Diagnosis Of Urinary Bladder Cancer Research Articles

An assessment of chromosomal alterations detected by FISH in urothelial carcinoma and its correlation to liquid-based urine cytology and histopathology

BackgroundThe present study aimed to evaluate the diagnostic usefulness, sensitivity, and specificity of urinary liquid-based cytology (LBC) versus multitarget, multicolor UroVysion fluorescence in situ hybridization (uFISH) assay for the diagnosis of urinary bladder cancer in light of the histological diagnosis. MethodsFifty patients and negative controls each were selected for the study. A 10 ml voided urine specimen was processed for urine cytology to prepare LBC smears. For urinary FISH analysis, 50 ml of voided urine was processed using multi-target FISH-containing probes for the centromeres of chromosomes 3, 7, and 17 and the 9p21 locus. Histopathological examination of transurethral resection of bladder tumor (TURBT) chips was performed on diseased cases only. ResultsAll 50 diseased cases exhibited 62%, 80%, 76%, and 68% of uFISH sensitivity, uFISH specificity, positive predictive value (PPV) and negative predictive value (NPV) respectively. Among negative controls, results of 40%, 84%, 71%, and 58% for LBC sensitivity, LBC specificity, PPV, and NPV were found, respectively. Among the diseased cases uFISH positivity of 20%, 45%, 83.3%, 82.4% and 100% for Ta, T1, T2a, T2b and T3 respectively. Among the diseased cases LBC positivity was 0%, 20%, 33.3%, 70% and 100% for Ta, T1, T2a, T2b and T3 respectively. ConclusionIncreased sensitivity and specificity of uFISH than LBC urine to detect urothelial carcinoma (UC) reflect the better potentiality of the former to detect UCs. The limitations of uFISH analysis include sophisticated equipment, higher cost, and experienced cytopathologists/technicians. It is proposed to conduct more such prospective trials with recent biomarkers so as to reduce the frequency of cystoscopy in such patients.

Relationship Between Availability of Urologists and Primary Care Providers and Stage of Diagnosis for Invasive Urinary Bladder Cancer.

With no recommended screening approach, urinary bladder cancer patients rely on referral to urologists to ensure timely diagnosis of bladder cancer. This requires coordination between primary and specialty care. We provide estimates of the relative association between primary care physician and urologist density on stage of urinary bladder cancer diagnosis. We used 2010 to 2016 Pennsylvania Cancer Registry data to identify all adult patients diagnosed with bladder cancer. Our primary outcome was locoregional stage of diagnosis, since treatment modality changes and prognosis worsens beyond this stage. Based on patient's residential location at the time of diagnosis we defined both density of urologists and number of primary care providers (defined as providers per population) within the patient's county. We used univariate and multivariate logistic regression to estimate the association between provider density and likelihood of locoregional stage of diagnosis. We also controlled for age, sex, race/ethnicity, insurance type, and year. Our sample included 11,771 urinary bladder cancer patients with 10,607 diagnosed at locoregional stage and 1164 at distant stage. Multivariate regression results show primary care density was associated with significantly higher odds of locoregional stage of diagnosis (odds ratio of 1.05 [95% CI: 1.02-1.08]) while urologist density was associated with significantly lower odds of locoregional stage (odds ratio of 0.65 [95% CI: 0.48-0.89]). We found primary care density but not urologist density was associated with earlier stage of diagnosis, highlighting the importance of access to primary care and need for timely referral to urologic care.

Electrochemical immunosensor utilizing a multifunctional 3D nanocomposite coating with antifouling capability for urinary bladder cancer diagnosis

