scholarly journals Bladder Cancer Diagnosis and Follow-Up: The Current Status and Possible Role of Extracellular Vesicles

2019 ◽  
Vol 20 (4) ◽  
pp. 821 ◽  
Author(s):  
Eline Oeyen ◽  
Lucien Hoekx ◽  
Stefan De Wachter ◽  
Marcella Baldewijns ◽  
Filip Ameye ◽  
...  

Diagnostic methods currently used for bladder cancer are cystoscopy and urine cytology. Cystoscopy is an invasive tool and has low sensitivity for carcinoma in situ. Urine cytology is non-invasive, is a low-cost method, and has a high specificity but low sensitivity for low-grade urothelial tumors. Despite the search for urinary biomarkers for the early and non-invasive detection of bladder cancer, no biomarkers are used at the present in daily clinical practice. Extracellular vesicles (EVs) have been recently studied as a promising source of biomarkers because of their role in intercellular communication and tumor progression. In this review, we give an overview of Food and Drug Administration (FDA)-approved urine tests to detect bladder cancer and why their use is not widespread in clinical practice. We also include non-FDA approved urinary biomarkers in this review. We describe the role of EVs in bladder cancer and their possible role as biomarkers for the diagnosis and follow-up of bladder cancer patients. We review recently discovered EV-derived biomarkers for the diagnosis of bladder cancer.

2019 ◽  
Vol 6 (10) ◽  
pp. 3521
Author(s):  
Ahmed M. Umar ◽  
Uzodimma E. Onwuasoanya ◽  
Emmanuel U. Oyibo ◽  
Adamu Dahiru ◽  
Ismaila A. Mungadi

Background: Urine cytology is a simple, safe, non-invasive and cheap investigation that is used as adjunct to cystoscopy in the diagnosis of bladder cancer. Its low sensitivity is a major limitation against its use as a sole diagnostic test for bladder cancer. The objective of this study was to determine the pattern of urine cytology seen in patients with clinical diagnosis of bladder tumour in our practice.Methods: This is a retrospective study of patients with clinical diagnosis of bladder tumour that had urine cytology in our centre. The age and gender of the patients, number of urine cytology per patient per year and cytologic diagnosis were analysed using the SPSS 20.Results: During the period under review, a total of 512 urine cytology was done for patients with clinical diagnosis of bladder tumour. The age range of the patients was 6 to 90 years with modal age of 60 years. 457 (89.3%) were males while 54 (10.5%) were females and 1 (0.2%) was unspecified. Male to female ratio was 8.5:1. The highest number of urine cytology was done in 2013 with 64 (12.5%) while the least number was 1 (0.2%) recorded in 2001 and 2003. Only 68 (13.3%) specimens were reported to be malignant while 245 (47.9%) were reported as negative representing the most common cytological diagnosis in the study.Conclusions: Although urine cytology is useful in the diagnostic workup of patients with bladder mass, it is unlikely it would supplant cystoscopy and biopsy in the diagnosis of bladder cancer. 


2008 ◽  
Vol 23 (4) ◽  
pp. 249-261 ◽  
Author(s):  
A. Volpe ◽  
M. Racioppi ◽  
D. D'Agostino ◽  
E. Cappa ◽  
M. Gardi ◽  
...  

Bladder cancer is among the top eight most frequent cancers. Its natural history is related to a combination of factors that impact on its aggressiveness. Cystoscopy and urine cytology are the currently used techniques for the diagnosis and surveillance of non-invasive bladder tumors. The sensitivity of urine cytology for diagnosis is not high, particularly in low-grade tumors. The combination of voided urine cytology and new diagnostic urine tests would be ideal for the diagnosis and follow-up of bladder cancer. However, in order to have some clinical utility, new diagnostic and/or prognostic markers should achieve better predictive capacity that the currently used diagnostic tools. None of the markers evaluated over the last years showed remarkable sensitivity or specificity for the identification of any of the diverse types of bladder cancer in clinical practice. The limitations of the known prognostic markers have led to the research of new molecular markers for early detection of bladder cancer. This research focused in particular on the discovery of biomarkers capable of reducing the need for periodic cystoscopies or, ideally, offering a non-invasive examination instead. In this review, we will examine various new markers of bladder cancer and their value in the diagnosis and follow-up of non-muscle-invasive bladder cancer. When compared with urine cytology, which showed the highest specificity, most of these markers demonstrated an increased sensitivity.


2020 ◽  
Author(s):  
Linlin Wang ◽  
Fuquan Jiang ◽  
Changfeng Li ◽  
Jiansong Han

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.


