1. ¹Department of Pathology, Centre Hospitalier Universitaire de Québec, L'Hôtel-Dieu de Québec, Laval University, Québec, Canada
2. ²Department of Urology, Centre Hospitalier Universitaire de Québec, L'Hôtel-Dieu de Québec, Laval University, Québec, Canada
3. ³Department of Epidemiology, Centre Hospitalier Universitaire de Québec, L'Hôtel-Dieu de Québec, Laval University, Québec, Canada

Correspondence: Dr B Têtu, MD, Department of Pathology, Centre Hospitalier Universitaire de Québec, L'Hôtel-Dieu de Québec, 11, Côte du Palais, Québec, Canada G1R 2J6. E-mail: bernard.tetu@chuq.qc.ca

Received 18 March 2004; Revised 15 July 2004; Accepted 15 July 2004; Published online 24 September 2004.

Abstract

ImmunoCyt/uCyt^TM is a fluorescent test combining three monoclonal antibodies. In this study, it has been tested as a complement to cytology in the detection of urothelial carcinoma in urine. It has been performed simultaneously with standard cytology and cystoscopy on 870 urine analyses from one hospital. In 136 cases, one or more bladder tumors were found. Overall sensitivity of cytology, ImmunoCyt/uCyt^TM and combined analyses reached 29, 74 and 84%, respectively, and overall specificity was 98, 62 and 61%. The negative predictive value of cytology, ImmunoCyt/uCyt^TM and both analyses was 88, 93 and 95%, respectively, and the positive predictive value was 70, 26 and 29%. The sensitivity of cytology for low malignant potential neoplasms, low- and high-grade papillary carcinomas was 6, 18 and 53%, while it reached 71, 79 and 93% when combined with ImmunoCyt/uCyt^TM. The sensitivity of cytology for stages Ta, T1, T2 and over and Tis tumors was12, 67, 47 and 50%, while it reached 78, 83, 79 and 100% when combined with ImmunoCyt/uCyt^TM. In the absence of tumor on cystoscopy but with positive ImmunoCyt/uCyt^TM, 18% of patients developed a tumor, 2–6 months later. Of the 109 cases diagnosed as suspicious for malignancy by cytology, a tumor was present in 30 cases and ImmunoCyt/uCyt^TM was positive in 22 (73%) of them. In conclusion, ImmunoCyt/uCyt^TM may be used to postpone cystoscopies in patients followed for bladder cancer and may help to save cytologist and pathologist screening time.