Currently available point-of-care tests for Bladder Cancer (BC) are qualitative and prone to high false positives, thus preventing them from replacing clinical cystoscopy as reliable stand-alone diagnostics. In this study, we have targeted this unmet need by developing a label-free electrochemical impedimetric immunosensor for detection of APO-A1, a major high-density lipoprotein that is overexpressed in the urine of early-stage bladder cancer patients. The immunosensor utilizes a novel multifunctional 3D nanocomposite coating consisting of a porous bovine serum albumin (BSA) matrix embedded with a network of highly conductive and biocompatible gold coated silver nanowires (Au@AgNWs). The main components of this nanocomposite coating and their specific functions include: (i) A 3D porous BSA matrix to enable oriented antibody conjugation and prevent non-specific protein adsorption while allowing diffusion of analyte with minimal hindrance as compared to traditional antifouling coatings (ii) Embedded Au@AgNWs that enhance biocompatibility and improve charge transfer to the underlying electrode. The nanocomposite coating demonstrated minimal decrease in electrochemical performance even after 1-month of incubation in 1% BSA, human serum and human urine. Furthermore, the low-cost and disposable screen-printed electrochemical immunosensor exhibited excellent feasibility for sensitive and specific APO-A1 detection in the clinically relevant sensing range of 100 pg/mL to 250 ng/mL with high reproducibility (n = 5, RSD=2.2%) and an impressive LOD of 22 pg/mL. These results highlight the potential of the proposed immunosensor to enable reliable early diagnosis of bladder cancer at the point-of-care and serve as a viable alternative to cystoscopy.

Urinary microRNA-10a levels in diagnosis and prognosis of urinary bladder cancer.

Urinary bladder cancer (UBC) is a disease quite common in developed countries; however, its incidence is increasing in developing countries as well. The diagnosis of UBC is generally based on a number of methods, of which urinary cytology is a very commonly used one. But it is not very reliable. Therefore many new markers and methods are being investigated to make non-invasive diagnosis of UBC easy and reliable. This study was carried out to find the usefulness of microRNA (miRNA)-10a as a diagnostic and prognostic marker in non-muscle-invasive urinary bladder carcinoma. Twenty patients with UBC were taken as cases with 20 controls. Urine cytological examination was done, as well as histopathological examination of tumor tissue of cases. Urinary miRNA-10a estimation of both the cases and controls were done. It was found that miRNA-10a is significantly high in urine of patients with UBC. Its value also significantly correlated with the grade and stage of the tumor. Hence it can be concluded that urinary miRNA-10a is a potential candidate in the diagnosis and prognosis of UBC.

Histopathological Study on Patients with Transitional Cell Carcinoma of Urinary Bladder in Al-Diwaniyah City/ Iraq

This study conducted on inpatients admitted to Al-Diwaniyah teaching hospital at period from January to June 2010 to recognize the histopathological changes of tumor cells of urinary bladder in comparison with normal cells. The histopathological examination of urinary tract infections (UTIs) showed normal thickness of urothelium, in addition, the submucosa and the muscular tissue were congested and oedematous. The present study showed that the transitional cell carcinoma of the bladder divided into three major grades: Grade І , Grade ІІ, Grade ІІІ. In this study, the immunehistochemical expression of cytokeratin 7 used to confirm the diagnosis of urinary bladder cancer. The results revealed a positive and negative reaction between tumor cells and cytokeratin7 antibody.

“Seeing” invisible volatile organic compound (VOC) marker of urinary bladder cancer: A development from bench to bedside prototype spectroscopic device

Urinary bladder cancer (UBC) is one of the most common cancers and has notoriously high risk of recurrence and mortality across the globe. Current clinical initial diagnostic approaches are either invasive or lacks sensitivity. In this study, an attempt has been made to invent a cost-effective, novel, portable diagnostic device based on the environmental sensitive fluorophores namely Nile Red (NR), Eosin Y (EY) and Rose Bengal (RB). They act as sensing agents for detecting volatile organic compounds (VOC) exclusively present in the urine sample of UBC patients and differentiate the UBC samples from the healthy control group. Upon exposure with a particular group of VOCs, a significant amount of increment in fluorescence intensities of NR, EY and RB were detected and recorded in our indigenously developed “NABIL” device. To check the performance of NABIL, the data collected from the device was compared with the conventional techniques by arranging a clinical trial with 21 healthy controls and 52 UBC patients. With the assistance of our analysis technique based on LabVIEW platform, very high sensitivity and accuracy from healthy controls have been achieved. For UBC patients, it shows impressive diagnostic results. In addition, depending on the sample processing mechanism, NABIL device can also reveal the grade of UBC and prognosis under treatment. Overall, this study contributes a novel, non-invasive, easy-to-use, inexpensive, real-time, accurate method for selectively UBC diagnosis, which can be useful for personalized care/diagnosis and postoperative surveillance, resulting in saving more lives.

