Diagnostic predictive value of Xpert Bladder Cancer Monitor in the follow-up of patients affected by non-muscle invasive bladder cancer

Caires

et al. 2020

Cancers

Extracellular vesicles (EVs) are small membrane vesicles released by all cells and involved in intercellular communication. Importantly, EVs cargo includes nucleic acids, lipids, and proteins constantly transferred between different cell types, contributing to autocrine and paracrine signaling. In recent years, they have been shown to play vital roles, not only in normal biological functions, but also in pathological conditions, such as cancer. In the multistep process of cancer progression, EVs act at different levels, from stimulation of neoplastic transformation, proliferation, promotion of angiogenesis, migration, invasion, and formation of metastatic niches in distant organs, to immune escape and therapy resistance. Moreover, as products of their parental cells, reflecting their genetic signatures and phenotypes, EVs hold great promise as diagnostic and prognostic biomarkers. Importantly, their potential to overcome the current limitations or the present diagnostic procedures has created interest in bladder cancer (BCa). Indeed, cystoscopy is an invasive and costly technique, whereas cytology has poor sensitivity for early staged and low-grade disease. Several urine-based biomarkers for BCa were found to overcome these limitations. Here, we review their potential advantages and downfalls. In addition, recent literature on the potential of EVs to improve BCa management was reviewed and discussed.

Section: Liquid Biopsy As a Source Of Biomarkers For Bladder Cancementioning

confidence: 99%

Urinary Biomarkers in Bladder Cancer: Where Do We Stand and Potential Role of Extracellular Vesicles

Caires

et al. 2020

Cancers

“…7,18 In contrast, the study performed by Elia et al reported an overall sensitivity of only 46.2% for the XBC, though the vast majority (87%) of the detected bladder tumours in that study were low-grade. 19 In our study, none of the patients with negative XBC had a positive VUC, therefore complementing the results of the XBC with VUC did not increase sensitivity, specificity, NPV, or PPV, which was also observed in the study by Pichler et al 7 Until more studies on the XBC have been conducted, the range of sensitivities and NPVs cannot be estimated, though our data and already published studies 7,18 show that the performance of the XBC is at least comparable to previously studied bladder cancer biomarkers for which studies have reported wide variability in performance. A recent review of bladder cancer biomarkers summarized data from several studies listing the sensitivities of NMP22 in the range of 24% to 81%, of BTA STAT 40% to 72%, of ImmunoCyt 50% to 85%, and of UroVysion 13 to 100%.…”

Section: Discussionmentioning

confidence: 99%

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

Smrkolj

Primozic

Fabjan

et al. 2020

Radiology and Oncology

BackgroundCystoscopy 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.

“…Comparing the Bladder EpiCheck test with other bladder tumor markers, it is superior to the Bladder Xpert Monitor, 18 nuclear matrix protein 22 (NMP 22) testing, the bladder tumor antigen (BTA) test, 19 or fluorescence in situ hybridization, 20 whereas cytology is more specific 18 (see also Grossman et al 21 ). In terms of sensitivity, specificity, and NPV, it performs very well with an area under the curve of 0.785.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic predictive value of the Bladder EpiCheck test in the follow‐up of patients with non–muscle‐invasive bladder cancer

Trenti

D’Elia

Mian

et al. 2019

Cancer Cytopathology

Self Cite

Background The objective of this study was to evaluate the diagnostic accuracy of the Bladder EpiCheck test in the follow‐up of patients with non–muscle‐invasive bladder cancer (NMIBC) and to compare it with the accuracy of urinary cytology, cystoscopy, and/or histology. Methods In total, 243 patients were enrolled in the current study. Patients were evaluated by voided urine cytology, by the Bladder EpiCheck test, and by white‐light cystoscopy. Results Overall sensitivity was 33.3% for cytology, 62.3% for Bladder EpiCheck, and 66.7% for the 2 tests combined. The sensitivity of cytology increased from 7.7% in low‐grade (LG) tumors to 66.6% in high‐grade (HG) tumors; whereas, for the Bladder EpiCheck test, the sensitivity was 46.1% in LG tumors and 83.3% in HG tumors. Combined cytology and Bladder EpiCheck testing yielded an overall sensitivity of 56.4% for LG tumors and 90% for HG tumors. Overall specificity was 98.6% for cytology, 86.3% for Bladder EpiCheck, and 85.6% for the 2 tests combined. The positive predictive value was 92% for cytology and 68.2% for Bladder EpiCheck. For the 2 tests combined, it was 68.6%. The negative predictive value was similar for the 2 tests: 75.8% for cytology, 82.9% for Bladder EpiCheck, and 84.5% for the 2 tests combined. Conclusions The sensitivity of the Bladder EpiCheck test was significantly higher than that of cytology. The test performed very well in terms of specificity but could not reach the high value of cytology. The positive predictive value was higher for Bladder EpiCheck, whereas the negative predictive value was approximately the same for both tests.