Combining cytology, TRAP assay, and FISH analysis for the detection of bladder cancer in symptomatic patients

S. Bravaccini, V. Casadio, R. Gunelli, L. Bucchi, W. Zoli, D. Amadori, R. Silvestrini, D. Calistri

Research output: Contribution to journalArticle

Abstract

Background: There is a need to improve the performance of urine cytology in bladder cancer diagnosis. We assessed the diagnostic performance of (i) telomerase activity detected by telomeric repeat amplification protocol (TRAP) assay, (ii) cytology and TRAP assay in parallel, (iii) cytology in parallel with the in-series combination of TRAP assay and FISH analysis, and (iv) the in-series combination of TRAP assay and FISH analysis. Patients and methods: Cross-sectional study of 289 consecutive patients who presented with urinary symptoms at a north Italian hospital between 2007 and 2008. All underwent cystoscopy and cytology evaluation, and conclusive results were available for TRAP assay and FISH analysis. Results: Sensitivity and specificity were 0.39 and 0.83, respectively, for cytology; 0.66 and 0.72 for TRAP; 0.78 and 0.60 for the combination of cytology and TRAP; 0.78 and 0.78 for the combination of cytology, TRAP, and FISH; and 0.65 and 0.93 for the combination of TRAP and FISH. All differences versus cytology alone were significant (P £ 0.011). Conclusion: Compared with cytology alone, the combination of cytology, TRAP, and FISH provided the best tradeoff between increase in sensitivity and loss in specificity, especially among non-bleeding patients, low-grade cancers, and early-stage cancers.

Original languageEnglish
Pages (from-to)2294-2298
Number of pages5
JournalAnnals of Oncology
Volume22
Issue number10
DOIs
Publication statusPublished - Oct 2011

Keywords

  • Bladder cancer
  • Cytology
  • Diagnosis
  • FISH
  • Telomerase activity

ASJC Scopus subject areas

  • Oncology
  • Hematology

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