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442 Increased rates of false positive urine based bladder cancer markers due to impaired renal function
442 - Increased rates of false positive urine based bladder cancer markers due to impaired... Page 1 of 2
e442 Increased rates of false positive urine based bladder cancer markers due to impaired renal function Todenhöfer T., Hennenlotter J., Witstruk M., Gakis G., Aufderklamm S., Kühs U., Stenzl A., Schwentner C. Eberhard-Karls-University, Dept. of Urology, Tübingen, Germany INTRODUCTION & OBJECTIVES: In case of hematuria (HU) urinebased tests are used for the detection of bladder cancer (BC) although their diagnostic yield remains insufficient. This is due to several influencing variables including infection (UTI). Many are elderly having renal insufficiency and proteinuria being an additional influencing factor. No data are available regarding the accuracy of urine-based BC tests in conjunction with renal function. MATERIAL & METHODS: Urine samples of 449 patients with HU and histological work-up were included. Cytology (CYT) as well as FISH, immunocytology and NMP22 were performed. Renal function was classified as normal, impaired and severely impaired based on serum creatinine, glomerular filtration rate (GFR) and proteinuria. Rates of false positives were statistically compared with regards to renal function. RESULTS: 382 patients did not have BC. There were increased rates of false positives with regards to creatinine and GFR-levels. NMP22 test showed 22.0 % false positives in the normal function cohort and 46.7% in those with limited function (p= 0.05). Similar trends could be observed regarding proteinuria. Indeterminate significance was detected separating those with severely impaired function for immunocytology (0.08) and in the normal group for FISH (0.06). Proteinuria was a significant factor for CYT (p=0.0017) with increased false positive results event in the absensence of UTI (p=0.05). CONCLUSIONS: This is the first study about renal function and accuracy of urine-based BC-markers. Renal function influences their diagnostic yield. Reduced GFR was associated with increased false
file://F:\RamShankar\April\04-05-12\Cip\Sour\442.html
4/7/2012
442 - Increased rates of false positive urine based bladder cancer markers due to impaired... Page 2 of 2
e442a positive NMP22 while proteinuria decreased the specificity of CYT. Hence, renal function should be considered whenever urine-based BCtests are interpreted.
file://F:\RamShankar\April\04-05-12\Cip\Sour\442.html
4/7/2012
e442 Increased rates of false positive urine based bladder cancer markers due to impaired renal function Todenhöfer T., Hennenlotter J., Witstruk M., Gakis G., Aufderklamm S., Kühs U., Stenzl A., Schwentner C. Eberhard-Karls-University, Dept. of Urology, Tübingen, Germany INTRODUCTION & OBJECTIVES: In case of hematuria (HU) urinebased tests are used for the detection of bladder cancer (BC) although their diagnostic yield remains insufficient. This is due to several influencing variables including infection (UTI). Many are elderly having renal insufficiency and proteinuria being an additional influencing factor. No data are available regarding the accuracy of urine-based BC tests in conjunction with renal function. MATERIAL & METHODS: Urine samples of 449 patients with HU and histological work-up were included. Cytology (CYT) as well as FISH, immunocytology and NMP22 were performed. Renal function was classified as normal, impaired and severely impaired based on serum creatinine, glomerular filtration rate (GFR) and proteinuria. Rates of false positives were statistically compared with regards to renal function. RESULTS: 382 patients did not have BC. There were increased rates of false positives with regards to creatinine and GFR-levels. NMP22 test showed 22.0 % false positives in the normal function cohort and 46.7% in those with limited function (p= 0.05). Similar trends could be observed regarding proteinuria. Indeterminate significance was detected separating those with severely impaired function for immunocytology (0.08) and in the normal group for FISH (0.06). Proteinuria was a significant factor for CYT (p=0.0017) with increased false positive results event in the absensence of UTI (p=0.05). CONCLUSIONS: This is the first study about renal function and accuracy of urine-based BC-markers. Renal function influences their diagnostic yield. Reduced GFR was associated with increased false
file://F:\RamShankar\April\04-05-12\Cip\Sour\442.html
4/7/2012
442 - Increased rates of false positive urine based bladder cancer markers due to impaired... Page 2 of 2
e442a positive NMP22 while proteinuria decreased the specificity of CYT. Hence, renal function should be considered whenever urine-based BCtests are interpreted.
file://F:\RamShankar\April\04-05-12\Cip\Sour\442.html
4/7/2012