The Early Detection and Diagnosis of Bladder Cancer: A Critical Review of the Options

Saad, Ali G.; Hanbury, Damian; McNicholas, Tom; Boustead, G.; Woodman, Anthony C.

doi:10.1159/000052519

Cited by 35 publications

(24 citation statements)

References 82 publications

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“…For example, in patients with an indwelling catheter or inflammation in course, cystoscopy may not be conclusive due to grossly abnormal appearance of the urothelial mucosa. In some cases, carcinoma in situ (pTIS tumors) (Saad et al, 2001). The high propensity of urothelial carcinomas for tumor recurrence makes necessary prolonged periods of follow up and frequent consultations for each patient treated after bladder cancer.…”

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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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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“…2 Therefore, those patients treated for bladder urothelial carcinoma should be closely followed up to detect recurrent diseases.…”

Section: Introductionmentioning

confidence: 99%

Detecting Malignant Urothelial Cells by Morphometric Analysis of ThinPrep® Liquid-based Urine Cytology Specimens

Shin

Lee

Jeong

et al. 2008

Korean J Cytopathol

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“…Moreover, FGFR3 mutation analysis and MIB-1 staining were more reproducible than histochemical analysis of the tumors by expert urinary pathologists. This was the first study to show that molecular markers can be used to predict disease course more accurately and reproducibly than traditional clinical pathology.Over the years, the need for an inexpensive, noninvasive, and simple procedure for the detection of bladder cancer has been expressed (11,12). Cytology done on voided urine is a noninvasive procedure with up to 100% specificity.…”

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confidence: 99%

“…Many potential molecular markers for progressive disease have been identified (10,11), of which Ki-67 labeling (MIB-1 staining) seemed to be the most promising marker. However, no single marker was able to predict the clinical behavior of bladder tumors, and none of the markers proved to be superior to histopathologic staging and grading (10).…”

mentioning

confidence: 99%

A Simple and Fast Method for the Simultaneous Detection of Nine Fibroblast Growth Factor Receptor 3 Mutations in Bladder Cancer and Voided Urine

Oers

Lurkin

Exsel

et al. 2005

Clinical Cancer Research

148

107

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Purpose: Mutations in the fibroblast growth factor receptor 3 (FGFR3) occur in 50% of primary bladder tumors. An FGFR3 mutation is associated with good prognosis, illustrated by significantly lower percentage of patients with progression and disease-specific mortality. FGFR3 mutations are especially prevalent in low grade/stage tumors, with pTa tumors harboring mutations in 85% of the cases. These tumors recur in 70% of patients. Efficient FGFR3 mutation detection for prognostic purposes and for detection of recurrences in urine is an important clinical issue. In this paper, we describe a simple assay for the simultaneous detection of nine different FGFR3 mutations. Experimental Design: The assay consists of one multiplex PCR, followed by extension of primers for each mutation with a labeled dideoxynucleotide. The extended primers are separated by capillary electrophoresis, and the identity of the incorporated nucleotide indicates the presence or absence of a mutation. Results: The assay was found to be more sensitive than single-strand conformation polymorphism analysis. Mutations could still be detected with an input of only 1ng of genomic DNA and in a 20-fold excess of wild-type DNA. Moreover, in urine samples from patients with a mutant tumor, the sensitivity of mutation detection was 62%. Conclusions: We have developed a fast, easy to use assay for the simultaneous detection of FGFR3 mutations, which can be of assistance in clinical decision-making and as an alternative for the follow-up of patients by invasive cystoscopy for the detection of recurrences in urine.Bladder cancer is the fifth most common cancer in the western world with an incidence of 20 new cases per year per 100,000 people in the U.S. (1). Unfortunately, these statistics do not include superficial pTa bladder cancer, which represents the most common type of bladder cancer. In the Netherlands, the incidence of both superficial and invasive bladder cancer is estimated as about 30 new cases per year per 100,000 people. This is in accordance with data from global cancer statistics for the western world (2). Superficial bladder tumors are removed by transurethral resection. However, up to 70% of these patients will develop one or more recurrences, and it has been estimated that 1 in 1,450 people is under surveillance for bladder cancer in the United Kingdom (3). Cystoscopy is an uncomfortable, invasive, and expensive procedure, but currently remains the gold standard for detection of recurrences. Because patients have to be monitored perpetually and have a long-term survival, bladder cancer is the most expensive cancer when calculated on a per patient basis (4).Activating mutations in the fibroblast growth factor receptor 3 (FGFR3) gene have been reported in >50% of primary bladder tumors (5, 6).1 Most of the somatic mutations found in bladder cancer are identical to germ line mutations responsible for skeletal disorders such as thanatophoric dysplasia and achondroplasia (7). It has been reported that FGFR3 mutations are very frequent ...

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The Early Detection and Diagnosis of Bladder Cancer: A Critical Review of the Options

Cited by 35 publications

References 82 publications

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

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

Detecting Malignant Urothelial Cells by Morphometric Analysis of ThinPrep® Liquid-based Urine Cytology Specimens

A Simple and Fast Method for the Simultaneous Detection of Nine Fibroblast Growth Factor Receptor 3 Mutations in Bladder Cancer and Voided Urine

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