A Comparison of the Availability of the Urine ThinPrep(R)test and Urine Cytology in the Diagnosis of Bladder Cancer

Park, Yeon Won; Chung, Jin Haeng; Lee, Hyun Moo

Abstract

PURPOSE: In noninvasive tests for the diagnosis of bladder cancer, it has been reported that urine cytology has high specificity but low sensitivity. This study compared urine cytology and the urine ThinPrep(R)test, a recently introduced noninvasive test, for assessing the diagnosis of bladder cancer.
MATERIALS AND METHODS
A single voided urine samples were obtained preoperatively from patients diagnosed with a transitional cell carcinoma of the bladder following a transurethral resection(TURB). The sensitivity and specificity of the urine ThinPrep(R)test was compared with the urine cytology, according to pathological stage, grade, size and number.
RESULTS
In the test group(n=40), the overall sensitivity of the urine ThinPrep(R)test was 75% versus 47.5% for urine cytology(p=0.012). In the control group(n=41), the specificity of the urine ThinPrep(R)test was 97.7% versus 100% for urine cytology (p=0.314). The sensitivity of urine cytology increased with the increasing pathological stage, grade, tumor size and number. Although not significant, the sensitivity of the urine ThinPrep(R)test also increased as the grade, tumor size and number increased, but not for the pathological stage. In the <3cm, single, grade 2 and stage Ta groups the urine ThinPrep(R)test gave a significantly higher increase in the sensitivity than for the same groups by urine cytology.
CONCLUSIONS
Although there was no significant increase in the sensitivity with grade 1 and stage T1, there were significant increases in the groups of stage Ta, grade 2, single and small size(<3cm) with the urine ThinPrep(R)test. Therefore it can be concluded that the urine ThinPrep(R)test has a potential to increase the sensitivity in low grade, low stage bladder cancer without loss of the high level of specificity and warrants further investigation, with more cases and controls, as an ancillary noninvasive test, with cystoscopy, in the diagnosis of bladder cancer.