The authors found that urine cytology detected high- grade disease in 8/15 patients with high-grade disease biopsy results who received induction BCG. In this group, cytology had a sensitivity of 53% (95% CI 27–79%), a specificity of 95% (95% CI 84–99%), a positive predictive value of 80% (95% CI 44–98%), and a negative predictive value of 85% (95% CI 71–94%).In the high grade and suspicious for high grade, urine cytology has a sensitivity of 67% (95% CI 38–88%) and specificity of 88% (95% CI 74–96%).
The authors conclude that while urinary cytology maintains a high specificity following intravesical therapy, it has low sensitivity for high-grade urothelial carcinoma. This study highlights the need for biomarkers that predict recurrences of NMIBC following intravesical BCG. Cell-free DNA technology is a promising developing technology in this space.
Written by: Bishoy M. Faltas, MD, Director of Bladder Cancer Research, Englander Institute for Precision Medicine, Weill Cornell Medicine
1. Gupta M, Milbar N, Tema G, Pederzoli F, Chappidi M, Kates M, VandenBussche CJ, Bivalacqua TJ. Impact of intravesical therapy for non-muscle invasive bladder cancer on the accuracy of urine cytology. World J Urol. 2019 Oct;37(10):2051-2058. DOI: 10.1007/s00345-018-02624-3. Epub 2019 Jan 23.
Read the Abstract