OBJECTIVETo evaluate the value of urine sediment analyzer in the screening of clinically suspected urinary tract infection (UTI) in cancer patients.

METHODSThe results of bacterial count of 1 053 midstream urine samples by UF-1000i urine sediment analyzer (UF-1000i urine sediment analyzer, UF-1000i) were compared with the results of bacterial culture. Moreover, the results of distinguishing bacterial species by the bacterial scattergram were compared with the results of bacteria culture. At the same time, the sensitivity, specificity, positive predictive value and negative predictive value of UF-1000i analyzer for UTI screening were evaluated.

RESULTSOf all the 1 053 samples, the top three bacteria were E. coli, Enterococci and P. aeruginosa. The top three malignant tumors of UTI were bladder, lung cancer and cervical cancers. The positive rate of UF-1000i analyzer was 20% (211/1 053), and that of bacteria culture was 17.9% (188/1 053). There was statistically no significant difference in the positive rates between the two methods (χ(2)=1.636, P>0.05), and the two methods had a considerable consistency (Kappa=0.756). Compared with the clinical diagnosis, UTI screening by UF-1000i analyzer showed a sensitivity of 79.6% (160/201), specificity of 95.5% (814/852), positive predictive value of 80.8% (160/198) and negative predictive value of 95.2%(814/855). The distribution of cocci and bacilli acquired by the bacterial scattergram was basically in accordance with the results of bacterial culture.

CONCLUSIONSBacterial count by UF-1000i analyzer plays an important role in early screening of UTI, and the bacterial scattergram may help to distinguish bacterial species, providing reference for the use of antibiotics in early medication.

Bacterial Load ; Enterococcus ; isolation & purification ; Escherichia coli ; isolation & purification ; Female ; Flow Cytometry ; Humans ; Leukocyte Count ; Lung Neoplasms ; urine ; Predictive Value of Tests ; Pseudomonas aeruginosa ; isolation & purification ; Sensitivity and Specificity ; Urinary Bladder Neoplasms ; urine ; Urinary Tract Infections ; diagnosis ; microbiology ; urine ; Uterine Cervical Neoplasms ; urine

No abstract available.
Aged ; Anti-Bacterial Agents/therapeutic use ; Bacteria/metabolism ; Catheter-Related Infections/diagnosis/drug therapy/*microbiology ; Color ; Equipment Design ; Escherichia coli Infections/diagnosis/drug therapy/*microbiology ; Female ; Humans ; Intestines/*microbiology ; Pigments, Biological/metabolism ; Treatment Outcome ; Tryptophan/metabolism ; Urinary Bladder Neoplasms/surgery ; Urinary Catheterization/adverse effects/*instrumentation ; *Urinary Catheters ; *Urinary Diversion ; Urinary Tract Infections/diagnosis/drug therapy/*microbiology ; Urine/chemistry/microbiology

PURPOSE: To investigate the usefulness of urine cytology in the detection of tumor recurrence in terms of practicality and cost-effectiveness. MATERIALS AND METHODS: We retrospectively analyzed 393 patients who underwent transurethral resection of bladder tumor (TURBT) for non-muscle-invasive bladder cancer (NMIBC) from January 2010 to June 2013. All patients underwent cystoscopy, urine cytology, urinalysis, and computed tomography (CT) at 3 and 6 months after TURBT. In 62 cases, abnormal bladder lesions were identified on cystoscopy within 6 months. Suspicious lesions were confirmed pathologically by TURBT or biopsy. Patients were grouped by modalities: group I, urine cytology; group II, CT; group III, urinalysis; group IV, urine cytology plus CT; group V, urine cytology plus urinalysis; group VI, CT plus urinalysis; group VII, combination of all three modalities. Each group was compared by cost per cancer detected. RESULTS: Forty-nine patients were confirmed to have tumor recurrence and 13 patients were confirmed to have inflammation by pathology. The overall tumor recurrence rate was 12.5% (49/393) and recurrent cases were revealed as NMIBC. Sensitivity in group I (24.5%) was lower than in group II (55.1%, p=0.001) and group III (57.1%, p<0.001). However, in group VII (77.6%), the sensitivity was statistically similar to that of group VI (75.5%, p=0.872). Under the Korean insurance system, total cost per cancer detected for group VII was almost double that of group VI (p=0.041). CONCLUSIONS: Routine urine cytology may not be useful for follow-up of bladder cancer in terms of practicality and cost-effectiveness. Application of urine cytology needs to be adjusted according to each patient.
Aged ; Aged, 80 and over ; Cost-Benefit Analysis ; Cystoscopy/economics ; Cytodiagnosis/economics/methods ; Female ; Health Care Costs/*statistics & numerical data ; Humans ; Male ; Middle Aged ; Neoplasm Recurrence, Local/*diagnosis/economics/pathology ; Neoplasm Staging ; Republic of Korea ; Retrospective Studies ; Sensitivity and Specificity ; Tomography, X-Ray Computed/economics ; Urinalysis/economics/methods ; Urinary Bladder Neoplasms/*diagnosis/economics/pathology/surgery ; Urine/*cytology