2021 ◽  
pp. bmjspcare-2020-002699
Author(s):  
Marthe Peeters ◽  
Germaine Ottenheijm ◽  
Paul Bienfait ◽  
Daniëlle Eekers ◽  
Anja Gijtenbeek ◽  
...  

IntroductionRoutine assessment of patient-reported outcomes (PROs) in oncology has shown to improve the quality of the delivered care and to prolong survival. However, for successful implementation of routine assessment of PROs, more knowledge on their usability in clinical practice is needed.ObjectiveThis study aimed to cross-sectionally assess the perspective of patients and clinicians on the practicality of routinely measuring PROs in clinical practice for glioma patients.MethodsSemistructured interviews were conducted evaluating the role of healthcare professionals (HCP) in discussing results of PRO measures (PROMs), and the preferred topics, methods and frequency of PRO assessment. Glioma patients, their proxies and HCPs involved in the treatment of glioma patients from eight centres in the Netherlands were included.ResultsTwenty-four patients, 16 proxies and 35 HCPs were interviewed. The majority of patients, proxies and HCPs (92%, 81% and 80%, respectively) were willing to discuss PRO results during consultations. Although HCPs prefer that results are discussed with the nurse specialist, only one-third of patients/proxies agreed. Functioning of daily life was considered important in all three groups. Most participants indicated that discussion of PROM results should take place during standard follow-up visits, and completed at home about 1 week in advance. On group level, there was no preference for administration of questionnaires on paper or digitally. Lastly, all centres had staff available to send questionnaires on paper.ConclusionThis study shows that routine assessment of PROs is desired by patients, proxies and HCP’s in neuro-oncological care in Dutch hospitals.


Author(s):  
Carlotta Giani ◽  
Liborio Torregrossa ◽  
Ramone Teresa ◽  
Romei Cristina ◽  
Antonio Matrone ◽  
...  

Abstract Context Tumour capsule integrity is becoming a relevant issue to predict the biological behaviour of human tumours, including thyroid cancer. Aim To verify if a whole tumour capsule in the classical variant of PTC (CVPTC) could have a predictive role of a good outcome as for follicular variant (FVPTC). Methods FVPTC (n=600) and CVPTC (n=554) cases, were analysed. We distinguished encapsulated-FVPTC (E-FVPTC) and encapsulated-CVPTC (E-CVPTC) and, thereafter, invasive (Ei-FVPTC and Ei-CVPTC) and non-invasive (En-FVPTC and En-CVPTC) tumours, according to the invasion or integrity of tumour capsule, respectively. Cases without tumour capsule were indicated as invasive-FVPTC (I-FVPTC) and invasive-CVPTC (I-CVPTC). Sub-group of each variant was evaluated for BRAF mutations. Results E-FVPTC was more frequent than E-CVPTC (p&lt;0.0001). No differences were found between En-FVPTC and En-CVPTC or between Ei-FVPTC and Ei-CVPTC. After 18 years of follow-up, a greater number of not-cured cases were observed in Ei-CVPTC with respect to Ei-FVPTC, but not in En-CVPTC to En-FVPTC. Multivariate clustering analysis showed that En-FVPTC, En-CVPTC, and Ei-FVPTC have similar features but different from I-FVPTC and I-CVPTC and, to a lesser extent, from Ei-CVPTC. 177/614 (28.8%) cases were BRAF  V600E-mutated and 10/614(1.6%) carried BRAF-rare alterations. Significantly higher rate of En-CVPTC (22/49,44.9%) than En-FVPTC (15/195,7.7%) (p&lt;0.0001) were BRAF  V600E-mutated. Conclusions En-CVPTC is less prevalent than En-FVPTC. However, they have a good clinical/ pathological behavior comparable to En-FVPTC. This finding confirms the good prognostic role of a whole tumour capsule also in CVPTC. New nomenclature for En-CVPTC, similar to that introduced for En-FVPTC (i.e, NIFTP) could be envisaged.


Diagnostics ◽  
2020 ◽  
Vol 10 (1) ◽  
pp. 39 ◽  
Author(s):  
Rui Batista ◽  
Nuno Vinagre ◽  
Sara Meireles ◽  
João Vinagre ◽  
Hugo Prazeres ◽  
...  

