PMID- 18815929
OWN - NLM
STAT- MEDLINE
DCOM- 20090206
LR  - 20151119
IS  - 0300-8886 (Print)
IS  - 0300-8886 (Linking)
IP  - 218
DP  - 2008 Sep
TI  - Detection of tumours of the urinary tract in voided urine.
PG  - 147-53
LID - 10.1080/03008880802283953 [doi]
AB  - Patients with non-muscle-invasive bladder cancer are treated by transurethral 
      resection. About 60-70% of these patients will develop recurrences and in 11% of 
      these cases progression to a muscle-invasive tumour occurs. Surveillance of 
      patients by cystoscopy is therefore carried out every 3-4 months in the first 2 
      years and yearly thereafter. Several biomarkers have been developed that 
      potentially can detect recurrent bladder cancer in voided urine samples and may 
      present an alternative for the invasive cystoscopy procedure. Recently, van Rhijn 
      reviewed the performance of several of these biomarkers regarding detection of 
      recurrent disease in patients under surveillance. In general, sensitivities were 
      much lower when only patients under surveillance were taken into account than 
      when the patient cohorts included patients with primary disease or patients with 
      high-grade tumours. In this article recent new data on those markers that 
      displayed a sensitivity and specificity of at least 70% as mentioned in the 
      review by van Rhijn are reviewed. The literature selected was limited to those 
      papers in which the performance of makers was assayed only on urine samples of 
      patients under surveillance. The markers with sensitivity and specificity over 
      70% that were selected from the previous study are Lewis X, NMP22, microsatellite 
      analysis (MA), CYFRA 21.1, cytokeratin 20 and the UroVysion fluorescence in situ 
      hybridization (FISH) test. Recent new developments such as the use of FGFR3 
      mutation analysis and methylation detection are also discussed. In conclusion, 
      tests such as the UroVysion FISH test and MA are able to detect most concomitant 
      recurrences and to predict recurrent disease. In general, lesions that are missed 
      are pTa and low grade. With MA several upper tract recurrences were identified 
      that were missed by cystoscopy. The value of the most promising urine tests needs 
      to be established in longitudinal studies and exclusively on patients under 
      surveillance for recurrent disease. A longitudinal setting allows subsequent 
      urine samples to be tested and this increases sensitivity because a negative test 
      outcome sometimes occurs between positive ones. Stratification of patients 
      according to the genetic status of their primary tumours and smoking habits 
      should be investigated. Decision models should be developed that recommend at 
      which points in time cystoscopy or urine testing should be performed.
FAU - Zwarthoff, Ellen C
AU  - Zwarthoff EC
AD  - Department of Pathology, Erasmus MC, Rotterdam, The Netherlands. 
      e.zwarthoff@erasmusmc.nl
LA  - eng
PT  - Journal Article
PT  - Review
PL  - England
TA  - Scand J Urol Nephrol Suppl
JT  - Scandinavian journal of urology and nephrology. Supplementum
JID - 0153034
RN  - 0 (Biomarkers, Tumor)
SB  - IM
MH  - Biomarkers, Tumor/*urine
MH  - Humans
MH  - Neoplasm Recurrence, Local/urine
MH  - Urinalysis/*methods
MH  - Urologic Neoplasms/*urine
RF  - 45
EDAT- 2008/12/05 09:00
MHDA- 2009/02/07 09:00
CRDT- 2008/12/05 09:00
PHST- 2008/12/05 09:00 [pubmed]
PHST- 2009/02/07 09:00 [medline]
PHST- 2008/12/05 09:00 [entrez]
AID - 902910477 [pii]
AID - 10.1080/03008880802283953 [doi]
PST - ppublish
SO  - Scand J Urol Nephrol Suppl. 2008 Sep;(218):147-53. doi: 
      10.1080/03008880802283953.