Süzan Serhat, Ulus İsmail, Hacıbey İbrahim, Müslümanoğlu Ahmet Yaser
Department of Urology, University of Health Sciences, Bagcilar Training and Research Hospital, Istanbul, 34200, Turkey.
World J Urol. 2025 Jan 27;43(1):89. doi: 10.1007/s00345-025-05453-3.
As Bladder EpiCheck (BE) is a promising urinary biomarker for diagnosis and follow up of non-muscle-invasive bladder cancer (NMIBC), there are no studies evaluated this tool for second transurethral resection (TUR) indication. We aim to evaluate the performance of BE in predicting residual tumor before second TUR in NMIBC and its effects on clinical decision making.
A total of 50 patients who were diagnosed with NMIBC and indicated for a second TUR were included in the study prospectively. The urine sample taken one day before the second TUR operation was evaluated with BE and the results were compared with second TUR pathologies.
The mean age was 65.3 and 45 of the patients were male. Specificity and negative predictive value of BE in primary tumor stage Ta were 100% and 87.5% while in primary tumor stage T1 were 71.4% and 68.2%, respectively. The specificity and negative predictive value of BE were 77.8% and 75%, respectively, in patients with high grade primary tumor. When all NMIBC were evaluated, the specificity and negative predictive value of BE were found to be 78.6% and 73.3% for second TUR, respectively. As an independent predictor of residual tumor in this group, positivity rates of BE were higher in T1 (p < 0.037) and high grade (p < 0.002) tumors.
BE may be useful in detecting residual tumor before second TUR and benefit in clinical decision making with high specificity and negative predictive value. These results encourage the use of BE to reduce number of unnecessary second TUR procedures. It may improve cost effectivity and quality of life as high numbered studies are needed to support these views and to incorporate BE into clinical practice.
由于膀胱上皮检测（BE）是一种用于非肌层浸润性膀胱癌（NMIBC）诊断和随访的有前景的尿液生物标志物，尚无研究评估该工具用于二次经尿道膀胱肿瘤切除术（TUR）的指征。我们旨在评估BE在预测NMIBC二次TUR前残留肿瘤方面的性能及其对临床决策的影响。
前瞻性纳入50例被诊断为NMIBC且需进行二次TUR的患者。在二次TUR手术前一天采集的尿液样本用BE进行评估，并将结果与二次TUR病理结果进行比较。
患者的平均年龄为65.3岁，其中45例为男性。BE在原发肿瘤Ta期的特异性和阴性预测值分别为100%和87.5%，而在原发肿瘤T1期分别为71.4%和68.2%。在原发肿瘤为高级别患者中，BE的特异性和阴性预测值分别为77.8%和75%。当评估所有NMIBC患者时，发现BE对二次TUR的特异性和阴性预测值分别为78.6%和73.3%。作为该组残留肿瘤的独立预测指标，BE在T1期（p < 0.037）和高级别（p < 0.002）肿瘤中的阳性率更高。
BE可能有助于在二次TUR前检测残留肿瘤，并以高特异性和阴性预测值在临床决策中发挥作用。这些结果鼓励使用BE以减少不必要的二次TUR手术数量。由于需要大量研究来支持这些观点并将BE纳入临床实践，这可能会提高成本效益和生活质量。
