scholarly journals The performance of the Xpert Bladder Cancer Monitor Test and voided urinary cytology in the follow-up of urinary bladder tumors

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Tomaz Smrkolj ◽  
Urska Cegovnik Primozic ◽  
Teja Fabjan ◽  
Sasa Sterpin ◽  
Josko Osredkar
Keyword(s):  
Bladder Cancer ◽  
Urinary Bladder ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Cancer Surveillance ◽  
Urinary Cytology ◽  
Time Intervals ◽  
Histopathological Results ◽  
Bladder Tumours

AbstractBackgroundCystoscopy 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.Patients and methodsThe 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.ResultsFor 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.ConclusionsThe 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.

scholarly journals THE VALUE OF URINARY CYTOLOGY AND HYDRONEPHROSIS TO PREDICT MUSCLE INVASIVE BLADDER CANCER

2016 ◽  
Vol 23 (1) ◽  
Author(s):  
Ferdi Ardiansyah ◽  
H R Danarto
Keyword(s):  
Bladder Cancer ◽  
General Hospital ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Tumor Location ◽  
Invasive Bladder Cancer ◽  
Bivariate Analysis ◽  
Urinary Cytology ◽  
Muscle Invasive Bladder Cancer ◽  
Muscle Invasive

Objective: We evaluated the value of urinary cytology, and presence of hydronephrosis to predict muscle invasive bladder cancer. Material & methods: We retrospectively analyzed data of 167 patients that diagnosed bladder cancer from medical record at Sardjito General Hospital Yogyakarta, between 2004-2011. Preoperative parameters were evaluated including age, gender, number and location of bladder cancer, urinary cytology, as well as presence of hydronephrosis. The outcome was muscle invasive bladder cancer. Results: A total of 96 (57.5%) patients had positive urinary cytology, 80 (47.9%) had hydronephrosis, most location of tumor were in trigone 43 (25.7%). The youngest patient was 26 years and the oldest was 84 years old, male was most affected in 145 (86.8%). On bivariate analysis, positive urinary cytology and hydronephrosis were associated with muscle invasive bladder cancer (OR 0.08 CI 0.038–0.167; OR 30.24 CI 12.72–71.89, respectively, each p < 0.05). Combination urinary cytology and hydronephrosis incrementally improved prediction of muscle invasive bladder cancer with positive and negative predictive value were 93.9% and 71.4%, respectively. Presence of hydronephrosis was associated with tumor location in trigone (p < 0.05). Conclusion: Urinary cytology and hydronephrosis were associated with muscle invasive bladder cancer, and can be used to predict muscle invasive bladder cancer.

Urinary Met level as a novel biomarker for urothelial carcinoma of the bladder.

2011 ◽  
Vol 29 (7_suppl) ◽  
pp. 257-257
Author(s):  
M. Sorbellini ◽  
B. McNeil ◽  
B. Cohen ◽  
G. Athauda ◽  
A. Giubellino ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Trial Design ◽  
Transitional Cell ◽  
Clinical Trial Design ◽  
Carcinoma Of The Bladder ◽  
Muscle Invasive ◽  
Sensitivity Specificity

257 Background: To determine whether urinary soluble Met (sMet) can differentiate between benign conditions and bladder cancer (CaB), and in cases of bladder cancer, between different stages of transitional cell carcinoma (TCC). Methods: Urinary samples from patients with (Total: 63, pTa: 12, pTis: 22, pT1: 13, ≥ pT2: 16) and without (Total: 27) CaB from three different institutions were prospectively collected prior to cystosopy, TURBT or cystectomy. sMet levels were determined by electrochemiluminescence immunoassay and normalized to urinary creatinine values. Normalized sMet values were compared to final pathologic stage. AUC values were obtained comparing patients with and without TCC. Results: Urinary sMet levels accurately differentiated between patients with and without CaB (AUC: 78%, sensitivity, specificity and negative predictive value were: 68%, 78% and 95%, respectively), patients with no CaB and those with lamina propria invasion (AUC: 79%, sensitivity, specificity and negative predictive value were: 65%, 81% and 95%, respectively) and patients with no CaB and those with muscle invasive CaB (AUC: 85%, sensitivity, specificity and negative predictive value were: 75%, 83% and 97%, respectively). Conclusions: Urinary sMet levels accurately distinguish patients with CaB from those without, and between patients with different CaB stages. These results suggest that urinary sMet may have utility as a bladder cancer marker for screening, treatment follow-up and clinical trial design. No significant financial relationships to disclose.

