scholarly journals Can CT Virtual Cystoscopy Replace Conventional Cystoscopy in Early Detection of Bladder Cancer?

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Sachin Abrol ◽  
Ankush Jairath ◽  
Sanika Ganpule ◽  
Arvind Ganpule ◽  
Shashikant Mishra ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Early Detection ◽  
Predictive Value ◽  
Bladder Tumor ◽  
Urothelial Cancer ◽  
Routine Clinical Practice ◽  
Bladder Tumors ◽  
Virtual Cystoscopy ◽  
Sensitivity Specificity

Aim. To correlate findings of conventional cystoscopy with CT virtual cystoscopy (CTVC) in detecting bladder tumors and to evaluate accuracy of virtual cystoscopy in early detection of bladder cancer.Material and Method. From June 2013 to June 2014, 50 patients (46 males, four females) with history and investigations suggestive of urothelial cancer, with mean age 62.76 ± 10.45 years, underwent CTVC by a radiologist as per protocol and subsequently underwent conventional cystoscopy (CPE) the same day or the next day. One urologist and one radiologist, blinded to the findings of conventional cystoscopy, independently interpreted the images, and any discrepant readings were resolved with consensus.Result. CTVC detected 23 out of 25 patients with bladder tumor(s) correctly. Two patients were falsely detected as negative while two were falsely labeled as positive in CTVC. Virtual and conventional cystoscopy were comparable in detection of tumor growth in urinary bladder. The sensitivity, specificity, positive predictive value, and negative predictive value of virtual cystoscopy were 92% each.Conclusion. CTVC correlates closely with the findings of conventional cystoscopy. Bladder should be adequately distended and devoid of urine at the time of procedure. However, more studies are required to define the role of virtual cystoscopy in routine clinical practice.

scholarly journals Correlation of colposcopy with biopsy in cases of abnormal cervical cytology

2019 ◽  
Vol 14 (1) ◽  
pp. 36-39
Author(s):  
Kirtipal Subedi
Keyword(s):  
Predictive Value ◽  
Prospective Observational Study ◽  
Accurate Diagnosis ◽  
Cervical Cytology ◽  
Histopathological Diagnosis ◽  
Cervical Biopsy ◽  
Abnormal Cervical Cytology ◽  
Disease Threshold ◽  
Sensitivity Specificity

Aims: This study aims to find out the role of colposcopy and its correlation with cervical biopsy in detection of pre malignant cervical lesion. Methodology: This is hospital based prospective observational study on 60 cases with abnormal cervical cytology reports conducted in the Department of Obstetrics and Gynecology, PMWH, Thapathali, Kathmandu. Colposcopy guided biopsies were done and findings noted. Results: Among 60 cases enrolled in the study the most common cervical cytology finding was ASCUS, LSIL, HSIL and ASC-H present in 46.6%, 31.6%, 15% and 6.6% respectively.  The colposcopy finding among these cases was normal, CIN1, CIN 2 and CIN 3 in 45%, 23.3%, 16.7% and 9% respectively. Among these cases the most common biopsy finding was normal, CIN 1, CIN 2, CIN 3 and squamous cell carcinoma in 55%, 18.3%, 8.3%, 15% and 3.3% respectively. The sensitivity, specificity, positive predictive value and negative predictive value of colposcopy with CIN 1 as disease threshold was calculated to be 80.6%, 93.1%, 81.8% and 92.6% respectively. While evaluating the validity of colposcopy with histopathology, colposcopy seems to make an accurate diagnosis in 75% of cases, overestimating in 15% and underestimating in 8% of cases. Conclusions: There is a good correlation of colposcopy with histopathological diagnosis of cervical cancer. Keywords: colposcopy, cytology, diagnosis, premalignant  

