Diagnostic efficacy of the Immunocyt test to detect superficial bladder cancer recurrence

Vriesema, J.L.J.; Atsma, Femke; Kiemeney, Lambertus A.; Peelen, W. P.; Witjes, J.A.; Schalken, Jack A.

doi:10.1016/s0090-4295(01)01217-1

Cited by 71 publications

(31 citation statements)

References 12 publications

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“…15,19 By contrast, results were found fairly reproducible in a recently reported ten-Center French study. 20 However, it is clear that the validity of the test relies largely on the quality of the training of cytologists and on the presence of well-established quality control programs in cytology laboratories.…”

Section: Discussionmentioning

confidence: 66%

ImmunoCyt/uCyt+™ improves the sensitivity of urine cytology in patients followed for urothelial carcinoma

et al. 2005

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ImmunoCyt/uCytt is a fluorescent test combining three monoclonal antibodies. In this study, it has been tested as a complement to cytology in the detection of urothelial carcinoma in urine. It has been performed simultaneously with standard cytology and cystoscopy on 870 urine analyses from one hospital. In 136 cases, one or more bladder tumors were found. Overall sensitivity of cytology, ImmunoCyt/uCytt and combined analyses reached 29, 74 and 84%, respectively, and overall specificity was 98, 62 and 61%. The negative predictive value of cytology, ImmunoCyt/uCytt and both analyses was 88, 93 and 95%, respectively, and the positive predictive value was 70, 26 and 29%. The sensitivity of cytology for low malignant potential neoplasms, low-and high-grade papillary carcinomas was 6, 18 and 53%, while it reached 71, 79 and 93% when combined with ImmunoCyt/uCytt. The sensitivity of cytology for stages Ta, T1, T2 and over and Tis tumors was12, 67, 47 and 50%, while it reached 78, 83, 79 and 100% when combined with ImmunoCyt/uCytt. In the absence of tumor on cystoscopy but with positive ImmunoCyt/uCytt, 18% of patients developed a tumor, 2-6 months later. Of the 109 cases diagnosed as suspicious for malignancy by cytology, a tumor was present in 30 cases and ImmunoCyt/uCytt was positive in 22 (73%) of them. In conclusion, ImmunoCyt/uCytt may be used to postpone cystoscopies in patients followed for bladder cancer and may help to save cytologist and pathologist screening Keywords: urothelial carcinoma; cytology; ImmunoCyt/uCytt; immunofluorescence; urinary bladder; recurrence Superficial bladder cancers are defined as tumors limited to the mucosa (Tis, Ta) or invading into the lamina propria (T1), without muscle invasion. 1 They represent more than 80% of urothelial carcinomas and more than 50% will recur. 1-3 Patients with bladder cancer are followed with regular cytologies and cystoscopies. Cytology is very specific but this test is limited by its low sensitivity ranging from 16 to 60%. 4 Cytology is most useful at detecting highgrade (HG) cancer, whereas its sensitivity for lowgrade (LG) urothelial tumors is low and merely reaches 17%. 4 Furthermore, criteria used in urinary cytology to detect tumor cells are largely subjective and the ability to detect cancer cells is dependent on the experience of cytologists or pathologists. For instance, atypical cells and papillary aggregates may be found in either reactive or neoplastic conditions. 5 Furthermore, LG urothelial carcinomas do not always exfoliate in aggregates and the cell characteristics are often so subtle that they might not be recognizable even by an experienced cytologist. 5 Standard practice in the follow-up of patients with bladder cancer requires cystoscopies at regular intervals, but this technique is invasive, costly and causes discomfort to the patient. It is thus estimated that by improving the sensitivity of cytology, fewer follow-up cystoscopies would be needed. Furthermore, improved sensitivity would help cytologists and pathologists to save time c...

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Section: Discussionmentioning

confidence: 66%

ImmunoCyt/uCyt+™ improves the sensitivity of urine cytology in patients followed for urothelial carcinoma

et al. 2005

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“…Four more recent series included Ͻ 120 patients and showed results varying between 45% and 100% sensitivity (Bunting et al, 2000;Lodde et al, 2001;Olsson and Zackrisson, 2001;Vriesema et al, 2001). A more recently published series included 235 patients and 102 cancer cases (Lodde et al, 2003).…”

Section: Discussionmentioning

confidence: 99%

Improved Detection of Urothelial Carcinomas with Fluorescence Immunocytochemistry (uCyt+ Assay) and Urinary Cytology: Results of a French Prospective Multicenter Study