Risk of Venous Thromboembolism Recurrence: High Negative Predictive Value of D-dimer Performed after Oral Anticoagulation Is Stopped

2002 ◽  
Vol 87 (01) ◽  
pp. 7-12 ◽  
Author(s):  
Cristina Legnani ◽  
Benilde Cosmi ◽  
Giuliana Guazzaloca ◽  
Claudia Pancani ◽  
Sergio Coccheri ◽  
...  
Keyword(s):  
Venous Thromboembolism ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Recurrent Events ◽  
Oral Anticoagulant Therapy ◽  
Lower Limbs ◽  
First Episode ◽  
Vein Thrombosis ◽  
D Dimer

SummaryIn some patients with previous venous thromboembolism (VTE) D-dimer levels (D-Dimer) tend to increase after oral anticoagulant therapy (OAT) is stopped. The aim of our study was to evaluate the predictive value of D-Dimer for the risk of VTE recurrence after OAT withdrawal. After a first episode of deep vein thrombosis (DVT) of the lower limbs and/or pulmonary embolism (PE), 396 patients (median age 67 years, 198 males) were followed from the day of OAT discontinuation for 21 months. D-dimer was measured on the day of OAT withdrawal (T1), 3-4 weeks (T2) and 3 months (+/− 10 days, T3) thereafter. The main outcome events of the study were: objectively documented recurrent DVT and/or PE. D-dimer was found to be increased in 15.5%, 40.3% and 46.2% of the patients at T1, T2 and T3, respectively. In 199 (50.2%) patients, D-dimer levels were elevated in at least one measurement. During a follow-up of 628.4 years, 40 recurrences were recorded (10.1% of patients; 6.4% patient-years of follow-up). D-dimer was increased in at least one measurement in 28 of these cases, but remained normal in 11 subjects (three of whom had recurrent events triggered by circumstantial factors, three with malignancyassociated factors) (in one subject D-dimer was not measured). The negative predictive value (NPV) of D-dimer was 95.6% (95% CI 91.6-98.1) at T3 and was even higher (96.7%; 95% CI 92.9-98.8) after exclusion of the six recurrences due to circumstantial factors. Only five idiopathic recurrences occurred in the 186 patients with consistently normal D-dimer. In conclusion, D-dimer has a high NPV for VTE recurrence when performed after OAT discontinuation.

Fractionated Urinary Cytology in the Follow-up of Bladder Cancer

1990 ◽  
Vol 66 (1) ◽  
pp. 40-41 ◽  
Author(s):  
K. J. HASTIE ◽  
R. AHMAD ◽  
C. U. MOISEY
Keyword(s):  
Bladder Cancer ◽  
Urinary Cytology

scholarly journals Association between clinical risk scores and mortality in atrial fibrillation: Systematic review and network meta-regression of 669,000 patients

2018 ◽  
Vol 27 (6) ◽  
pp. 633-644 ◽  
Author(s):  
Marco Proietti ◽  
Alessio Farcomeni ◽  
Giulio Francesco Romiti ◽  
Arianna Di Rocco ◽  
Filippo Placentino ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Predictive Ability ◽  
Risk Scores ◽  
Clinical Risk ◽  
Increased Risk ◽  
High Negative Predictive Value ◽  
Meta Regression

Aims Many clinical scores for risk stratification in patients with atrial fibrillation have been proposed, and some have been useful in predicting all-cause mortality. We aim to analyse the relationship between clinical risk score and all-cause death occurrence in atrial fibrillation patients. Methods We performed a systematic search in PubMed and Scopus from inception to 22 July 2017. We considered the following scores: ATRIA-Stroke, ATRIA-Bleeding, CHADS2, CHA2DS2-VASc, HAS-BLED, HATCH and ORBIT. Papers reporting data about scores and all-cause death rates were considered. Results Fifty studies and 71 scores groups were included in the analysis, with 669,217 patients. Data on ATRIA-Bleeding, CHADS2, CHA2DS2-VASc and HAS-BLED were available. All the scores were significantly associated with an increased risk for all-cause death. All the scores showed modest predictive ability at five years (c-indexes (95% confidence interval) CHADS2: 0.64 (0.63–0.65), CHA2DS2-VASc: 0.62 (0.61–0.64), HAS-BLED: 0.62 (0.58–0.66)). Network meta-regression found no significant differences in predictive ability. CHA2DS2-VASc score had consistently high negative predictive value (≥94%) at one, three and five years of follow-up; conversely it showed the highest probability of being the best performing score (63% at one year, 60% at three years, 68% at five years). Conclusion In atrial fibrillation patients, contemporary clinical risk scores are associated with an increased risk of all-cause death. Use of these scores for death prediction in atrial fibrillation patients could be considered as part of holistic clinical assessment. The CHA2DS2-VASc score had consistently high negative predictive value during follow-up and the highest probability of being the best performing clinical score.