Tumor Markers (CEA, TPA and CA 19–9) in Urine of Bladder Cancer Patients

1987 ◽  
Vol 2 (2) ◽  
pp. 121-124 ◽  
Author(s):  
Alessandro Tizzani ◽  
Giovanni Cassetta ◽  
Anna Cicigoi ◽  
Paolo Piana ◽  
Antonella Cerchier ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Urinary Tract ◽  
Diagnostic Accuracy ◽  
Inflammatory Diseases ◽  
Diagnostic Procedures ◽  
Bladder Tumors ◽  
Cancer Antigen ◽  
Urinary Marker ◽  
Urinary Levels ◽  
Sensitivity Specificity

This study was carried out to evaluate the usefulness of determining urinary levels of carcinoembryogenic antigen (CEA), tissue-polypeptide antigen (TPA), and gastrointestinal cancer antigen (Cal 9-9) in addition to the usual diagnostic procedures for bladder cancer. Sixty-seven patients with transitional bladder cancer, 40 healthy controls and 20 patients with inflammatory diseases of the urinary tract were considered. All urine samples were obtained from patients with intact renal function and no urinary tract infection. TPA and Cal 9-9 urinary levels in patients with G3 bladder tumors were significantly higher than in those with lower graded neoplasms. The sensitivity, specificity, and predictive value of a positive (PV+) or negative (PV–) test and the diagnostic accuracy were also evaluated. Cal 9-9 was the best urinary marker for bladder cancer (sensitivity 71.6%, specificity 91.6%, PV + 90.5%, PV–74.3%, diagnostic accuracy 81%).

Neoadjuvant chemotherapy and bladder-sparing surgery for invasive bladder cancer: ten-year outcome.

1998 ◽  
Vol 16 (4) ◽  
pp. 1298-1301 ◽  
Author(s):  
H W Herr ◽  
D F Bajorin ◽  
H I Scher
Keyword(s):  
Bladder Cancer ◽  
Radical Cystectomy ◽  
Bladder Tumor ◽  
Tumor Node Metastasis ◽  
Bladder Tumors ◽  
Primary Tumor Site ◽  
Node Metastasis ◽  
Bladder Sparing ◽  
Salvage Cystectomy

PURPOSE To evaluate the 10-year outcome of patients with invasive (T2-3N0M0, staged according to the tumor, node, metastasis system) bladder cancer who responded completely to a combination of methotrexate, vinblastine, adriamycin, and cisplatin (MVAC) chemotherapy followed by bladder-sparing surgery. PATIENTS AND METHODS Of 111 surgical candidates who received neoadjuvant MVAC, 60 (54%) achieved a complete clinical response (T0) on transurethral resection (TUR) of the primary tumor site. Of these, 28 requested follow-up with TUR alone, 15 had a partial cystectomy, and 17 elected a radical cystectomy. The patients were followed up for a median of 10 years (range, 8 to 13 years). RESULTS Of 43 patients who had bladder-sparing surgery, 32 (74%) are alive, which includes 25 (58%) with an intact functioning bladder. Twenty-four patients (56%) developed bladder tumor recurrences from 5 to 96 months, which were invasive in 13 (30%) and superficial in 11 (26%). Thirteen patients required a salvage cystectomy, of whom 6 died, which includes 4 (9%) from a new invasive neoplasm. Of the 17 patients who had radical cystectomy, 11 (65%) are alive. CONCLUSION The majority of patients with invasive bladder tumors who achieve T0 status after neoadjuvant MVAC chemotherapy preserve their bladders for up to 10 years with bladder-sparing surgery. The bladder remains at risk for new invasive tumors. Cystectomy salvages the majority, but not all, of relapsing patients.

