在高风险非肌层浸润性膀胱癌的随访中使用膀胱Epicheck®:系统性文献综述。

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引用次数: 0

摘要

简介:目的:对膀胱Epicheck®及其在非肌层浸润性膀胱癌(NMIBC)随访和复发检测中的临床应用进行系统综述:根据PRISMA和Quadas-2标准,在PubMed、Web of Science和Scopus数据库中进行文献检索,系统综述截至2023年10月。计算标记物的敏感性(Se)、特异性(Sp)、阳性预测值(PPV)和阴性预测值(NPV)。诊断性能通过曲线下面积(AUC)进行评估:分析了 15 项研究(n = 3761),其中 86.7% 为前瞻性研究。53.2%的患者曾接受过膀胱内注射。生物标记物检测复发的平均 Se 因肿瘤级别而异(高级别/HG 与低级别/LG 分别为 87.9% 与 44.9%)。它们的加权平均 Se 和 Sp 分别为 71.6% 和 84.5%。平均复发率为 29.1%。加权平均PPV和NPV分别为56.4%和92.8%(非LG为97.7%)。平均AUC为85.63%:结论:膀胱Epicheck®是随访NMIBC的一种有用的尿液标记物,在检测复发,尤其是HG病例方面具有显著的高Se和NPV。使用它可以减少 NMIBC 随访中所需的膀胱镜检查次数,提高患者的生活质量,并有可能节约更多的医疗经济成本。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Use of Bladder Epicheck® in the follow-up of non-muscle-invasive Bladder cancer: A systematic literature review

Introduction

In recent years, different urinary markers such as the Bladder Epicheck® have been developed in an attempt to reduce the number of cystoscopies in the follow-up of non-muscle invasive bladder cancer (NMIBC).

Aim

To provide a systematic review of Bladder Epicheck® and its current clinical utility in the follow-up and detection of recurrence of NMIBC.

Material and methods

Systematic review based on a literature search of PubMed, Web of Science and Scopus databases until October 2023, according to PRISMA and Quadas-2 criteria. Sensitivity (Se), specificity (Sp), positive predictive value (PPV) and negative predictive value (NPV) of the marker were calculated. Diagnostic performance was evaluated by the area under the curve (AUC).

Results

Fifteen studies were analyzed (n = 3761) including 86.7% prospective studies. Of the patient series, 53.2% had received previous intravesical instillations. The mean Se of the biomarker in the detection of recurrence varied according to tumor grade (87.9%-high grade/HG vs. 44.9%-low grade/LG, respectively). Their weighted mean Se and Sp were 71.6% and 84.5%, respectively. The mean recurrence rate was 29.1%. The weighted mean PPV and NPV were 56.4% and 92.8% (97.7% non-LG), respectively. The mean AUC was 85.63%.

Conclusion

Bladder Epicheck® is a useful urinary marker in the follow-up of NMIBC, with significantly high Se and NPV in the detection of recurrences, especially in cases of HG disease. Its use can reduce the number of cystoscopies required in the follow-up of NMIBC, improving the quality of life of patients and potentially increasing health economic savings.
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