scholarly journals Evaluation of transvaginal ultrasound role in the prediction of adenomyosis: correlation with histopathology

2021 ◽  
Vol 10 (8) ◽  
pp. 2987
Author(s):  
Naglaa Ali M. Hussein ◽  
Mohammed H. El Rafaey
Keyword(s):  
Negative Predictive Value ◽  
Predictive Value ◽  
Transvaginal Ultrasound ◽  
Reproductive Age ◽  
True Positive ◽  
Women Of Reproductive Age ◽  
Presenting Symptoms ◽  
Us Findings ◽  
Histopathological Results ◽  
Symptoms And Signs

Background: Adenomyosis is a common gynecologic disorder that primarily affects women of reproductive age that has reported incidence of 5-70% in surgical and postmortem specimens. The aim of this study was to evaluate the accuracy of various transvaginal sonographic findings in adenomyosis by comparing them with histopathological results and to determine the most valuable sonographic feature in the diagnosis of adenomyosis.Methods: All transvaginal US findings were correlated with those from histologic examination. The frequency of presenting symptoms and signs of adenomyosis were evaluated. Transvaginal US depicted 10 of 12 pathologically proved cases of adenomyosis. Adenomyosis was correctly ruled out in 33 of 38 patients.Results: Transvaginal US had a sensitivity of 83%, a specificity of 86%, and a positive and negative predictive value of 66% and 94%, respectively. Of the 10 patients with true-positive findings at transvaginal US, the myometrium demonstrated heterogeneous with or without the presence of cysts in nine (75%) patients, linear striation in four (33.3%) patients and globular uterus in six (50%) patients. Three (25%) of 12 cases of adenomyosis had an enlarged uterus, adenomyosis was a significant association with high parity.Conclusions: Adenomyosis can be diagnosed with a considerable accuracy by transvaginal ultrasound. The most common sonographic criteria of adenomyosis are heterogeneous myometrial appearance while the most specific criteria are myometrial cysts, sub-endometrial echogenic linear striations and globular configuration of the uterus.

scholarly journals Combination role of DAPK methylation in urinary sediment and B ultrasound in evaluating follow-up of urinary bladder cancer

2020 ◽  
Author(s):  
Linlin Wang ◽  
Fuquan Jiang ◽  
Changfeng Li ◽  
Jiansong Han
Keyword(s):  
Bladder Cancer ◽  
Urinary Bladder ◽  
High Performance ◽  
Urinary Bladder Cancer ◽  
Youden Index ◽  
Urinary Sediment ◽  
Negative Results ◽  
Kappa Test

Abstract Background: Urinary bladder cancer (UBC) is a highly prevalent disease and is associated with substantial morbidity, mortality and cost. This paper aims to explore the combination role of DAPK methylation in urinary sediment and B ultrasound in diagnosing recurrent UBC. Methods: A total of 1021 cases of primary UBC undergone electrocision of bladder tumor through urethra were included and were subjected to follow up every 3 month within 2 years. B ultrasound, DAPK methylation in urinary sediment, examination of exfoliated cells in urine and cystoscopy were performed during the follow up. The data recorded in follow up were subjected to chi-square test and Kappa test. ROC was drawn to evaluate the diagnostic role of each parameter in recurrent UBC. Results: Among the 1021 patients, 115 patients were found with recurrent UBC by cystoscopy and biopsy two years after the operation, and failed to complete the follow up, thus the effective number of follow up was 906. The cystoscopy results were not only consistent with that of B ultrasound (Kappa = 0.785, P < 0.05), but also agreed with that of DAPK methylation in urinary sediment and combination of B ultrasound with DAPK methylation (Kappa = 0.517, P < 0.05, Kappa = 0.593, P < 0.05). ROC curve indicated that the area under curve of combination of B ultrasound with DAPK methylation was 0.922 (sensitivity, 92.86%; specificity, 91.63%; Youden index, 0.845) with negative prediction value of 99.4% which suggested that the recurrent risk would be low in case negative results were obtained. Conclusion: Those data supported that combination of DAPK methylation with B ultrasound has high performance in diagnosing recurrent UBC.

