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Titolo:
Current bladder tumor tests: Does their projected utility fulfill clinicalnecessity?
Autore:
Lokeshwar, VB; Soloway, MS;
Indirizzi:
Univ Miami, Sch Med, Dept Urol, Miami, FL 33152 USA Univ Miami Miami FL USA 33152 mi, Sch Med, Dept Urol, Miami, FL 33152 USA Univ Miami, Sch Med, Dept Cell Biol & Anat, Miami, FL USA Univ Miami Miami FL USA i, Sch Med, Dept Cell Biol & Anat, Miami, FL USA
Titolo Testata:
JOURNAL OF UROLOGY
fascicolo: 4, volume: 165, anno: 2001,
pagine: 1067 - 1077
SICI:
0022-5347(200104)165:4<1067:CBTTDT>2.0.ZU;2-7
Fonte:
ISI
Lingua:
ENG
Soggetto:
TRANSITIONAL-CELL CARCINOMA; PROSTATE-SPECIFIC ANTIGEN; NUCLEAR MATRIX PROTEIN-22; VOIDED URINE CYTOLOGY; BTA STAT TEST; DIGITAL RECTAL EXAMINATION; COMPLEMENT FACTOR-H; OF-THE-ART; TELOMERASE ACTIVITY; MICROSCOPIC HEMATURIA;
Keywords:
bladder; bladder neoplasms; tumor markers, biological; diagnosis;
Tipo documento:
Review
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
90
Recensione:
Indirizzi per estratti:
Indirizzo: Lokeshwar, VB Univ Miami, Sch Med, Dept Urol, Miami, FL 33152 USA Univ Miami Miami FL USA 33152 ept Urol, Miami, FL 33152 USA
Citazione:
V.B. Lokeshwar e M.S. Soloway, "Current bladder tumor tests: Does their projected utility fulfill clinicalnecessity?", J UROL, 165(4), 2001, pp. 1067-1077

Abstract

Purpose: We reviewed currently available bladder cancer tests in the context of the clinical expectations of a noninvasive bladder cancer test. Materials and Methods: We reviewed the literature on bladder cancer tests that are commercially available or have shown clinical usefulness and examined how each test compares with standard methods of bladder cancer diagnosis. Results: The clinical necessity for a noninvasive test for bladder cancer is 2-fold, including the early detection of high grade bladder tumors before muscle invasion and monitoring tumor recurrence or new onset. An ideal noninvasive test should be sensitive, specific, rapid, technically simple andhave low intra-assay and interassay variability. Urine cytology has high specificity but limited applicability due to its relatively low sensitivity and subjective nature. Hematuria detection by Hemastix* dipstick is sensitive but not specific for detecting bladder cancer. Molecules associated withbladder tumor growth and progression may serve as a basis for designing noninvasive diagnostic tests. The Food and Drug Administration approved BTA Stat and BTA TRAK dagger tests, which detect human complement factor H and arelated protein in urine, have 60% to 80% sensitivity and 50% to 70% specificity (lower in symptomatic patients) for bladder cancer. The Food and Drug Administration approved NMP22 double dagger test, which measures the level of nuclear mitotic apparatus protein in urine, has 50% to 100% sensitivity and 60% to 90% specificity. Accu-Dx detects fibrin degradation products, fibrin and fibrinogen in urine, although this test is no longer commercially available. The Immunocyt parallel to test combines cytology with an immunofluorescence technique to improve the sensitivity of cytology for detecting low grade tumors. The telomeric repeat amplification protocol assay for telomerase in exfoliated cells has 70% to 86% sensitivity and 60% to 90% specificity for bladder cancer. However, the low stability of telomerase in urine affects its sensitivity. The hyaluronic acid and hyaluronidase (HA-HAase) test, which measures the urinary level of hyaluronic acid and hyaluronidase, has 90% to 92% sensitivity and 80% to 84% specificity for bladder cancer. Quanticyt karyometry evaluates nuclear shape and DNA content of exfoliated cells to detect bladder cancer. The list of bladder tumor markers is growing rapidly and large multicenter trials are essential to assess their usefulness. Conclusions: Although currently noninvasive bladder cancer tests cannot replace cystoscopy, some have shown a promise of being clinically useful. Oneor a combination of these tests-markers may prove to be a prostate specific antigen for bladder cancer provided that patients and, more importantly, clinicians accept it.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 05/12/20 alle ore 08:10:23