Urinary Bladder Cancer as a Long-term Sequela of Spinal Cord Injury - Relevance to Practice

Urinary bladder cancer is the second most common tumour disease after lung cancer leading to death in people with a spinal cord injury. This paper provides a comprehensive overview of the differences relevant to urologists between urinary bladder tumours in this population compared with urinary bladder tumours in the general population.People with a spinal cord injury are 1 to 2 decades younger on average at the time of tumour diagnosis than patients without a spinal cord injury. Histopathologic findings at the initial diagnosis of urinary bladder cancer in people with a spinal cord injury are much less favourable than for urinary bladder cancers in the general population. Muscle-invasive tumours and tumours with poor differentiation are much more common, and the proportion of squamous cell carcinomas is significantly higher. The incidence rises after more than 10 years of paralysis. Urinary bladder cancer mortality is significantly elevated and increases with the duration of paralysis. In diagnostic procedures and, in particular, in radical cystectomy, clinically important features have to be considered. For example, urodynamic examinations or cystoscopy may trigger autonomic dysreflexia with hypertensive crises and the risk of life-threatening bradycardia.In the case of radical cystectomy, frequent adhesions and callosities of the urinary bladder, among other things, must be taken into account intraoperatively. Severe paralysis, prolonged intestinal atony and other conditions are frequently observed after the surgical procedure due to neurogenic bowel dysfunction. Correct positioning of the patient immediately after surgery to avoid decubitus and to support breathing, as well as bowel management specific to spinal cord injury, must be strictly observed.Other special features of paraplegic patients with urinary bladder cancer that should also be considered in clinical practice, as well as considerations for screening for urinary bladder tumors, are presented in the article.

Preparation, characterization and evaluation of [125I]-pirarubicin: A new therapeutic agent for urinary bladder cancer with potential for use as theranostic agent

Improving urinary bladder cancer diagnosis, follow-up, and therapy tools to overcome existing limitations and increase survival rates is a highly desirable goal. In the current investigation, pirarubicin, a new generation antineoplastic anthracycline, was labeled with [125I] via an electrophilic substitution reaction. The reaction parameters were studied to optimize the iodination process. The labeled compound showed high radiochemical yield (98.5 ± 2.1%) and consistently remained above 90% for more than 20 h at room temperature and in the presence of serum at 37 °C. The binding of [125I]-pirarubicin to its target DNA-human topoisomerase II complex was assessed in-silico. The in-vitro tracer uptake by cancer cells was high and reached saturation (88.4 ± 2.3%) after 3 h with nuclei to cells ratio of 40 ± 1.2%. The labeled compound antiproliferative effect was much stronger than the unlabelled pirarubicin, as cleared by the growth inhibition test. Radiotoxicity improved cancer cells drug cytotoxicity. The in-vivo evaluation results showed that the [125I]-pirarubicin tends to preferentially accumulate in urinary bladder cancerous tissues.

Urinary bladder cancer as a late sequela of traumatic spinal cord injury

BackgroundTraumatic spinal cord injury (SCI) is also a combat-related injury that is increasing in modern warfare. The aim of this work is to inform medical experts regarding the different course of bladder cancer in able-bodied patients compared with SCI patients based on the latest medical scientific knowledge, and to present decision-making aids for the assessment of bladder cancer as a late sequela of traumatic SCI.MethodsA study conducted between January 1998 and December 2019 in the BG Trauma Hospital Hamburg formed the basis for the decision-making aids. Urinary bladder cancer was diagnosed in 40 out of 7396 treated outpatient and inpatient SCI patients. General patient information, latency period, age at initial diagnosis, type of bladder management and survival of SCI patients with bladder cancer were collected and analysed. T category, grading and tumour entity in these patients were compared with those in the general population. Relevant bladder cancer risk factors in SCI patients were analysed. Furthermore, relevant published literature was taken into consideration.ResultsInitial diagnosis of urinary bladder cancer in SCI patients occurs at a mean age of 56.4 years (SD ± 10.7 years), i.e., approximately 20 years earlier as compared with the general population. These bladder cancers are significantly more frequently muscle invasive (i.e., T category ≥ T2) and present a higher grade at initial diagnosis. Furthermore, SCI patients show a significantly higher proportion of the more aggressive squamous cell carcinoma than that of the general population in areas not endemic for the tropical disease schistosomiasis. Consequently, the survival time is extremely unfavourable. A very important finding, for practical reasons is that, in the Hamburg study as well as in the literature, urinary bladder cancer is more frequently observed after 10 years or more of SCI. Based on these findings, a matrix was compiled where the various influencing factors, either for or against the recognition of an association between SCI and urinary bladder cancer, were weighted according to their relevance.ConclusionsThe results showed that urinary bladder cancer in SCI patients differs considerably from that in able-bodied patients. The presented algorithm is an important aid in everyday clinical practice for assessing the correlation between SCI and bladder cancer.