OBJECTIVETo investigate the significance of apolipoprotein (Apo)-A1 in urine as a biomarker for early diagnosis and classification of bladder urothelial carcinoma (BUC).

METHODSUrine samples were divided into four groups: normal control group, benign bladder disease group, low-grade malignant BUC group, and high-grade malignant BUC group. Apo-A1, which showed significantly different expression among the four groups, was selected according to the two-dimensional electrophoresis (2-DE) images of the four groups, and enzyme-linked immunosorbent assay (ELISA) was used to quantify Apo-A1 in the four groups. A receiver operating characteristic (ROC) curve was generated, and the optimal operating points on the ROC curve were found to determine the critical concentrations of Apo-A1 for early diagnosis of BUC and differentiation of low-grade and high-grade malignant BUC. The results were verified clinically, and the specificity and sensitivity were calculated.

RESULTSThe 2-DE images showed that that the level of Apo-A1 increased from the normal control grouP to high-grade malignant BUC group. The ELISA showed that there was no significant difference in Apo-A1 level between the normal control grouP and benign bladder disease group, but the Apo-A1 level was significantly higher in the BUC groups than in the normal control grouP and benign bladder disease grouP (P < 0.01); the high-grade BUC grouP had a significantly higher Apo-A1 level than the low-grade BUC grouP (P < 0.01). The BUC patients and those without BUC could be differentiated with an Apo-A1 concentration of 18.22 ng/ml, while the low-grade and high-grade malignant BUC could be differentiated with an Apo-A1 concentration of 29.86 ng/ml. When used as a biomarker, Apo-A1 had a sensitivity of 91.6% (98/107) and a specificity of 85.7% (42/49) for diagnosis of BUC and had a sensitivity of 83.7% (41/49) and a specificity of 89.7% (52/58) for BUC classification.

CONCLUSIONApo-A1 may be a biomarker for early diagnosis and classification of BUC and shows promise for clinical application.

Aged ; Apolipoprotein A-I ; urine ; Early Detection of Cancer ; Female ; Humans ; Male ; Middle Aged ; Urinary Bladder Neoplasms ; diagnosis ; urine

OBJECTIVETo investigate the difference in urinary proteome between patients with bladder urothelial carcinoma (BUC) and healthy volunteers and to provide a basis for the early diagnosis of BUC.

METHODSThe urine samples from BUC patients and healthy volunteers (controls) were treated by 25% ethanol precipitation and two-dimensional gel electrophoresis (2-DE), and the obtained urinary proteins were subjected to Coomassie brilliant blue staining and analysis by PDQuest 8.0 (2-DE image analysis software); the differentially expressed proteins were sequenced by matrix-assisted laser desorption/ionization time-of-flight/time-of-flight mass spectrometry and identified using the Swiss-Prot database; the differential expression of these proteins was verified by western blot.

RESULTSHigh-resolution and high-reproducibility 2-DE images were obtained from the urine samples of BUC patients and controls, with 789 ± 18 and 762 ± 14 protein spots, respectively. Compared with the control group, the BUC grouP had significantly decreased expression of 6 protein spots and significantly increased expression of 11 protein spots. The mass spectrometry revealed five proteins with increased expression in the BUC group, including fibrinogen, lactate dehydrogenase B, apolipoprotein A1, clusterin, and haptoglobin, and the results were confirmed by western blot.

