Article
Diagnostic predictive value of Xpert bladder cancer monitor in the follow up of patients affected by non-muscle invasive bladder cancer (NMIBC)
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Authors
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Carolina D'Elia
- Zentralkrankenhaus Bozen
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Alexander Pycha
- Riga Stradins University, Riga, Lettland
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Esther Hanspeter
- Krankenhaus Bozen
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Emanuela Trenti
- Krankenhaus Bozen
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Salvatore Palermo
- Zentralkrankenhaus Bozen
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Armin Pycha
- Krankenhaus Bozen
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Christiane Mian
- Krankenhaus Bozen
| Published: | May 17, 2018 |
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Outline
Text
Introduction: The Xpert Bladder Cancer Monitor is a new urinary marker test based on the evaluation of the presence of 5 targets mRNAs overexpressed in patient with bladder cancer. The aim of our study was to evaluate diagnostic accuracy of the Xpert test in the follow up of patients with NMIBC.
Materials and methods: 141 patients under follow up for NMIBC were included in this prospective study. Urine samples were analyzed with the Xpert BC Monitor kit and urinary cytology. Subsequently, patients underwent cystoscopy and if positive a transurethral resection of the bladder. Cytologies were evaluated according to the Paris System;Xpert BC Monitor test was reported as negative or positive (cut-off total LDA=0.5). Sensitivity, specificity, positive (PPV) and negative predictive value (NPV) of Xpert and cytology were calculated using cystoscopy or histology as gold standard.
Results: Median age was 73 years (range 28-95). One patient had to be excluded due to not diagnostic cytology and Xpert BC Monitor. Of the remaining 140, 34 had tumour recurrence (29 LG (85.3%), 5 HG (14.7%)). Cytology was positive in 3 out of 34 cases (8.8%), the Xpert BC Monitor test in 17 out of 34 patients (50%) with BC. The Xpert BC Monitor was correctly negative in 84/106 patients, resulting in a specificity of 79.2%. 22 were „false positive“, 10 of which after a intravesical therapy with BCG. The PPV for cytology was 42.8% and 43.6%, the NPP 76.7% and 83.2%, respectively.
Conclusions: Sensitivity of Xpert BC Monitor Test was significantly higher than for cytology as expected in a LG predominated BC group. The test performed very well in terms of specificity but could not reach the extremely high value of cytology, while PPV and NPV performed approximately the same for both tests.