On Urinary Bladder Cancer Diagnosis: Utilization of Deep Convolutional Generative Adversarial Networks for Data Augmentation.

Urinary bladder cancer is one of the most common urinary tract cancers. Standard diagnosis procedure can be invasive and time-consuming. For these reasons, procedure called optical biopsy is introduced. This procedure allows in-vivo evaluation of bladder mucosa without the need for biopsy. Although less invasive and faster, accuracy is often lower. For this reason, machine learning (ML) algorithms are used to increase its accuracy. The issue with ML algorithms is their sensitivity to the amount of input data. In medicine, collection can be time-consuming due to a potentially low number of patients. For these reasons, data augmentation is performed, usually through a series of geometric variations of original images. While such images improve classification performance, the number of new data points and the insight they provide is limited. These issues are a motivation for the application of novel augmentation methods. Authors demonstrate the use of Deep Convolutional Generative Adversarial Networks (DCGAN) for the generation of images. Augmented datasets used for training of commonly used Convolutional Neural Network-based (CNN) architectures (AlexNet and VGG-16) show a significcan performance increase for AlexNet, where AUCmicro reaches values up to 0.99. Average and median results of networks used in grid-search increases. These results point towards the conclusion that GAN-based augmentation has decreased the networks sensitivity to hyperparemeter change.

Detection Of Urinary Bladder Cancer By (ATR-FTIR) Spectroscopy

Due to the spectroscopic analysis sensitivity to the molecular structure and biochemical variations in the cells, it has received considerable attention recently to be a diagnosis technique of cancer tissues. In the study reported here, a spectra of Attenuated Total Reflection (ATR) Fourier Transform Infrared (FTIR) Spectroscopy, ware taken for 46 samples of urinary bladder tissues that were previously histopathologically specified by pathologist experienced as: 23 normal (N) samples and 23 transitional cell carcinoma (TCC) samples. Several spectral variations were detected in the frequency range between 400 cm-1 and 4000 cm-1.The ratio of bands intensities of A2925/A2853, A1650/A1540 and A1343/A1450 supplied conformational changes of lipids, protein and collagen respectively in the urinary bladder tissues. Between normal and cancerous tissues, there are noticeable variance in the spectral features because during carcinogenesis, the transformation from a normal to a cancerous state accompany variation in molecules structure, where the concentration of lipid is lower in cancerous urinary bladder tissues, unlike normal tissue, while the content of protein and collagen have been increased in cancerous urinary bladder tissues. These differences in the spectral information serve for the diagnosis of urinary bladder cancer and the results displayed that ATR-FTIR spectroscopy is a promising as a rapid, accurate, and simple method utilized for identification and diagnosis of cancerous urinary bladder tissues.

UP69 - Telomerase activity detection in urine for non-invasive diagnosis of urinary bladder cancer and its relapses

UP69 - Telomerase activity detection in urine for non-invasive diagnosis of urinary bladder cancer and its relapses

Serum Paraoxonase-1 Concentration as a Potential Predictor of Urinary Bladder Cancer Recurrence. A Five Year Follow-Up Study

