的敏感性和特异性分别为40.6%和96.7%。uCyt+对低级别肿瘤的敏感性更高(87.5%),而细胞学检查的敏感性为37.5%。对于高级别肿瘤,uCyt+的结果与细胞学检查相当(80%)。
uCyt+检测的表现优于标准细胞学检查。它可以减少膀胱镜监测检查的频率,尤其是对于低级别病变的患者。