방광암 진단에 있어서 요ThinPrep® 검사와 요세포검사의 유용성 비교
A Comparison of the Availability of the Urine ThinPrep®test and Urine Cytology in the Diagnosis of Bladder Cancer
박연원, 정진행, 이현무,
소속 상세정보
박연원 ( Park Yeon-Won )
원자력병원 비뇨기과
정진행 ( Chung Jin-Haeng )
원자력병원 병리학과
이현무 ( Lee Hyun-Moo )
성균관대학교 의과대학 비뇨기과학교실
KMID : 0358320030440080734
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®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®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®test was 75% versus 47.5% for urine cytology (p=0.012). In the control group (n=41), the specificity of the urine ThinPrep? 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?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?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®test. Therefore it can be concluded that the urine ThinPrep®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.
키워드
Bladder cancer; Tumor makers; Cytology; Urine
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