Premium
Predictive value of MCM5 (ADXBLADDER) analysis in urine of men evaluated for the initial diagnosis of bladder cancer: A comparative prospective study
Author(s) -
Anastasi Emanuela,
Maggi Martina,
Tartaglione Sara,
Angeloni Antonio,
Gennarini Giuseppina,
Leoncini Pier Paolo,
Sperduti Isabella,
Di Lascio Giovanni,
De Stefano Virgilio,
Di Pierro Giovanni Battista,
Del Giudice Francesco,
Busetto Gian Maria,
De Berardinis Ettore,
Sciarra Alessandro
Publication year - 2020
Publication title -
diagnostic cytopathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.417
H-Index - 65
eISSN - 1097-0339
pISSN - 8755-1039
DOI - 10.1002/dc.24530
Subject(s) - medicine , bladder cancer , urine , predictive value , urology , prospective cohort study , gynecology , value (mathematics) , cancer , oncology , statistics , mathematics
Background To compare predictive value of MCM5 to urinary cytology (UC) for the primary diagnosis of bladder cancer (BCa). Methods We prospectively enrolled 91 patients who presented macroscopic hematuria or persistent lower urinary tract symptoms at our institution. Single voided mid‐stream urine specimens were collected for UC and MCM5 (ADXBLADDER; Arquer Diagnostics Ltd, Sunderland, United Kingdom) assessment. Cystoscopy was used as confirmatory test, and positive cases underwent transurethral resection of bladder tumor with histopathological evaluation. Results Forty cases (43.9%) showed a positive cystoscopy for BCa. Histology was obtained in 37 cases: 16 (43.2%) high‐grade (HG) and 21 (56.8%) low‐grade (LG) transitional cell carcinoma (TCC). UC had a sensitivity of 62.5%, specificity of 86.3%, PPV of 78.1% and NPV of 74.6%. Sensitivity, specificity, PPV and NPV of MCM5 were 60.0%, 88.2%, 80.0% and 73.8%, respectively. According to tumor grade, MCM5 and UC showed a sensitivity of 47.6% and 52.4% in LG, and 87.5% and 75.0%, respectively, in HG TCC. False‐positive rates were 11.8% and 13.7% of negative cases for BCa with MCM5 and UC test, whereas false‐negative results were found in 40.0% and 37.5% of BCa cases, respectively. The combination of the two tests showed a sensitivity of 71.4% in LG, and 93.8% in HG TCC. Conclusion In the present analysis, MCM5 showed lower sensitivity than UC in predicting BCa primary diagnosis. According to tumor grade, MCM5 showed a higher sensitivity in the detection of HG BCa compared to UC, although values were not significantly different.