Treatment of metastatic bladder cancer

2017 ◽  
Author(s):  
Fabio Calabrò ◽  
Cora N. Sternberg
Keyword(s):  
Bladder Cancer ◽  
Urothelial Cancer ◽  
Clinical Investigation ◽  
Good Prognosis ◽  
New Drugs ◽  
Urothelial Bladder Cancer ◽  
Urothelial Bladder ◽  
Molecular Patterns ◽  
The Impact

Although bladder cancer is considered a chemosensitive malignancy, the prognosis of patients with metastatic disease is poor, with a median survival of approximately 12–14 months in good prognosis patients and with cure in only a minority. The addition of new drugs to the standard cisplatin-based regimens has not improved these outcomes. In this chapter, we highlight the role of chemotherapy and the impact of the new targeted agents in the treatment of metastatic bladder carcinoma. A better understanding of the underlying biology and the molecular patterns of urothelial bladder cancer has led to clinical investigation of several therapeutic targets. To date, these agents have yet to demonstrate an improvement in overall survival. Urothelial cancer is extremely sensitive to checkpoint inhibition with both anti PD-1 and anti PDL1 antibodies. The future seems brighter with the advent of these new therapies.

scholarly journals Utility of the methylated SEPT9 test for the early detection of colorectal cancer: a systematic review and meta-analysis of diagnostic test accuracy

2020 ◽  
Vol 7 (1) ◽  
pp. e000355 ◽  
Author(s):  
Rohit Hariharan ◽  
Mark Jenkins
Keyword(s):  
Colorectal Cancer ◽  
Systematic Review ◽  
Early Detection ◽  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Diagnostic Test ◽  
Predictive Value ◽  
Meta Analysis ◽  
Test Accuracy ◽  
Sensitivity Specificity

BackgroundCirculating tumour DNA from colorectal cancer (CRC) is a biomarker for early detection of the disease and therefore potentially useful for screening. One such biomarker is the methylated SEPT9 (mSEPT9) gene, which occurs during CRC tumourigenesis. This systematic review and meta-analysis aims to establish the sensitivity, specificity and accuracy of mSEPT9 tests for the early diagnosis of CRC.MethodsA systematic search of the relevant literature was conducted using Medline and Embase databases. Data were extracted from the eligible studies and analysed to estimate pooled sensitivity, specificity and diagnostic test accuracy.ResultsBased on 19 studies, the pooled estimates (and 95% CIs) for mSEPT9 to detect CRC were: sensitivity 69% (62–75); specificity 92% (89–95); positive likelihood ratio 9.1 (6.1–13.8); negative likelihood ratio 0.34 (0.27–0.42); diagnostic OR 27 (15–48) and area under the curve 0.89 (0.86–0.91). The test has a positive predictive value of 2.6% and negative predictive value of 99.9% in an average risk population (0.3% CRC prevalence), and 9.5% (positive predictive value) and 99.6% (negative predictive value) in a high-risk population (1.2% CRC prevalence).ConclusionThe mSEPT9 test has high specificity and moderate sensitivity for CRC and is therefore a potential alternative screening method for those declining faecal immunochemical test for occult blood (FIT) or other screening modalities. However, it is limited by its poor diagnostic performance for precancerous lesions (advanced adenomas and polyps) and its relatively high costs, and little is known about its acceptability to those declining to use the FIT.

The significance of urine NMP22 in the screening of urothelial cancer (comparison of ELISA and immunochromatography method)

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e16024-e16024
Author(s):  
H. Ikeda ◽  
Y. Ishida ◽  
T. Dejima ◽  
M. Nomura ◽  
H. Sanefuji
Keyword(s):  
Predictive Value ◽  
Matrix Protein ◽  
Urothelial Cancer ◽  
Transitional Cell ◽  
False Negative ◽  
Local Treatment ◽  
Urine Cytology ◽  
Nuclear Matrix Protein ◽  
Sensitivity Specificity ◽  
Higher Sensitivity

