UroVysion FISH test for detecting urothelial cancers: Meta-analysis of diagnostic accuracy and comparison with urinary cytology testing
UroVysion FISH test for detecting urothelial cancers: Meta-analysis of diagnostic accuracy and comparison with urinary cytology testing
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DOI：
10.1016/j.urolonc.2007.06.002
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发表时间：
2008-11-01
影响因子：
2.7
通讯作者：
Hajdinjak, Tine
中科院分区：
文献类型：
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作者：
Hajdinjak, Tine
目的：自引入UroVysion检测试剂盒用于检测尿液中的尿路上皮癌以来，其报告的性能各不相同。本文系统地分析了reported result.Methods：符合牛津循证医学标准的英文文章被纳入，与评价集中在组织学证实的油癌，在测试时，而不是油的任何癌症，可能会发展以后。如适用，将不含细胞的样品重新分类为阴性，以进一步改善试验性能的实际估计。如果可用，还分析了细胞学数据。结果：共纳入14篇文献，涉及2477例FISH检测结果。尿路上皮癌的总患病率为35%。所有研究的合并敏感性和特异性分别为72%（69%-75%）和83%（82%-85%）。从12项研究中获得了细胞学数据。总的敏感性和特异性分别为42%（38%-45%）和96%（95%-97%）。不包括Ta肿瘤。UroVysion的敏感性为86%（82%-89%），细胞学的敏感性为61%（56%-66%）。UroVysion的总体性能高于细胞学：诊断比值比，16.8和14.1; AUC，0.867（SE 0.021）和0.626（SE 0.091）。这些差异，在整体测试性能措施几乎消失时，表面癌症的情况下被排除在analysis.Conclusions：发表的试验表明，一般混合的情况下。细胞学结果是高度特异性的。然而，阴性细胞学结果不会有意义地改变检测后存在尿路上皮癌的概率。UroVysion FISH检测结果不应被视为提供存在或不存在尿路上皮癌的决定性证据，但阳性和阴性结果确实会适度影响检测后疾病的概率。(c)2008年爱思唯尔公司All rights reserved.
Objectives: Since the introduction of the UroVysion test for detecting urothelial cancers in urine, its reported performance has varied. This article systematically analyzed reported results.Methods: Articles in English conforming to the Oxford EBM criteria were included, with the evaluation focused oil cancers that were histologically confirmed at the time of testing rather than oil any cancers that might develop later. Where applicable, samples with no cells were reclassified as negative so as to further improve the actual estimation of test performance. Where available, cytology data were also analyzed. Meta-DiSc software was used for the statistical analyses.Results: We identified 14 studies involving 2477 FISH tests. The overall prevalence Of urothelial cancers was 35%. The pooledsensitivity and specificity of all studies were 72% (69%-75%) and 83% (82%-85%), respectively. Cytology data were available from 12 Studies. with the overall sensitivity and specificity being 42% (38%-45%) and 96% (95%-97%). Excluding Ta tumors. the sensitivity was 86% (82%-89%) for UroVysion and 61% (56%-66%) for cytology. The overall performance was higher for UroVysion than for cytology: diagnostic odds ratio, 16.8 and 14.1; AUC, 0.867 (SE 0.021) and 0.626 (SE 0.091). These differences in overall test performance measures almost disappeared when superficial cancer cases were excluded from the analysis.Conclusions: The Published trials Suggest that for a general mix of cases. cytology results are highly specific. However, a negative cytology result does not meaningfully change the post-test probability of the presence of urothelial cancer. UroVysion FISH test results should not be considered to provide conclusive evidence for the presence or absence of urothelial cancer, but both positive and negative results do moderately influence the post-test probability of disease. (c) 2008 Elsevier Inc. All rights reserved.