Bladder cancer (BC) ranks as the sixth most prevalent cancer in the world, with a steady rise in its incidence and prevalence, and is accompanied by a high morbidity and mortality. BC is a complex disease with several molecular and pathological pathways, thus reflecting different behaviors depending on the clinical staging of the tumor and molecular type. Diagnosis and monitoring of BC is mainly performed by invasive tests, namely periodic cystoscopies; this procedure, although a reliable method, is highly uncomfortable for the patient and it is not exempt of comorbidities. Currently, there is no formal indication for the use of molecular biomarkers in clinical practice, even though there are several tests available. There is an imperative need for a clinical non-invasive testing for early detection, disease monitoring, and treatment response in BC. In this review, we aim to assess and compare different tests based on molecular biomarkers and evaluate their potential role as new molecules for bladder cancer diagnosis, follow-up, and treatment response monitoring.


Cancers ◽  
2020 ◽  
Vol 12 (6) ◽  
pp. 1683
Author(s):  
Annu Heinonen ◽  
Maija Jakobsson ◽  
Mari Kiviharju ◽  
Seppo Virtanen ◽  
Karoliina Aro ◽  
...  

Colposcopy is often used in follow-up after treatment for cervical intraepithelial neoplasia (CIN) despite its marked inter-observer variability and low sensitivity. Our objective was to assess the role of colposcopy in post-treatment follow-up in comparison to hrHPV (high-risk human papillomavirus) testing, cytology, and cone margin status. Altogether, 419 women treated for histological high-grade lesion (HSIL) with large loop excision of the transformation zone (LLETZ) attended colposcopy with cytology and hrHPV test at six months. Follow-up for recurrence of HSIL continued for 24 months. Colposcopy was considered positive if colposcopic impression was recorded as high grade and cytology if HSIL, ASC-H (atypical squamous cells, cannot exclude HSIL), or AGC-FN (atypical glandular cells, favor neoplasia) were present. Overall, 10 (10/419, 2.4%) recurrent HSIL cases were detected, 5 at 6 months and 5 at 12 months. Colposcopic impression was recorded at 407/419 6-month visits and was positive for 11/407 (2.7%). None of them had recurrent lesions, resulting in 0% sensitivity and 97% specificity for colposcopy. Sensitivity for the hrHPV test at 6 months was 100% and specificity 85%, for cytology 40% and 99%, and for margin status at treatment 60% and 82%, respectively. While the hrHPV test is highly sensitive in predicting recurrence after local treatment for CIN, colposcopy in an unselected population is not useful in follow-up after treatment of CIN.


Cancers ◽  
2020 ◽  
Vol 12 (6) ◽  
pp. 1493 ◽  
Author(s):  
Carmelo Messina ◽  
Rodolfo Bignone ◽  
Alberto Bruno ◽  
Antonio Bruno ◽  
Federico Bruno ◽  
...  

To date, diffusion weighted imaging (DWI) is included in routine magnetic resonance imaging (MRI) protocols for several cancers. The real additive role of DWI lies in the “functional” information obtained by probing the free diffusivity of water molecules into intra and inter-cellular spaces that in tumors mainly depend on cellularity. Although DWI has not gained much space in some oncologic scenarios, this non-invasive tool is routinely used in clinical practice and still remains a hot research topic: it has been tested in almost all cancers to differentiate malignant from benign lesions, to distinguish different malignant histotypes or tumor grades, to predict and/or assess treatment responses, and to identify residual or recurrent tumors in follow-up examinations. In this review, we provide an up-to-date overview on the application of DWI in oncology.


2018 ◽  
Vol 45 (1-3) ◽  
pp. 260-269 ◽  
Author(s):  
Federico Nalesso ◽  
Francesco Garzotto ◽  
Ilaria Petrucci ◽  
Sara Samoni ◽  
Grazia Maria Virzì ◽  
...  

Introduction: Ultrasound and colorDoppler technique, which is relatively inexpensive, rapid, non-invasive and repeatable is a powerful tool used for early diagnosis of vascular access (VA) complications in hemodialysis patients. To date a standard and widely comprehensible echocolorDoppler (ECD) protocol is not available. Materials and Methods: A simple step-by-step protocol based on anatomical and hemodynamic parameters of VA has been developed during a 3-years VA ECD follow-up. It consists of an ECD study scheme. The algorithm created involves the calculation of brachial artery flow, description of artero-venous and/or graft-vascular anastomosis and efferent vessel and/or graft. Results: The algorithm allows to formulate a medical report that takes into account both anatomic and hemodynamic parameters of the VA. Reduction of complications and the prevention of chronic complications as well as the early detection of acute problems were achieved. Discussion and Conclusion: The creation of a step-by-step protocol may simplify the multidisciplinary management of VA, its monitoring and the early diagnosis of its complications.


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