CONCLUSIONThere is significant difference in urinary proteome between BUC patients and healthy volunteers; the identification of differentially expressed proteins in urine lays the foundation for identifying potential molecular markers in early diagnosis of BUC.

Aged ; Case-Control Studies ; Early Detection of Cancer ; Female ; Humans ; Male ; Middle Aged ; Proteomics ; methods ; Urinary Bladder Neoplasms ; diagnosis ; urine

OBJECTIVETo investigate the value of cytokeratin 20 (CK20) immunocytochemical (ICC) detection in the urine liquid-based cytological specimens in diagnosis of urothelial carcinoma (UC).

METHODSThe study consisted of prospective and retrospective groups. In the prospective group, voided urine samples were collected from patients with a variety of urological conditions and healthy individuals. Urine cytological diagnosis and CK20 ICC were performed on the collected specimens. In the retrospective group, archived urine slides with cytological diagnoses of atypical urothelial cells (AUC), suspicious carcinoma (SuCA) and carcinoma (CA) were selected. Then they were re-stained immunocytochemically with monoclonal antibody against CK20 after decolorization. Histological diagnosis and clinical follow-up result were used as the gold standard for analysis.

RESULTSThere were 136 cases in the prospective group, including 89 cases of UC, 19 cases of other urogenital malignancies, 12 cases of benign lesions and 16 cases of normal control. The sensitivity of CK20 ICC in detection of UC was 75.3%, significantly higher than that of LBC (48.3%, P < 0.001). The positive rate of CK20 was 64.7% (22/34) in G1 UC, 73.3% (22/30) in G2 UC, and 91.3% (21/23) in G3 UC (P < 0.001). The specificity of CK20 ICC was 91.5%, the same as that of LBC. There were 163 cases in retrospective group, including 119 cases of UC, 17 cases of other urogenital malignancies and 27 cases of benign lesions. The cytological diagnoses of them were 68 cases of CA, 47 cases of SuCA and 48 cases of AUC. The positive rates of CK20 ICC in UC and non-UC (other urogenital malignancies and benign lesions) cases were 90.8% and 15.9%, respectively, with a statistically very significant difference (P < 0.001). The LBC of all the 119 cases of UC included 62 (52.1%) cases of CA, 35 (29.4%) cases of SuCA and 22 (18.5%) cases of AUC. The positive rates of CK20 in the LBC-diagnosed CA, SuCA and AUC were 96.8%, 97.1% and 63.6%, respectively. The LBC of all the 44 non-UC cases included 6 (13.6%) cases of CA, 12 (27.3%) cases of SuCA and 26 (59.1%) cases of AUC, and the positive rates of CK20 in the LBC-diagnosed CA, SuCA and AUC were 33.3%, 33.3% and 3.8%, respectively. The differences of UC and non-UC cases between the corresponding categories of LBC were significant (P < 0.0001, respectively).

CONCLUSIONCK20 immunocytochemistry as an auxiliary method to urine liquid-based cytology can increase the sensitivity in detection of urothelial carcinomas.

Adult ; Aged ; Aged, 80 and over ; Biomarkers, Tumor ; metabolism ; Carcinoma, Transitional Cell ; diagnosis ; metabolism ; urine ; Cytodiagnosis ; Female ; Follow-Up Studies ; Humans ; Immunohistochemistry ; Keratin-20 ; metabolism ; Kidney Neoplasms ; diagnosis ; metabolism ; urine ; Male ; Middle Aged ; Prospective Studies ; Retrospective Studies ; Urinary Bladder Neoplasms ; diagnosis ; metabolism ; urine ; Young Adult

BACKGROUND AND OBJECTIVESurvivin has gradually become an important target in diagnosis, prognosis prediction and treatment of tumor. There are many studies on urine-based survivin mRNA test using reverse transcription-polymerase chain reaction (RT-PCR) as a noninvasive examination for bladder cancer. However, its clinical value remains controversial. This study was to evaluate the diagnostic value of urine survivin mRNA detection with RT-PCR for bladder cancer by a systematic review of related studies.

