Nomograms including the UBC (R) Rapid test to detect primary bladder cancer based on a multicentre dataset
Por:
Meisl, CJ, Karakiewicz, PI, Einarsson, R, Koch, S, Hallmann, S, Weiss, S, Hemdan, T, Malmstrom, PU, Styrke, J, Sherif, A, Hasan, MN, Pichler, R, Tulchiner, G, Palou, J, Faba, OR, Hennenlotter, J, Stenzl, A, Ritter, R, Niegisch, G, Grunewald, CM, Schlomm, T, Friedersdorff, F, Barski, D, Otto, T, Gossl, A, Arndt, C, Esuvaranathan, K, Kesavan, NR, Zang, ZJ, Kramer, MW, Hennig, MJP, Ecke, TH
Publicada:
1 dic 2022
Ahead of Print:
1 ene 2022
Resumen:
Objectives
To evaluate the clinical utility of the urinary bladder cancer antigen test UBC (R) Rapid for the diagnosis of bladder cancer (BC) and to develop and validate nomograms to identify patients at high risk of primary BC.
Patients and Methods
Data from 1787 patients from 13 participating centres, who were tested between 2012 and 2020, including 763 patients with BC, were analysed. Urine samples were analysed with the UBC (R) Rapid test. The nomograms were developed using data from 320 patients and externally validated using data from 274 patients. The diagnostic accuracy of the UBC (R) Rapid test was evaluated using receiver-operating characteristic curve analysis. Brier scores and calibration curves were chosen for the validation. Biopsy-proven BC was predicted using multivariate logistic regression.
Results
The sensitivity, specificity, and area under the curve for the UBC (R) Rapid test were 46.4%, 75.5% and 0.61 (95% confidence interval [CI] 0.58-0.64) for low-grade (LG) BC, and 70.5%, 75.5% and 0.73 (95% CI 0.70-0.76) for high-grade (HG) BC, respectively. Age, UBC (R) Rapid test results, smoking status and haematuria were identified as independent predictors of primary BC. After external validation, nomograms based on these predictors resulted in areas under the curve of 0.79 (95% CI 0.72-0.87) and 0.95 (95% CI: 0.92-0.98) for predicting LG-BC and HG-BC, respectively, showing excellent calibration associated with a higher net benefit than the UBC (R) Rapid test alone for low and medium risk levels in decision curve analysis. The R Shiny app allows the results to be explored interactively and can be accessed at www.blucab-index. net.
Conclusion
The UBC (R) Rapid test alone has limited clinical utility for predicting the presence of BC. However, its combined use with BC risk factors including age, smoking status and haematuria provides a fast, highly accurate and non-invasive tool for screening patients for primary LG-BC and especially primary HG-BC.
Filiaciones:
Meisl, CJ:
Charite Univ Med Berlin, Dept Urol, Charitepl 1, D-10117 Berlin, Germany
Free Univ Berlin, Berlin, Germany
Humbold Univ Berlin, Berlin, Germany
Berlin Inst Hlth, Berlin, Germany
Karakiewicz, PI:
Univ Montreal, Dept Surg, Montreal, PQ, Canada
Einarsson, R:
IDL Biotech, Bromma, Sweden
Koch, S:
HELIOS Hosp Bad Saarow, Dept Pathol, Bad Saarow Pieskow, Germany
Brandenburg Med Sch Theodor Fontane, Neuruppin, Germany
Hallmann, S:
HELIOS Hosp Bad Saarow, Dept Urol, Bad Saarow Pieskow, Germany
Weiss, S:
HELIOS Hosp Bad Saarow, Dept Urol, Bad Saarow Pieskow, Germany
Hemdan, T:
Uppsala Univ, Dept Surg Sci, Uppsala, Sweden
Malmstrom, PU:
Uppsala Univ, Dept Surg Sci, Uppsala, Sweden
Styrke, J:
Umea Univ, Dept Surg & Perioperat Sci Urol & Androl, Umea, Sweden
Sherif, A:
Umea Univ, Dept Surg & Perioperat Sci Urol & Androl, Umea, Sweden
Hasan, MN:
Danderyd Hosp, Dept Urol, Danderyd, Sweden
Pichler, R:
Med Univ Innsbruck, Dept Urol, Innsbruck, Austria
Tulchiner, G:
Med Univ Innsbruck, Dept Urol, Innsbruck, Austria
Palou, J:
Autonomous Univ Barcelona, Dept Urol, Fundacio Puigvert, Barcelona, Spain
Faba, OR:
Autonomous Univ Barcelona, Dept Urol, Fundacio Puigvert, Barcelona, Spain
Hennenlotter, J:
Univ Hosp Tubingen, Dept Urol, Tubingen, Germany
Stenzl, A:
Univ Hosp Tubingen, Dept Urol, Tubingen, Germany
Ritter, R:
Diakonie Klinikum Stuttgart, Dept Urol, Stuttgart, Germany
Niegisch, G:
Heinrich Heine Univ Dusseldorf, Dept Urol, Fac Med, Dusseldorf, Germany
Grunewald, CM:
Heinrich Heine Univ Dusseldorf, Dept Urol, Fac Med, Dusseldorf, Germany
Schlomm, T:
Charite Univ Med Berlin, Dept Urol, Charitepl 1, D-10117 Berlin, Germany
Free Univ Berlin, Berlin, Germany
Humbold Univ Berlin, Berlin, Germany
Berlin Inst Hlth, Berlin, Germany
Friedersdorff, F:
Charite Univ Med Berlin, Dept Urol, Charitepl 1, D-10117 Berlin, Germany
Free Univ Berlin, Berlin, Germany
Humbold Univ Berlin, Berlin, Germany
Berlin Inst Hlth, Berlin, Germany
Evangel Krankenhaus Konigin Elisabeth Herzberge, Dept Urol, Berlin, Germany
Barski, D:
Rheinland Klinikum Neuss, Dept Urol, Neuss, Germany
Otto, T:
Rheinland Klinikum Neuss, Dept Urol, Neuss, Germany
Univ Duisburg Essen, Med Fac, Essen, Germany
Gossl, A:
HELIOS Hosp Krefeld, Dept Urol, Krefeld, Germany
Arndt, C:
HELIOS Hosp Krefeld, Dept Urol, Krefeld, Germany
Esuvaranathan, K:
Natl Univ Singapore Hosp, Dept Urol, Singapore, Singapore
Kesavan, NR:
Natl Univ Singapore Hosp, Dept Urol, Singapore, Singapore
Zang, ZJ:
Natl Univ Singapore Hosp, Dept Urol, Singapore, Singapore
Kramer, MW:
Univ Hosp Schleswig Holstein, Dept Urol, Campus Lubeck, Lubeck, Germany
Hennig, MJP:
Univ Hosp Schleswig Holstein, Dept Urol, Campus Lubeck, Lubeck, Germany
Ecke, TH:
Charite Univ Med Berlin, Dept Urol, Charitepl 1, D-10117 Berlin, Germany
Free Univ Berlin, Berlin, Germany
Humbold Univ Berlin, Berlin, Germany
Berlin Inst Hlth, Berlin, Germany
HELIOS Hosp Bad Saarow, Dept Urol, Bad Saarow Pieskow, Germany
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