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KMID : 1001020070050030111
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Korean Journal of Urological Oncology
2007 Volume.5 No. 3 p.111 ~ p.115
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Is Cytology Still the Gold Standard?: Updates in Tumor Markers and Recent Research
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Lee Gil-Ho
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Abstract
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Carcinoma of the urinary bladder is a common malignant tumor of the urinary tract in Korea. The majority of bladder cancer patients present with superficial papillary disease. Furthermore, 50% of patients with superficial bladder cancer will have recurrent diseases during follow-up. These statistics emphasize the need for close long-term follow up for all bladder cancer patients. Cystoscopy and urine cytology have been a gold standard to do a follow-up the patients for at least 50 years. However, the cystoscopic examination is an invasive procedure and some patients after the cystoscopic examination complains of pain and urinary tract infection. Urine cytology is a noninvasive study and a high specificity for tumor follow-ups. However, it gives false-negatives in about half of cases, mainly in patients with low-grade, early-stage tumors. It is therefore evident that more sensitive noninvasive diagnostic approaches are warranted to replace the urine cytology or give more additive information to the patients. Recent evidence has suggested that new developed markers(BTA stat, BTA TRAK, BTA, NMP22, ImmunoCyt, Hb-dipstick, FISH, Telomerase, Microsatellite, CYFRA21-1, UBC, Cytokeratin20) are used in the world. However, all above tests have pros and cons to be widely used in the point of specificity and sensitivity, clinical convenience, and expenses. Because limited tests are available in Korean market, it is impossible to evaluate all new tests in my experiences. Therefore, I performed online search and obtain references of the various urine tests.
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KEYWORD
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Urinary bladder, Neoplasms, Tumor markers, Cytology
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