METHODSWith the search terms such as bladder neoplasm, survivin, RT-PCR, sensitivity, specificity and diagnosis, we systematically searched through PubMed, EMBASE, SCI, Cochrane Library, Chinese Biomedical Literature Database (CBM), Chinese Scientific Journal Full-text Database (CSJD), China Journal Full-text Database (CJFD), Chinese Medical Association (CMA) digital periodicals and Google Scholar totally from January 1997 to April 2009 for diagnostic trials with RT-PCR detection of urine survivin mRNA for bladder cancer. The Quality Assessment of Diagnostic Accuracy Studies (QUADAS) items were used to evaluate the quality of the included studies. Meta-disc software was used to calculate outcome indicators.

RESULTSTwenty-six studies, totally 2 416 patients, were eligible. Meta-analysis showed that compared with pathologic examination, the summary values of sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and summary receiver operating characteristic curve (SROC) of urine-based survivin mRNA test using RT-PCR for bladder cancer were 88%, 94%, 14.56, 0.13 and 0.9736, respectively. Nested RT-PCR got the highest sensitivity, specificity and SROC and the values were 91%, 95% and 0.9805, respectively. The sensitivity and specificity of general RT-PCR were the second highest, which were 87% and 94%, respectively. The sensitivity of quantitative RT-PCR was 80% and the specificity was 93%.

CONCLUSIONSComparing with pathologic examination, the sensitivity and specificity of urine-based survivin mRNA test using RT-PCR are relatively high. It can be used as an important adjunct method for cystoscope in early screening and postoperative monitoring of bladder cancer.

Databases, Bibliographic ; Humans ; Inhibitor of Apoptosis Proteins ; genetics ; urine ; RNA, Messenger ; urine ; Reverse Transcriptase Polymerase Chain Reaction ; methods ; Sensitivity and Specificity ; Urinary Bladder Neoplasms ; diagnosis ; genetics ; urine

BACKGROUND AND OBJECTIVEFunctional paraganglioma of the urinary bladder (FPUB) is a rare tumor. Misdiagnosis of FPUB before operation can lead to serious intraoperative consequences. In this article, we reported our experience in preoperative diagnosis and surgical treatment of FPUB.

METHODSClinical data of nine patients with FPUB treated between June 1985 and January 2009 at Peking Union Medical College Hospital were analyzed.

RESULTSAll patients underwent urinary catecholamine (CA) detection, B-ultrasound, CT and/or MRI scan; 5 underwent nailfola microcirculation inspection; 4 underwent 131I-metaiodobenzyl guanidine (MIBG) detection; and 6 underwent 111In-DTPA-Octreotide (OCT) scintiscan. According to the UICC bladder tumor classification, 5 patients had T2, 3 had T3, and 1 had T4 disease. All patients underwent surgical treatment, and 1 received 131I-MIBG therapy. All patients had paroxysmal hypertension and palpitation and six had cold sweat, headache, and dizziness after emphatic urination. The definitive diagnosis was made by histopathologic examination of the removed tumors and was confirmed in 7 cases by the immunohistochemical staining of chromogranin A, Ki-67 and S100 protein. The tumor consisted of discrete aggregates of zellballen cells separated by a network of vascular channels. One patient had metastases in the pelvic lymph nodes, liver and colon. Follow-up ranged from 7 to 289 months (mean, 127.2 ± 34.2). Six of the nine cases reported here were found in the usual locations. One patient had multiple tumors. The catecholamine level was elevated under basal conditions in 8 patients and during endoscopic resection of the tumor in 1 patient; it returned to normal after surgery in 8 patients. Three patients had recurrence and 1 had metastasis following surgery.

CONCLUSIONSEarly preoperative diagnosis of FPUB is difficult, but it should be suspected in patients with typical tetrad symptoms: headache and micturition syncope, sweating, palpitation and hematuria. In those patients with unresectable multiple tumors, medicine and 131I-MIBG therapy may be helpful for controlling hypertension and delaying disease progression. Advanced classification (≥T3), multifocal tumors and CgA expression are risk factors of recurrence and metastasis.