Piaton

Daniel

Verrièle³

et al. 2003

Laboratory Investigation

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SUMMARY:The aim of the study was to assess the sensitivity and specificity of fluorescence immunocytochemistry (uCytϩ assay) as combined with urinary cytology for detection of primary and recurrent urothelial carcinomas. We analyzed 694 urinary samples from 236 new symptomatic patients and 458 patients followed after transurethral resection (TUR) for bladder tumor. Lesions suspicious for cancer at cystoscopy were sampled by biopsies or TUR. Sensitivity and specificity of tests were calculated using cystoscopy and histopathology, whether or not combined as gold standards. In new symptomatic patients, sensitivity of uCytϩ was 40%, 88.2%, and 76.7%, whereas that of urinary cytology was 30%, 70.6%, and 83.3%, respectively, in G1, G2, and G3 tumors. In follow-up cases, sensitivity of uCytϩ was 61.9%, 66.7%, and 76.9%, whereas that of urinary cytology was 38.1%, 58.3%, and 64.1%, respectively, in G1, G2, and G3 tumors. The combination of uCytϩ and urinary cytology significantly increased mean sensitivity in newly diagnosed cases (86.4% versus 71.2% with urinary cytology only, p Ͻ 0.05), as well as in patients followed after TUR (79.3% versus 55.2%, p Ͻ 0.001). Specificity of uCytϩ and urinary cytology was identical in new patients (83.3%) and was 81.9% and 86.2%, respectively, in patients followed after TUR. In patients with negative cystoscopy, positive uCytϩ tests had a strong predictive value for tumor recurrence at 1 year (47.0% versus 11.9% in patients with negative assay, p Ͻ 0.01). We conclude that combining uCytϩ with urinary cytology improves the detection of urothelial carcinomas as well in patients with symptoms suggesting bladder cancer as in those followed after treatment. (Lab Invest 2003, 83:845-852).

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“…It is thus a cell-based essay, requiring microscopic evaluation by trained personnel. Although its overall sensitivity and specificity are limited [67-69], it is superior for the detection of low-grade BC as compared to conventional cytology [70]. …”

Section: Molecular Follow-up In Urinary Bladder Carcinomamentioning

confidence: 99%

MtDNA As a Cancer Marker: A Finally Closed Chapter?

Kirches

2017

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Sequence alterations of the mitochondrial DNA (mtDNA) have been identified in many tu-mor types. Their nature is not entirely clear. Somatic mutation or shifts of heteroplasmic mtDNA vari-ants may play a role. These sequence alterations exhibit a sufficient frequency in all tumor types investi-gated thus far to justify their use as a tumor marker. This statement is supported by the high copy num-ber of mtDNA, which facilitates the detection of aberrant tumor-derived DNA in bodily fluids. This will be of special interest in tumors, which release a relatively high number of cells into bodily fluids, which are easily accessible, most strikingly in urinary bladder carcinoma. Due to the wide distribution of the observed base substitutions, deletions or insertions within the mitochondrial genome, high efforts for whole mtDNA sequencing (16.5 kb) from bodily fluids would be required, if the method would be in-tended for initial tumor screening. However, the usage of mtDNA for sensitive surveillance of known tumor diseases is a meaningful option, which may allow an improved non-invasive follow-up for the urinary bladder carcinoma, as compared to the currently existing cytological or molecular methods. Fol-lowing a short general introduction into mtDNA, this review demonstrates that the scenario of a sensi-tive cancer follow-up by mtDNA-analysis deserves more attention. It would be most important to inves-tigate precisely in the most relevant tumor types, if sequencing approaches in combination with simple PCR-assays for deletions/insertions in homopolymeric tracts has sufficient sensitivity to find most tu-mor-derived mtDNAs in bodily fluids.

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Diagnostic efficacy of the Immunocyt test to detect superficial bladder cancer recurrence

Cited by 71 publications

References 12 publications

ImmunoCyt/uCyt+™ improves the sensitivity of urine cytology in patients followed for urothelial carcinoma

ImmunoCyt/uCyt+™ improves the sensitivity of urine cytology in patients followed for urothelial carcinoma

Improved Detection of Urothelial Carcinomas with Fluorescence Immunocytochemistry (uCyt+ Assay) and Urinary Cytology: Results of a French Prospective Multicenter Study

MtDNA As a Cancer Marker: A Finally Closed Chapter?

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