e16024 Background: The early diagnosis of urothelial cancer allows for effective local treatment and optimizes the success of surgical therapy. Urine nuclear matrix protein 22 (NMP22) was introduced for the detection of transitional cell carcinoma. Add to old NMP22 (ELISA), new NMP22 (immunochromotography method : BladderChek) can be available from 2004. The objective of this study is to determine whether there are any correlation between urine NMP22 (two methods) and the grade or stage of urothelial cancer, and whether it can serve as a biochemical marker of urothelial cancer. Methods: A total of 246 patients with hematuria or followed up after TUR-BT, from March 2007 to December 2007,visited our hospital and subsequently underwent cystoscopy. The 246 patients provided voided urine samples. We immediately examined urine cytology and NMP22 (two methods). We set the cut off value on 12.0U/ml for NMP22 (ELISA). NMP22 (BladderChek) was judged by qualitative analysis. We decided that in urine cytology, classI,II,III were negative, while IV,V were positive by Papanicolaou classification. Results: Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) were 66.7 %, 98.3 %, 81.8 %, 96.3 % in urine cytology, 40.7 %, 75.9 %, 16.2 %, 91.8 % in NMP22 (ELISA), 59.3 %, 79.3 %, 24.6 %, 94.5 % in NMP22 (BladderChek). In 9 cases with false negative of urine cytology, 4 cases were picked up by NMP22 (ELISA), and 5 cases by NMP22 (BladderChek). Sensitivity of grade 1 was 33.3 % in urine cytology, while 66.7 % in NMP22 (BladderChek). By adding NMP22 (BladderChek) to urine cytology, sensitivity rose about 18 %. Conclusions: The sensitivity of urine cytology was unexpectedly high. NMP22 (BladderChek) is more useful than NMP22 (ELISA) because of higher sensitivity, specificity and advantage of simplicity, rapidity. It seems that the addition of NMP22 (BladderChek) to urine cytology is beneficial. No significant financial relationships to disclose.

Novel oncogenic function of ATDC in bladder cancer.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 4591-4591
Author(s):  
Phillip Lee Palmbos ◽  
Lidong Wang ◽  
Huibin Yang ◽  
Taylor Detzler ◽  
Gina Ney ◽  
...  
Keyword(s):  
Gene Expression ◽  
Bladder Cancer ◽  
Cancer Cell ◽  
Pten Expression ◽  
Cancer Tissue ◽  
Bladder Tumors ◽  
Human Bladder ◽  
Urothelial Carcinomas ◽  
Normal Bladder

4591 Background: Bladder cancer is a common and deadly disease, but the molecular events leading to its initiation and progression are incompletely understood. We recently identified Ataxia-Telangiectasia Group D Associated (ATDC) as a novel oncogene which drives tumor proliferation and invasion in pancreatic carcinoma (Cancer Cell, 2009). In this study, we describe the role of ATDC as an oncogene in bladder cancer. Methods: To further determine the oncogenic role of ATDC, we generated ATDC transgenic (tg) mice in which ATDC expression was driven by a CMV promoter and characterized the resulting tumors. Results: Interestingly, the dominant phenotype in these mice was the development of both non-invasive and invasive urothelial carcinomas (9% and 20% respectively, average age of onset 10-12 months of age). Histologically, these tumors were indistinguishable from human urothelial carcinomas. Gene expression profiling of invasive tumors derived from ATDC tg mice demonstrated a marked overlap with gene signatures of human invasive bladder cancers. ATDC was the 11th most highly up-regulated gene in bladder cancers represented in the Oncomine gene expression database. Analysis of a human bladder cancer tissue microarray (311 samples) by IHC showed elevated expression in 70% (173/252) of muscle-invasive carcinomas, 22% (5/23) of papillary tumors and little or no expression in normal bladder urothelium. ATDC tg mouse bladder tumors demonstrated loss of p53 signaling and down-regulation of PTEN expression, which correlated with ATDC induced methylation of the PTEN promoter by DNMT3A. Furthermore, ATDC knock-down in invasive cancer cell lines resulted in decreased proliferation, invasion and reactivation of p53-mediated signaling and PTEN expression. Conclusions: ATDC is a novel oncogene that is highly expressed in human bladder cancers and is sufficient to drive the development of invasive bladder tumors in tg mice. The mechanism by which ATDC drives bladder cancer formation involves alterations in p53 and PTEN pathways known to be important in bladder tumorigenesis.

