Comparisons of voided urine cytology, nuclear matrix protein-22 and bladder tumor associated antigen tests for bladder cancer of geriatric male patients in Taiwan, China.

AIM: To compare the results of bladder tumor associated antigen (BTA TRAK), nuclear matrix protein 22 (NMP 22) and voided urine cytology (VUC) in detecting bladder cancer. METHODS: A total of 135 elderly male and 50 healthy volunteers enrolled in this study were classified into three groups: (i) 93 patients with bladder cancer; (ii) 42 patients with urinary benign conditions; and (iii) 50 healthy volunteers. BTA TRAK and NMP 22 kits were used to detect bladder cancer. Voided urine cytology was used to compare the sensitivity and specificity of the screening tests. RESULTS: The sensitivity and specificity of cytology, BTA TRAK and NMP 22 were 24% and 97%, 51% and 73%, 78% and 73%, respectively. The level of NMP 22 increased with tumor grading. The BTA TRAK kit has the lowest sensitivity among the screening tests. The NMP 22 with the best sensitivity can be an adjunct to cytology for evaluating bladder cancer. CONCLUSION: The NMP 22 test has a better correlation with the grading of the bladder cancer than BTA TRAK. As cytology units are typically not available in hospitals or in outpatient clinics, NMP 22 might be a promising tool for screening bladder cancer.

Correlation between the Gleason scores of needle biopsies and radical prostatectomy specimens.

BACKGROUND: The Gleason score has been shown to offer important information with regard to prognosis and therapy for patients with adenocarcinoma of the prostate gland. In this study, Gleason scores, as determined by 18-gauge core needle biopsies, were compared with both Gleason scores and the pathological staging of corresponding radical prostatectomy specimens. METHODS: Records of 78 consecutive patients undergoing a radical retropubic prostatectomy between 1998 and 2002 were reviewed. In total, 78 patients were enrolled, all of whom had been diagnosed with adenocarcinoma by transrectal needle biopsies using an 18-gauge automated spring-loaded biopsy gun. RESULTS: Grading errors were greatest with well-differentiated tumors. The accuracy was 6 (23%) for Gleason scores of 2-4 on needle biopsy. Of the 36 evaluable patients with Gleason scores of 5-7 on needle biopsy, 28 (78%) were graded correctly. All of the Gleason scores of 8-10 on needle biopsy were graded correctly. Eighteen (33%) of 54 patients with a biopsy Gleason score of < 7 had their cancer upgraded to above 7. Tumors in 6 patients (60%) with both a Gleason score < 7 on the needle biopsy and a Gleason score of 7 for the prostatectomy specimen were confined to the prostate. CONCLUSION: The potential for grading errors is greatest with well-differentiated tumors and in patients with a Gleason score of < 7 on the needle biopsy. Predictions using Gleason scores are sufficiently accurate to warrant its use with all needle biopsies, recognizing that the potential for grading errors is greatest with well-differentiated tumors.