PMID- 26501851
OWN - NLM
STAT- MEDLINE
DCOM- 20160414
LR  - 20220331
IS  - 1539-3704 (Electronic)
IS  - 0003-4819 (Linking)
VI  - 163
IP  - 12
DP  - 2015 Dec 15
TI  - Urinary Biomarkers for Diagnosis of Bladder Cancer: A Systematic Review and 
      Meta-analysis.
PG  - 922-31
LID - 10.7326/M15-0997 [doi]
AB  - BACKGROUND: Urinary biomarkers may be a useful alternative or adjunct to 
      cystoscopy for diagnosis of bladder cancer. PURPOSE: To systematically review the 
      evidence on the accuracy of urinary biomarkers for diagnosis of bladder cancer in 
      adults who have signs or symptoms of the disease or are undergoing surveillance 
      for recurrent disease. DATA SOURCES: Ovid MEDLINE (January 1990 through June 
      2015), Cochrane Central Register of Controlled Trials, Cochrane Database of 
      Systematic Reviews, and reference lists. STUDY SELECTION: 57 studies that 
      evaluated the diagnostic accuracy of quantitative or qualitative nuclear matrix 
      protein 22 (NMP22), qualitative or quantitative bladder tumor antigen (BTA), 
      fluorescence in situ hybridization (FISH), fluorescent immunohistochemistry 
      (ImmunoCyt [Scimedx]), and Cxbladder (Pacific Edge Diagnostics USA) using 
      cystoscopy and histopathology as the reference standard met inclusion criteria. 
      Case-control studies were excluded. DATA EXTRACTION: Dual extraction and quality 
      assessment of individual studies. Overall strength of evidence (SOE) was also 
      assessed. DATA SYNTHESIS: Across biomarkers, sensitivities ranged from 0.57 to 
      0.82 and specificities ranged from 0.74 to 0.88. Positive likelihood ratios 
      ranged from 2.52 to 5.53, and negative likelihood ratios ranged from 0.21 to 0.48 
      (moderate SOE for quantitative NMP22, qualitative BTA, FISH, and ImmunoCyt; low 
      SOE for others). For some biomarkers, sensitivity was higher for initial 
      diagnosis of bladder cancer than for diagnosis of recurrence. Sensitivity 
      increased with higher tumor stage or grade. Studies that directly compared the 
      accuracy of quantitative NMP22 and qualitative BTA found no differences in 
      diagnostic accuracy (moderate SOE); head-to-head studies of other biomarkers were 
      limited. Urinary biomarkers plus cytologic evaluation were more sensitive than 
      biomarkers alone but missed about 10% of bladder cancer cases. LIMITATION: 
      Restricted to English-language studies; no search for studies published only as 
      abstracts; statistical heterogeneity present in most analyses; few studies for 
      qualitative NMP22, quantitative BTA, and Cxbladder; and methodological 
      shortcomings in almost all studies. CONCLUSION: Urinary biomarkers miss a 
      substantial proportion of patients with bladder cancer and are subject to 
      false-positive results in others. Accuracy is poor for low-stage and low-grade 
      tumors. PRIMARY FUNDING SOURCE: Agency for Healthcare Research and Quality. 
      (PROSPERO registration number: CRD42014013284).
FAU - Chou, Roger
AU  - Chou R
FAU - Gore, John L
AU  - Gore JL
FAU - Buckley, David
AU  - Buckley D
FAU - Fu, Rongwei
AU  - Fu R
FAU - Gustafson, Katie
AU  - Gustafson K
FAU - Griffin, Jessica C
AU  - Griffin JC
FAU - Grusing, Sara
AU  - Grusing S
FAU - Selph, Shelley
AU  - Selph S
LA  - eng
GR  - HHSA290201200014I/PHS HHS/United States
PT  - Journal Article
PT  - Meta-Analysis
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
PT  - Review
PT  - Systematic Review
DEP - 20151215
PL  - United States
TA  - Ann Intern Med
JT  - Annals of internal medicine
JID - 0372351
RN  - 0 (Antigens, Neoplasm)
RN  - 0 (Biomarkers, Tumor)
RN  - 0 (Nuclear Proteins)
RN  - 0 (bladder tumor-associated antigen)
RN  - 0 (nuclear matrix protein 22)
SB  - IM
CIN - Ann Intern Med. 2015 Dec 15;163(12):954-5. PMID: 26501942
MH  - Antigens, Neoplasm/urine
MH  - Biomarkers, Tumor/*urine
MH  - Cystoscopy
MH  - Humans
MH  - Immunohistochemistry
MH  - In Situ Hybridization, Fluorescence
MH  - Neoplasm Grading
MH  - Neoplasm Recurrence, Local/diagnosis
MH  - Neoplasm Staging
MH  - Nuclear Proteins/urine
MH  - Sensitivity and Specificity
MH  - Urinary Bladder Neoplasms/*diagnosis
EDAT- 2015/10/27 06:00
MHDA- 2016/04/15 06:00
CRDT- 2015/10/27 06:00
PHST- 2015/10/27 06:00 [entrez]
PHST- 2015/10/27 06:00 [pubmed]
PHST- 2016/04/15 06:00 [medline]
AID - 2466370 [pii]
AID - 10.7326/M15-0997 [doi]
PST - ppublish
SO  - Ann Intern Med. 2015 Dec 15;163(12):922-31. doi: 10.7326/M15-0997. Epub 2015 Dec 
      15.