Der Wert von Mikrohämaturie, Harnzytologie, TPA und Neopterin in der Nachsorge von Blasentumorpatienten

Abstract

Tumor recurrences were observed 70 times in 715 cystoscopies performed in 253 patients. The sensitivity of microhematuria to detect a tumor recurrence was 61%, the specificity 84%. The sensitivity of microhematuria increased to 90% in T_is and T₂ tumors. Urine cytology showed a specificity of 100% and a sensitivity of only 43%. The specificity and sensitivity of TPA was only 58% and 41%, respectively, the latter increased to 80% in T_is. 60 patients with proven tumor recurrence showed an increase of neopterine with higher tumor stage. In tumors of stage T₂ and T_is serum neopterine was raised in 90% and urine neopterine in 75%. Based on these results cystoscopy, exfoliative urinary cytology and urine analysis are obligatory in the follow-up of patients with superficial bladder cancer. Because of the low specificity (29–41%) TPA and neopterine are not suitable for follow-up.

Diagnostic Problems of Urine Cytology on Initial Follow-Up after Intravesical Immunotherapy with Calmette-Guérin Bacillus for Superficial Bladder Cancer

“…Positive urine cytology means a probable tumor recurrence of 85% [6], Riibben and Dahm [5] found a sensitivity of 76% and a specificity of 89% for urine cytology in patients with superficial bladder cancer. Beyer-Boon et al [7] estimated a specificity of 99%, while Mack et al [8] calculated a specificity of 100%, and there fore a predictive value of 100%. However, it is now known that when treating superfi cial bladder cancer with topical chemotherapy, changes occur in the urothelium that make evaluation of urine cytology difficult for the follow-up of bladder cancer patients [9,10].…”