Diagnostic evaluation of immune checkpoint inhibitor (CPI) colitis: The role of CT scan.

2020 ◽  
Vol 38 (4_suppl) ◽  
pp. 821-821
Author(s):  
Sienna Durbin ◽  
Meghan Mooradian ◽  
Leyre Zubiri ◽  
Ian Matthew Allen ◽  
Florian Fintelmann ◽  
...  
Keyword(s):  
Ct Scan ◽  
Predictive Value ◽  
Gold Standard ◽  
Invasive Procedure ◽  
Primary Objective ◽  
Lower Endoscopy ◽  
Grade 3 ◽  
Sensitivity Specificity ◽  
Tumor Types

821 Background: CPI therapy has expanded rapidly in recent years and represents a major advancement in the treatment of many cancers, including hepatocellular carcinoma, gastric cancer, and colon cancer. However, these therapies are associated with significant toxicities. CPI colitis is one of the most common toxicities and can be fatal, especially when not diagnosed and treated promptly. The current gold standard for diagnosis is endoscopy with biopsy, an invasive procedure that is resource- and time-intensive. CT has emerged as a possible alternative. The primary objective of this study is to identify the diagnostic performance of CT in the evaluation of CPI colitis. Methods: With IRB approval, we conducted a retrospective cohort study of patients who received CPI therapy between 2009-2019 across a single healthcare system. Patients were included if they underwent both abdominal CT and upper/lower endoscopy with biopsy within 72 hours of each other. We reviewed the electronic medical record to identify possible cases of colitis based on either CT or pathology. All cases were labeled as either true positive or false positive based on pathology. We examined clinical characteristics, including CTCAE grade and treatment received. We calculated the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of CT for diagnosing CPI colitis when compared to the gold standard of tissue diagnosis. Results: Of the 4,474 patients screened, 141 met inclusion criteria. Average age was 63 years (23 – 91); 43% were male. Most common tumor types were melanoma (36%) and NSCLC (20%). Seventy-four percent of patients were treated with anti-PD-1/PD-L1 monotherapy. Forty percent had signs of colitis on CT scan and 59% had biopsy-proven CPI colitis. Sensitivity and specificity of CT were 51% and 74%, respectively. PPV of CT was 74% and NPV was 51%. Of those with confirmed CPI colitis, 78% had symptoms that were classified as grade 3 or above. Seventy-three percent received IV steroids and 38% received infliximab. Conclusions: CT demonstrates moderate specificity and PPV and remains an important diagnostic test but does not replace endoscopy/biopsy in the evaluation of CPI colitis.

scholarly journals The emerging role of the androgen receptor in bladder cancer

2015 ◽  
Vol 22 (5) ◽  
pp. R265-R277 ◽  
Author(s):  
Alan P Lombard ◽  
Maria Mudryj
Keyword(s):  
Bladder Cancer ◽  
Androgen Receptor ◽  
Therapeutic Potential ◽  
Gender Disparity ◽  
Bladder Tumors

Men are three to four times more likely to get bladder cancer than women. The gender disparity characterizing bladder cancer diagnoses has been investigated. One hypothesis is that androgen receptor (AR) signaling is involved in the etiology and progression of this disease. Although bladder cancer is not typically described as an endocrine-related malignancy, it has become increasingly clear that AR signaling plays a role in bladder tumors. This review summarizes current findings regarding the role of the AR in bladder cancer. We discuss work demonstrating AR expression in bladder cancer and its role in promoting formation and progression of tumors. Additionally, we discuss the therapeutic potential of targeting the AR in this disease.

Sign in / Sign up

Export Citation Format

Share Document