Department of Urology, Ljubljana University Medical Centre, Ljubljana, Slovenia.
Department of Surgery, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.
Radiol Oncol. 2020 Dec 29;55(2):196-202. doi: 10.2478/raon-2020-0072.
Cystoscopy in complement with urinary cytology represents the gold standard for the follow-up of patients with urinary bladder tumours. Xpert Bladder Cancer Monitor Test (XBC) is a novel mRNA-based urine test for bladder cancer surveillance. The aim of the study was to evaluate the performance of the XBC and voided urinary cytology (VUC) in the follow-up of bladder tumours.
The XBC was performed on stabilized voided urine and VUC was performed on urine samples. The results were compared to cystoscopic findings and histopathological results after transurethral resection of the bladder lesion.
For the prediction of malignant histopathological result sensitivity, the specificity and negative predictive value were 76.9%, 9 7.5% and 93.0% for the XBC and 38.4%, 9 7.5% and 83.3%, respectively for VUC. For the prediction of suspicious or positive cystoscopic finding sensitivity, the specificity and negative predictive value were 75.0%, 95.2%, and 93.0% respectively for the XBC and 41.7%, 97.6%, and 85.4% for VUC. The sensitivities for papilary urothelial neoplasms of low malignant potential (PUNLMP), low- and high-grade tumours were 0.0%, 66.7% an d 100.0% for the XBC and 0.0%, 66 .7% and 42.9%, respectively for VUC.
The XBC showed significantly higher overall sensitivity and negative predictive value than VUC and could be used to increase the recommended follow-up cystoscopy time intervals. Complementing the XBC and voided urinary cytology does not improve performance in comparison to the XBC alone.
膀胱镜检查结合尿细胞学检查是膀胱癌患者随访的金标准。Xpert 膀胱癌监测测试 (XBC) 是一种新型的基于 mRNA 的尿液膀胱癌监测检测方法。本研究旨在评估 XBC 和尿脱落细胞学 (VUC) 在膀胱癌随访中的表现。
XBC 检测在稳定的尿液中进行，VUC 在尿液样本中进行。结果与膀胱镜检查结果和经尿道膀胱病变切除术的组织病理学结果进行比较。
对于恶性组织病理学结果的预测，XBC 的敏感性、特异性和阴性预测值分别为 76.9%、97.5%和 93.0%，VUC 分别为 38.4%、97.5%和 83.3%。对于可疑或阳性膀胱镜检查结果的预测，XBC 的敏感性、特异性和阴性预测值分别为 75.0%、95.2%和 93.0%，VUC 分别为 41.7%、97.6%和 85.4%。XBC 对低级别乳头状尿路上皮肿瘤的敏感性为 0.0%，低级别和高级别肿瘤的敏感性分别为 66.7%和 100.0%，VUC 的敏感性分别为 0.0%、66.7%和 42.9%。
XBC 的总体敏感性和阴性预测值均明显高于 VUC，可用于增加推荐的随访膀胱镜检查时间间隔。XBC 与尿脱落细胞学检查互补并不能提高与单独使用 XBC 相比的性能。