This study provides preliminary information on the usefulness of measuring serum paraoxonase-1 (PON1) concentration and activity (and other inflammatory markers) to predict tumor recurrence in patients with urinary bladder cancer. We studied a total of 39 hospitalized patients in whom the diagnosis of urinary bladder cancer was confirmed by transurethral resection. After five years of follow-up, 29 patients presented with tumor recurrence. As control subjects, we also studied 61 healthy subjects and a further 132 hospitalized patients who had a urinary catheter-related infection due to causes other than cancer. Results showed that urinary bladder patients had lower serum PON1 concentration and activity, and higher chemokine (C-C motif) ligand 2, C-reactive protein, and procalcitonin concentrations than the control individuals. Patients with tumor recurrence had significantly lower serum PON1 concentration than patients without tumor recurrence. The mean area under the curve of the receiver operating characteristics plot for serum PON1 concentration in discriminating patients with and those without tumor recurrence was 0.755 and the best combination of sensitivity and specificity was obtained at PON1=100mg/L (0.72 and 0.80, respectively). Establishing this value as a cut-off, positive predictive value was=0.91, and negative predictive value was=0.50. These results suggest that the measurement of serum PON1 concentration may be a high-sensitivity marker of tumor recurrence in urinary bladder cancer patients.

Long non-coding RNA urothelial carcinoma-associated 1 as a tumor biomarker for the diagnosis of urinary bladder cancer.

To investigate the diagnostic value of urothelial carcinoma-associated 1 as a urine biomarker in urinary bladder cancer patients by performing a comprehensive meta-analysis. A comprehensive literature search was conducted by the databases PubMed, Embase, Cochrane Library, China Knowledge Resource Integrated, and Web of Science. The quality of eligible studies was scored with the Quality Assessment of Diagnostic Accuracy Studies. The bivariate meta-analysis model was used to pool the sensitivity, specificity, likelihood ratio, and diagnostic odds ratio. Receiver operating characteristic curves and hierarchical summary receiver operating characteristic models were employed to check the overall test performance in this meta-analysis. Seven publications involving 678 patients and 563 controls were included in this meta-analysis. The pooled sensitivity was 0.84 (95% confidence interval: 0.80-0.88), specificity was 0.87 (95% confidence interval: 0.75-0.94), positive likelihood ratio was 6.5 (95% confidence interval: 3.10-13.62), negative likelihood ratio was 0.18 (95% confidence interval: 0.13-0.25), and diagnostic odds ratio was 36 (95% confidence interval: 13-99). The area under the summary receiver operating characteristic curve was 0.89 (95% confidence interval: 0.86-0.91). Our results indicated that urothelial carcinoma-associated 1 was a potential diagnostic biomarker with good specificity and sensitivity in urinary bladder cancer. Further prospective studies with larger cohorts are necessary to evaluate the diagnostic accuracy of urothelial carcinoma-associated 1 for urinary bladder cancer.

Clinical value of digital image analysis in the diagnosis of urinary bladder cancer, particularly in aggressive tumors: a preliminary report.

The aim of the project was to evaluate the clinical value of a computer analysis of cytological specimen images obtained from urine and bladder washing samples. Three sample types (voided urine, catheterized urine and bladder washing) from 59 patients with primary or recurrent tumor were analyzed. All patients underwent cystoscopy and biopsy or resection. The histological results were compared with the results of the image analyzing computer system of collected urine samples. The consistency between the computer diagnosis and the clinical or histological diagnosis both in the presence and absence of cancer was as follows: 77% for voided urine samples, 72.5% for catheterized urine samples and 78% for bladder washing samples. The specificity of the method at the standard pathology level was 71%, and the sensitivity was 83%. The positive and negative predictive values (PPV and NPV) were 87.5% and 63% respectively. The sensitivity for G3 or CIS or T2 or T3 tumors reached nearly 100%. Computer analysis of urine provided correct diagnoses in cancer and control patients with the sensitivity of 83% and specificity of 71% and gave excellent results in aggressive tumors such as T2, T3, G3 and in CIS.

Diagnostic value of [18F] FDG-PET and PET/CT in urinary bladder cancer: a meta-analysis.

