Sordelli Federica, Desai Antonio, Dagnino Filippo, Contieri Roberto, Giuriolo Sofia, Paciotti Marco, Fasulo Vittorio, Mancon Stefano, Maffei Davide, Avolio Pier Paolo, Da Rin Giorgio, Maura Federica, Vanni Elena, Federico Davide, Colombo Piergiuseppe, Lughezzani Giovanni, Buffi Nicolò Maria, Casale Paolo, Saita Alberto, Lazzeri Massiomo, Hurle Rodolfo, Voza Antonio
Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy.
Department of Urology, IRCCS Humanitas Research Hospital, Rozzano, Italy.
Eur Urol Open Sci. 2024 Dec 31;71:172-179. doi: 10.1016/j.euros.2024.09.001. eCollection 2025 Jan.
Bladder cancer (BC) represents a significant health care challenge and is frequently detected during evaluations for haematuria in emergency departments (EDs). Our aim was to evaluate the clinical performance and economic implications of the Xpert BC Detection (BCD) test for patients presenting to the ED with haematuria to address the pressing need for more efficient and accurate diagnostic tools in this setting.
We conducted a prospective single-centre observational study in the ED of a tertiary university hospital. Patients presenting with gross haematuria as the primary reason for their visit were enrolled. Urine samples collected in the ED were analysed using the Xpert BCD test. The primary outcomes were sensitivity, specificity, and a cost analysis for the Xpert BCD test in comparison to standard diagnostic methods such as urine cytology (UC) and white-light cystoscopy (WLC).
The Xpert BCD test exhibited superior sensitivity to UC, particularly in identifying high-grade tumours. Importantly, Xpert BCD implementation has the potential to significantly reduce the number of unnecessary WLC procedures and streamline diagnostic pathways. The cost analysis also highlighted potential cost savings for Xpert BCD adoption in the ED setting.
Our findings underscore the promise of Xpert BCD for revolutionising the diagnostic approach to BC in the ED for patients with gross haematuria. Its greater sensitivity and efficiency mean that Xpert BCD has the potential to improve patient care, optimise resource use, and alleviate the economic burden associated with unnecessary procedures.
Xpert Bladder Cancer Detection is a simple urine test that detects the presence of five genes associated with bladder cancer. We found that for patients visiting the emergency department because of blood in their urine, use of this test could save time and money over urine cell analysis (UCA) for ruling out or diagnosing bladder cancer. The test was also more sensitive in detecting higher-grade cancers. More research is needed to confirm our results.
膀胱癌（BC）是一项重大的医疗保健挑战，常在急诊科（ED）对血尿进行评估时被发现。我们的目的是评估Xpert BC检测（BCD）试验对因血尿就诊于急诊科的患者的临床性能和经济影响，以满足在这种情况下对更高效、准确的诊断工具的迫切需求。
我们在一所三级大学医院的急诊科进行了一项前瞻性单中心观察性研究。纳入以肉眼血尿为主要就诊原因的患者。在急诊科收集的尿液样本使用Xpert BCD试验进行分析。主要结局是与标准诊断方法（如尿液细胞学检查（UC）和白光膀胱镜检查（WLC））相比，Xpert BCD试验的敏感性、特异性和成本分析。
Xpert BCD试验对UC表现出更高的敏感性，尤其是在识别高级别肿瘤方面。重要的是，实施Xpert BCD有可能显著减少不必要的WLC程序数量并简化诊断途径。成本分析还凸显了在急诊科采用Xpert BCD可能节省的成本。
我们的研究结果强调了Xpert BCD在为肉眼血尿患者彻底改变急诊科膀胱癌诊断方法方面的前景。其更高的敏感性和效率意味着Xpert BCD有潜力改善患者护理、优化资源利用并减轻与不必要程序相关的经济负担。
Xpert膀胱癌检测是一种简单的尿液检测，可检测与膀胱癌相关的五种基因的存在。我们发现，对于因血尿就诊于急诊科的患者，使用该检测在排除或诊断膀胱癌方面比尿液细胞分析（UCA）更节省时间和金钱。该检测在检测高级别癌症方面也更敏感。需要更多研究来证实我们的结果。