Serum Paraoxonase-1 Concentration as a Potential Predictor of Urinary Bladder Cancer Recurrence. A Five Year Follow-Up Study

2018 ◽  
Vol 49 (2) ◽  
pp. 119-122 ◽  
Author(s):  
Simona Iftimie ◽  
Anabel García-Heredia ◽  
Francesc Pujol-Bosch ◽  
Antoni Pont-Salvadó ◽  
Ana Felisa López-Azcona ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Urinary Bladder ◽  
Cancer Recurrence ◽  
Urinary Bladder Cancer ◽  
Paraoxonase 1 ◽  
Potential Predictor ◽  
Follow Up Study ◽  
Serum Paraoxonase ◽  
Bladder Cancer Recurrence

Abstract 094: Predicting the Risk of Apparent Treatment Resistant Hypertension: A Retrospective, Longitudinal, Cohort Study in an Urban Hypertension Referral Clinic Setting

Hypertension ◽  
2017 ◽  
Vol 70 (suppl_1) ◽  
Author(s):  
Michael G Buhnerkempe ◽  
Albert Botchway ◽  
Carlos Nolasco-Morales ◽  
Vivek Prakash ◽  
Lowell Hedquist ◽  
...  
Keyword(s):  
Negative Predictive Value ◽  
Risk Score ◽  
Resistant Hypertension ◽  
Predictive Value ◽  
Low Risk ◽  
Uncontrolled Hypertension ◽  
Treatment Resistant ◽  
Index Visit ◽  
Drug Classes

Background: Apparent treatment resistant hypertension (aTRH) is associated with increased prevalence of secondary hypertension and adverse pressure-related clinical outcomes. We previously showed that cross-sectional prevalence estimates of aTRH are lower than its true prevalence as patients with uncontrolled hypertension undergoing intensification/optimization of therapy will, over time, increasingly satisfy diagnostic criteria for aTRH. Methods: aTRH (SBP and/or DBP at or above a clinically defined goal BP [140/90, 130/85, 130/80, or 125/75 mmHg] over two consecutive office visits when on ≥ 3 antihypertensive drug classes, including a diuretic; or SBP and DBP below goal when on ≥ 4 drug classes, including a diuretic) was assessed in an urban referral hypertension clinic in 924 patients ≥ 30 years old (57.7 ± 12.6) with at least two follow-up visits over 240 days. Patients were mostly African-American (86%; 795/924) and female (65%; 601/924). A minority (28.7%; 265/924) were taking diuretics at their index visit, and analyses were stratified according to this use. Risk for aTRH was estimated using logistic regression with patient characteristics at index visit as predictors. Performance of this risk score at discriminating aTRH status over follow-up was assessed using AUC and was internally validated using bootstrapping. Results: Amongst those on diuretics, 80/265 (30.2%) developed aTRH; the risk score discriminated well (AUC = 0.79, bootstrapped 95% CI [0.73, 0.84]). In patients not on a diuretic, 151/659 (22.9%) developed aTRH, and the risk score showed moderate, but significantly lower, discriminative ability (AUC = 0.71 [0.66, 0.74]; p < 0.001). In the diuretic and non-diuretic cohorts, 43/265 (16.2%) and 101/265 (38.1%) of patients, respectively, had estimated risks for development of aTRH < 10%. Of these low-risk patients, 42/43 (97.7%) and 97/101 (96.0%) did not develop aTRH (negative predictive value, diuretics – 0.95 [0.93, 1.00], no diuretics – 0.96 [0.91, 1.00]). Conclusions: We created a novel clinical score that discriminates well between those who will and will not develop aTRH, especially amongst those taking diuretics initially. Irrespective of diuretic treatment status, a low risk score had very high negative predictive value.

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