3-Iodobenzylguanidine ; Adolescent ; Adult ; Aged ; Catecholamines ; urine ; Chromogranin A ; metabolism ; Cystectomy ; methods ; Female ; Follow-Up Studies ; Humans ; Ki-67 Antigen ; metabolism ; Liver Neoplasms ; secondary ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; Neoplasm Staging ; Paraganglioma ; diagnosis ; secondary ; surgery ; urine ; S100 Proteins ; metabolism ; Tomography, X-Ray Computed ; Urinary Bladder Neoplasms ; diagnosis ; metabolism ; surgery ; urine ; Young Adult

OBJECTIVETo assess the value of fluorescence in situ hybridization (FISH) in the diagnosis of bladder cancer.

METHODSUrine samples from 100 patients suspected of having bladder cancer were collected before cystoscopy for immediate urine cytology and FISH analysis. The criteria for FISH abnormality were determined by evaluating the urine specimens from 20 subjects without urogenital neoplasm.

RESULTSThe overall sensitivity of cytology and FISH was 43.2% and 82.4%, and their specificity was 92.3% and 88.5%, with diagnostic concordance rate of 56.0% and 84.0%, respectively. The differences between FISH and cytology showed statistical significance in the sensitivity, diagnostic concordance rate, non-muscle-invasive cancer and primary cancer.

CONCLUSIONThe sensitivity and efficiency of FISH in the detection of bladder cancer are superior to those of cytology, especially for prophase cancer.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Carcinoma, Transitional Cell ; diagnosis ; Cytodiagnosis ; Female ; Humans ; In Situ Hybridization, Fluorescence ; Male ; Middle Aged ; Sensitivity and Specificity ; Urinary Bladder Neoplasms ; diagnosis ; Urine ; cytology ; Young Adult

OBJECTIVETo evaluate the expression and clinical significance of urinary nuclear matrix protein (NMP22) and cytokeratin 18 (CK18) for transitional cell carcinoma of the bladder.

METHODSUrinary NMP22 and CK18 levels of 293 patients with transitional cell carcinoma of the bladder, 400 patients with non-transitional cell carcinoma of the bladder, and 105 bladder benign disease were analysed by enzyme-linked-immunosorbent assay (ELISA).

RESULTSThe levels of urinary NMP22 and CK18 in the patients with transitional cell carcinoma of the bladder (M = 17.3 U/ml, M(CK18) = 484.2 U/L) were significantly higher than those in the non-transitional cell carcinoma of the bladder (M = 6.8 U/ml, M(CK18) = 156.0 U/L) and the benign disease group (M(NMP22) = 2.3 U/ml, M(CK18) = 66.6 U/L) (P < 0.001). The sensitivity and specificity of urinary NMP22 and CK18 were 79.2%, 88.6% and 78.2%, 82.9%, respectively, for transitional cell carcinoma of the bladder before any treatment. The joint sensitivity of the two markers was 91.7%. The NMP22 and CK18 levels were significantly lower in the recovered patients after surgical operation (P < 0.01), while in patients with recurrence or metastasis the levels of the markers were significantly higher (P < 0.01). There was a significant relationship between NMP22 and CK18, (r = 0.689, P < 0.01). The levels of urinary nmp22 and CK18 were significantly different among pathological grade G1, G2, G3, and stage Ta, T1, T2, T3 (P < 0.01).

CONCLUSIONNMP22 and CK18 are useful tumor marker for diagnosis of transitional cell carcinoma of the bladder and for monitoring the state of illness. The joint use of the two markers can improve the sensitivity of cancer detection. NMP22 and CK18 may become a new class of tumor markers, and to be the basis for development of a new assay with an increased efficacy for the detection and treatment of bladder cancer.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Biomarkers, Tumor ; urine ; Carcinoma, Renal Cell ; urine ; Carcinoma, Transitional Cell ; diagnosis ; pathology ; surgery ; urine ; Child ; Female ; Follow-Up Studies ; Humans ; Keratin-18 ; urine ; Male ; Middle Aged ; Neoplasm Metastasis ; Neoplasm Recurrence, Local ; urine ; Neoplasm Staging ; Nuclear Proteins ; urine ; Prognosis ; Sensitivity and Specificity ; Urinary Bladder Neoplasms ; diagnosis ; pathology ; surgery ; urine ; Young Adult