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Thomas Flaig, MD


Novel Combination Approach to Diagnosing Recurrent Urinary Bladder Cancer

By: Joshua D. Madera, MD
Posted: Tuesday, October 3, 2023

Current investigative efforts have been dedicated to evaluating novel diagnostic modalities to identify patients with recurrent urinary bladder carcinoma, according to a study published in the World Journal of Surgical Oncology. The combined approach of evaluating methylation levels of the tumor suppressor DAPK in urinary sediment with B ultrasound may prove to offer increased diagnostic value, suggested Changli Wu, MD, of the Second Hospital of Tianjin Medical University, China, and colleagues.

“Future research should focus on evaluating the screening and diagnostic tools for bladder cancer using the combined detection of DAPK methylation and B ultrasound, taking into consideration factors such as histologic grade, tumor stage, grade, muscle invasiveness, and racial/ethnic disparities. Furthermore, larger studies with diverse patient populations are needed to validate our findings and ensure the reliability of clinical research in this field,” the study authors noted.

From 2014 to 2016, 1,021 cases of patients with primary urinary bladder carcinoma were retrospectively reviewed for the study. All patients had undergone transurethral electrocision of their bladder tumor. Patients attended regular follow-up appointments, where a series of additional assessments were performed including DAPK methylation in urinary sediment, B ultrasound in the bladder, cystoscopic observation, and detection of exfoliated cells in the urine.

The study authors reported consistency in their findings when comparing cystoscopy with B ultrasound (Kappa = 0.785) and DAPK methylation in urinary sediment (Kappa = 0.517). This consistency was similarly observed when compared with the combined analysis of B ultrasound and DAPK methylation in urinary sediment (Kappa = 0.593). Furthermore, when B ultrasound was combined with DAPK methylation, the sensitivity of this diagnostic tool was 92.9%, the specificity was 91.6%, and the negative predictive value was 99.4%. These findings suggest that patients who obtained a negative result on this combined diagnostic modality may have an increasingly low risk of tumor recurrence.

Disclosure: The study authors reported no conflicts of interest.

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