Diagnostic value of Xpert® BC Detection, Bladder Epicheck®, Urovysion® FISH and cytology in the detection of upper urinary tract urothelial carcinoma

• Published in: World journal of urology Vol. 41; no. 5; pp. 1323 - 1328
• Main Authors: Pycha, Stefan, Trenti, Emanuela, Mian, Christine, Schwienbacher, Christine, Hanspeter, Esther, Palermo, Margherita, Pycha, Armin, Danuser, Hansjörg, D’Elia, Carolina
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.05.2023; Springer Nature B.V
• Subjects: Bladder; Bladder cancer; Carcinoma, Transitional Cell - diagnosis; Carcinoma, Transitional Cell - pathology; Cellular biology; Computed tomography; Cytodiagnosis - methods; Cytology; Diagnosis; Histology; Humans; Kidney Neoplasms - diagnosis; Kidney Neoplasms - pathology; Medicine; Medicine & Public Health; Nephrology; Oncology; Original Article; Predictive Value of Tests; Sensitivity and Specificity; Tumors; Ureter; Ureteral Neoplasms - diagnosis; Ureteral Neoplasms - pathology; Urinary Bladder - pathology; Urinary Bladder Neoplasms - diagnosis; Urinary Bladder Neoplasms - pathology; Urinary tract; Urogenital system; Urography; Urologic Neoplasms - pathology; Urology; Urothelial carcinoma; Upper urinary tract; Urinary cytology; Urothelial carcinoma; Urinary markers
• ISSN: 1433-8726; 0724-4983; 1433-8726
• DOI: 10.1007/s00345-023-04350-x

Purpose Following the current guidelines, diagnosis and staging for upper urinary tract tumours (UTUC) can be performed with Computed Tomography, urography, ureterorenoscopy (URS) and selective cytology. The aim of the study was to evaluate the performance of the Xpert®-BC-Detection and the Bladder-Epicheck®-test in the detection of UTUC and compare it with cytology and the Urovysion®-FISH test using histology and URS as gold standard. Methods A total of 97 analyses were collected through selective catheterization of the ureter before URS to test for cytology, Xpert®-BC-Detection, Bladder-Epicheck® and Urovysion®-FISH. Sensitivity, specificity, and predictive values were calculated using histology results/URS as reference. Results Overall sensitivity was 100% for Xpert®-BC-Detection, 41.9% for cytology, 64.5% for Bladder-Epicheck® and 87.1% for Urovysion®-FISH. The sensitivity of Xpert®-BC-Detection was 100% in both, LG and HG tumours, sensitivity of cytology increased from 30.8% in LG to 100% in HG, for Bladder-Epicheck® from 57.7% in LG to 100% in HG and of Urovysion®-FISH from 84.6% in LG to 100% in HG tumours. Specificity was 4.5% for Xpert®-BC-Detection, 93.9% for cytology, 78.8% for Bladder-Epicheck® and 81.8% for Urovysion®-FISH. PPV was 33% for Xpert®-BC-Detection, 76.5% for cytology, 58.8% for Bladder-Epicheck® and 69.2% for Urovysion®FISH. NPV was 100% for Xpert®-BC-Detection, 77.5% for cytology, 82.5% for Bladder-Epicheck® and 93.1% for Urovysion®FISH. Conclusion Bladder-Epicheck® and Urovysion®FISH along with cytology could be a helpful ancillary method in the diagnosis and follow-up of UTUC while due to its low specificity Xpert®-BC Detection seems to be of limited usefulness.