Precisión de Bladder EpiCheck en el diagnóstico del carcinoma urotelial del tracto urinario superior: un metaanálisis

IF 1.2 4区医学 Q3 UROLOGY & NEPHROLOGY

Actas urologicas espanolas Pub Date : 2025-05-01 DOI:10.1016/j.acuro.2025.501720

S. Artero Fullana , J. Caño Velasco , A. Lafuente Puentedura , L. Polanco Pujol , V. Bataller Monfort , M. Moralejo Gárate , J.D. Subiela , A. Gallioli , M. Moschini , R. Pichler , F. del Giudice , G. Marcq , J. Teoh , F. Soria , L. Mertens , W. Krajewski , E. Laukhtina , K. Mori , B. Pradere , L. Afferi , C. Hernández Fernández

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引用次数: 0

Abstract

Introduction and objective

Current upper tract urothelial carcinoma (UTUC) diagnosis and disease management rely on the combination of CT Urography (CTU), cytology and ureteroscopy (URS). The limited accuracy and complications associated with these tools have led to the search for non-invasive and reliable biomarkers. Our aim was to review and analyse the existing data on the use of Bladder EpiCheck® to assess its performance as a diagnostic tool for UTUC.

Material and methods

A literature search on the diagnostic value of Bladder EpiCheck® as a urinary biomarker in UTUC was conducted through PubMed, Web of Science and Scopus until February 2024. Pooled sensitivity (Se), specificity (Sp), negative predictive value (NPV) and positive predictive value (PPV) of the biomarker were calculated. Diagnostic performance was assessed through the area under the curve (AUC).

Results

Four studies, including 334 patients, were included in the quantitative analysis. Bladder EpiCheck® showed promising pooled diagnostic values with Se of 0.85 (95% CI: 0.55-0.96), Sp of 0.93 (95% CI: 0.56-0.99), PPV of 0.74 (95% CI: 0.54-0.87) and NPV of 0.84 (95% CI: 0.77-0.89). The exact AUC obtained was 0.912.

Conclusions

Bladder EpiCheck® is an effective diagnostic tool in UTUC, showing a promising diagnostic accuracy, with a Se and NPV of 85% and 84%, respectively. Its use in UTUC diagnosis and follow-up could reduce or postpone the need for more invasive procedures, such as URS, thereby reducing the procedure-associated risks and improving patients’ quality of life. Although further research and large prospective studies are needed, the current results indicate that Bladder EpiCheck® is a promising tool in UTUC diagnosis, treatment decision-making, and follow-up.

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膀胱EpiCheck在上尿道输尿管癌诊断中的准确性：荟萃分析

简介与目的目前上尿路上皮癌（UTUC）的诊断和治疗依赖于CT尿路造影（CTU）、细胞学和输尿管镜检查（URS）的结合。这些工具有限的准确性和相关的并发症促使人们寻找非侵入性和可靠的生物标志物。我们的目的是回顾和分析膀胱EpiCheck®使用的现有数据，以评估其作为UTUC诊断工具的性能。材料与方法通过PubMed、Web of Science和Scopus检索膀胱EpiCheck®作为尿液生物标志物在UTUC诊断价值的文献，检索截止至2024年2月。计算该生物标志物的综合敏感性（Se）、特异性（Sp）、阴性预测值（NPV）和阳性预测值（PPV）。通过曲线下面积（AUC）评估诊断效果。结果纳入4项研究，共纳入334例患者。膀胱EpiCheck®显示出有希望的综合诊断价值，Se为0.85 (95% CI: 0.55-0.96)， Sp为0.93 (95% CI: 0.56-0.99)， PPV为0.74 (95% CI: 0.54-0.87)， NPV为0.84 （95% CI: 0.77-0.89）。得到的精确AUC为0.912。结论膀胱EpiCheck®是一种有效的诊断UTUC的工具，其Se和NPV分别为85%和84%，具有良好的诊断准确性。它在UTUC诊断和随访中的应用可以减少或推迟对更具侵入性的手术的需要，例如尿路手术，从而减少手术相关的风险，提高患者的生活质量。虽然还需要进一步的研究和大规模的前瞻性研究，但目前的结果表明，膀胱EpiCheck®在UTUC的诊断、治疗决策和随访中是一个很有前景的工具。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Actas urologicas espanolas UROLOGY & NEPHROLOGY-

CiteScore

1.90

自引率

0.00%

发文量

审稿时长

46 days

期刊介绍： Actas Urológicas Españolas is an international journal dedicated to urological diseases and renal transplant. It has been the official publication of the Spanish Urology Association since 1974 and of the American Urology Confederation since 2008. Its articles cover all aspects related to urology. Actas Urológicas Españolas, governed by the peer review system (double blinded), is published online in Spanish and English. Consequently, manuscripts may be sent in Spanish or English and bidirectional free cost translation will be provided.