MP38-04 THE ROLE OF BLADDER EPICHECK IN PATIENTS WITH ATYPICAL UROTHELIAL CELLS IN THE VOIDED URINARY CYTOLOGY

Abstract

You have accessJournal of UrologyBladder Cancer: Epidemiology & Evaluation I (MP38)1 Sep 2021MP38-04 THE ROLE OF BLADDER EPICHECK IN PATIENTS WITH ATYPICAL UROTHELIAL CELLS IN THE VOIDED URINARY CYTOLOGY Mauro Ragonese, Luca Di Gianfrancesco, Giuseppe Palermo, Massimiliano Foti, Marco Racioppi, and PierFrancesco Bassi Mauro RagoneseMauro Ragonese More articles by this author , Luca Di GianfrancescoLuca Di Gianfrancesco More articles by this author , Giuseppe PalermoGiuseppe Palermo More articles by this author , Massimiliano FotiMassimiliano Foti More articles by this author , Marco RacioppiMarco Racioppi More articles by this author , and PierFrancesco BassiPierFrancesco Bassi More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002053.04AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: One of the main issue in bladder cancer is the role of non invasive test both in diagnosis and in follow-up of patients with non muscle invasive disease, moreover in patients with high risk disease. Urinary cytology is a milestone in the diagnostic workout of bladder cancer and it is routinely used in follow up of patients. The standard report for cytology has been defined in The Paris System (TPS) for reporting urinary cytopathology. This system has been introduced to standardize the pathological report and to increase the diagnostic relevance of cytology. The categories negative for High grade urotelial carcinoma (NGHUC) and HGUC are straightforward, but the category 'atypical urothelial cells (AUC)' and 'suspicious of HGUC (SHGUC)' are inconclusive. During follow-up of patients with HG NMBC these reports must be further investigated in order not to miss a tumor recurrence. EpiCheck is a urinary test that analyzes DNA methylation biomarkers in order to identify high-risk urothelial cancer; it has shown promising result particulary in high grade disease. We sought to analyze if Epicheck could be useful in patients with inconclusive results at urinary cytology, particularly regarding AUC category. METHODS: In a retrospective analysis, we looked at all the patients in follow-up for high grade NMBC in our Department since January 2019 to December 2020 that have a AUC report in their urinary cytology. For all these patients, a sample of urine for Epicheck was collected and analyzed. After that, a cystoscopy was performed with biopsy of any macroscopic recurrence or any suspected area. Sensitivity, specicity, negative predictive value (NPV) and positive predictive value (PPV) of EpiCheck were compared to cystoscopy and histology results. RESULTS: In the period of study 62 patients were analyzed. All the patients have a history of HG NMBC and a cytology result with AUC during follow-up. All the patients underwent cystoscopy and the pathology report was recurrent disease in 21 patients (33.8 %): 3 cases of T1G3 disease, 8 TaG3 and 10 Carcinoma in situ. Among the 62 patients analyzed, the Epicheck was reported positive in 24 patients (38%). Only 1 patient had a recurrent disease and a negative Epicheck, even if the value was 54, therefore not so far from the treshold of positivity that is > 60. The sensitivity of Epicheck in the detection of high risk disease was 95 %, and specificity was 89.5 %. Negative predictive value was 97 % and positive predictive value was 83%. CONCLUSIONS: The AUC is a category of urinary cytology that could be inconclusive and need to be strictly followed in order to avoid the risk of missing tumor recurrence during follow-up of HG NMBC. Epicheck is a non invasive tool that overcome cytology in some situations and could be helpful in case where cytology is not straightforward. The inclusion of this non invasive tool in the routinary diagnostic setting of patients with HG NMBC must be considered and larger studies for the use of Epicheck in inconclusive cytology must be evaluated. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e693-e693 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Mauro Ragonese More articles by this author Luca Di Gianfrancesco More articles by this author Giuseppe Palermo More articles by this author Massimiliano Foti More articles by this author Marco Racioppi More articles by this author PierFrancesco Bassi More articles by this author Expand All Advertisement Loading ...