An early diagnosis of urinary bladder cancer is crucial for early treatment and management. The objective of this systematic review was to assess the overall diagnostic accuracy of 18 F FDG-PET and PET/CT in urinary bladder cancer with meta-analysis. The PubMed and CNKI databases were searched for the eligible studies published up to June 01, 2014. The sensitivity, specificity, and other measures of accuracy of 18 F FDG-PET and PET/CT in the diagnosis of urinary bladder cancer were pooled along with 95 % confidence intervals (CI). Summary receiver operating characteristic (ROC) curves were used to summarize overall test performance. Ten studies met our inclusion criteria. The summary estimates for 18 F FDG-PET and PET/CT in the diagnosis of urinary bladder cancer in meta-analysis were as follows: a pooled sensitivity, 0.82 (95 % confidence interval [CI], 0.75 to 0.88); a pooled specificity, 0.92 (95 % CI, 0.87 to 0.95); positive likelihood ratio, 6.80 (95 % CI, 4.31 to 10.74); negative likelihood ratio, 0.27 (95 % CI, 0.19 to 0.36); and diagnostic odds ratio, 25.18 (95 % CI, 17.58 to 70.4). The results indicate that 18 F FDG-PET and PET/CT are relatively high sensitive and specific for the diagnosis of urinary bladder cancer.

Screening for urinary bladder cancer with the use of nuclear matrix protein (NMP) 22: is it feasible?

Background Tobacco use accounts for the majority of urinary bladder cancer (UBC) cases both in men and women. It is widely accepted that smokers have increased risk of UBC [1-4]. An early diagnosis of UBC is crucial because patients with superficial UBC have much better prognosis than those with invasive UBC [1,2,4,5]. During the past years a variety of urine based markers have been introduced for screening of UBC. Nuclear matrix protein 22 (NMP22) is a nuclear protein that is accountable for chromatid regulation and cell separation during replication. The detection of NMP22 has been used from many clinical studies to evaluate the possibility of UBC screening [2,6-8]. The purpose of this review is to access the current literature in order to determine the usefulness of NMP22 in screening of UBC.

Risk of in‐hospital complications after radical cystectomy for urinary bladder carcinoma: population‐based follow‐up study of 7608 patients

ObjectiveTo evaluate the risk of different in-hospital complications for patients undergoing a radical cystectomy (RC), as limited nationwide population data on short- and long-term complications after RC is available, despite it being the standard treatment for localised muscle-invasive urinary bladder cancer (UBC).Patients and MethodsIn all, 7608 persons underwent a RC after UBC diagnosis, as registered in the Swedish National Patient Register between 1964 and 2008.We estimated the frequency and incidences and calculated hazard ratios (HR) and 95% confidence intervals (CI) using multivariate Cox proportional hazards models.ResultsUrinary tract infection/septicaemia was the most common complication following radical cystectomy, with an incidence of 90.4 per 1,000 person years.There was a higher risk of urinary tract infection among patients who had a continent cutaneous reservoir (HR: 1.11 (0.94–1.30) or orthotopic neobladder 1.21 (1.05–1.39) than among those with ileal conduit.Similarly, continent cutaneous reservoir and orthotopic neobladder were associated with increased risks for wound and abdominal wall hernias, stones in the urinary tract, hydronephrosis and nephrostomy tube treatment, and kidney failure.In contrast, risk of bowel obstruction was lower among those with orthotopic neobladder than those with ileal conduit (HR: 0.64 (0.50–0.81)) and those with continent cutaneous reservoir (HR: 0.92 (0.73–1.16).ConclusionsIn-hospital complications after RC are numerous and continue to accumulate for many years after surgery, indicating the need for life-long follow-up of these patients.Comparison between different types of diversion should, however, be made with care because of potential confounding by indication.

The diagnostics of the superficialtransitional cell bladder carcinoma

The literature review is devoted to current methods of transitional cell urinary bladder cancer diagnosis and is based on European association of urology guidelines. Perspectives of the future development of diagnostic tests aimed towards higher sensitivity and specificity in early stages of bladder cancer development are shown.

P626 Prevalence of different immune mediated inflammatory diseases in patients with inflammatory bowel disease. AQUILES study

age of these patients was 50±12, 61% were males, 33% were being treated with thiopurines and 6% were on anti-TNF drugs. The average period from IBD diagnosis to cancer development was 71 months (IQR 21 111). The cancer incidence rate among IBD patients was 0.53% per patient-year of follow-up. The specific type of cancer and the RR compared with the local population are shown in Table 1. All patients with urinary bladder cancer diagnosis were men and all patients with breast cancer had previous family history. Colorectal cancer diagnoses were not found despite dysplasia screening by colonoscopy being performed following standard recommendations.