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Diagnostic Value of Liquid-Based Cytology in Urothelial Carcinoma Diagnosis: A Systematic Review and Meta-Analysis.

Luo Y, She DL, Xiong H, Yang L, Fu SJ - PLoS ONE (2015)

Bottom Line: The results of the meta-analysis showed that the pooled sensitivity and specificity of LBC were 0.58 (0.51-0.65) and 0.96 (0.93-0.98), respectively.The post-test probability was 80% when a positive diagnosis was made.Further research is needed to validate these findings.

View Article: PubMed Central - PubMed

Affiliation: Gansu Nephro-Urological Clinical Center, Institute of Urology, Department of Urology, Key Laboratory of Urological Disease of Gansu Province, Lanzhou University Second Hospital, Lanzhou 730000, China.

ABSTRACT

Objective: To evaluate the value of liquid-based cytology (LBC) in the diagnosis of urothelial carcinoma.

Method: Diagnostic studies were searched for the diagnostic value of LBC in urothelial carcinoma in PubMed, Embase, Cochrane Library, Web of Science, CBM and CNKI. The latest retrieval date was September 2014. The data were extracted and the quality of the included studies was independently assessed by 2 reviewers. Stata 13 software was used to perform the statistical analysis. The research was conducted in compliance with the PRISMA statement.

Result: Nineteen studies, which included 8293 patients, were evaluated. The results of the meta-analysis showed that the pooled sensitivity and specificity of LBC were 0.58 (0.51-0.65) and 0.96 (0.93-0.98), respectively. The diagnostic odds ratio (DOR) was 31 (18-56) and the area under the curve (AUC) of summary receiver operating characteristic (SROC) was 0.83 (0.80-0.86). The post-test probability was 80% when a positive diagnosis was made. Compared with high grade urothelial carcinoma (HGUC), the sensitivity of detecting low-grade urothelial carcinoma (LGUC) was significantly lower, risk ratio of sensitivity was 0.54 (0.43-0.66), P<0.001. However, no significant sensitivity improvement was observed with LBC when compared with traditional cytospin cytology, risk ratio was 1.03 (0.94-1.14), P = 0.524.

Conclusion: Despite LBC having a pooled 58% positive rate for urothelial carcinoma diagnosis in our meta-analysis, no significant improvement in sensitivity was observed based on the studies evaluated. Further research is needed to validate these findings.

No MeSH data available.


Related in: MedlinePlus

Sensitivity analysis of Comparison of sensitivity of LBC versus CS.
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pone.0134940.g006: Sensitivity analysis of Comparison of sensitivity of LBC versus CS.

Mentions: Only 4 studies [14,16,26,27] (Fig 5) of the 19 citations compared the sensitivity of LBC and traditional cytospin cytology (CS). I2 and P value were 0% and 0.590, respectively. Fixed model was used and the synthetic risk ratio (RR) was 1.03 (95%CI 0.94–1.14), P = 0.524, which indicated that LBC did not yield a significant improvement in the sensitivity of detection. Sensitivity analysis did not alter the outcome (Fig 6).


Diagnostic Value of Liquid-Based Cytology in Urothelial Carcinoma Diagnosis: A Systematic Review and Meta-Analysis.

Luo Y, She DL, Xiong H, Yang L, Fu SJ - PLoS ONE (2015)

Sensitivity analysis of Comparison of sensitivity of LBC versus CS.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4524610&req=5

pone.0134940.g006: Sensitivity analysis of Comparison of sensitivity of LBC versus CS.
Mentions: Only 4 studies [14,16,26,27] (Fig 5) of the 19 citations compared the sensitivity of LBC and traditional cytospin cytology (CS). I2 and P value were 0% and 0.590, respectively. Fixed model was used and the synthetic risk ratio (RR) was 1.03 (95%CI 0.94–1.14), P = 0.524, which indicated that LBC did not yield a significant improvement in the sensitivity of detection. Sensitivity analysis did not alter the outcome (Fig 6).

Bottom Line: The results of the meta-analysis showed that the pooled sensitivity and specificity of LBC were 0.58 (0.51-0.65) and 0.96 (0.93-0.98), respectively.The post-test probability was 80% when a positive diagnosis was made.Further research is needed to validate these findings.

View Article: PubMed Central - PubMed

Affiliation: Gansu Nephro-Urological Clinical Center, Institute of Urology, Department of Urology, Key Laboratory of Urological Disease of Gansu Province, Lanzhou University Second Hospital, Lanzhou 730000, China.

ABSTRACT

Objective: To evaluate the value of liquid-based cytology (LBC) in the diagnosis of urothelial carcinoma.

Method: Diagnostic studies were searched for the diagnostic value of LBC in urothelial carcinoma in PubMed, Embase, Cochrane Library, Web of Science, CBM and CNKI. The latest retrieval date was September 2014. The data were extracted and the quality of the included studies was independently assessed by 2 reviewers. Stata 13 software was used to perform the statistical analysis. The research was conducted in compliance with the PRISMA statement.

Result: Nineteen studies, which included 8293 patients, were evaluated. The results of the meta-analysis showed that the pooled sensitivity and specificity of LBC were 0.58 (0.51-0.65) and 0.96 (0.93-0.98), respectively. The diagnostic odds ratio (DOR) was 31 (18-56) and the area under the curve (AUC) of summary receiver operating characteristic (SROC) was 0.83 (0.80-0.86). The post-test probability was 80% when a positive diagnosis was made. Compared with high grade urothelial carcinoma (HGUC), the sensitivity of detecting low-grade urothelial carcinoma (LGUC) was significantly lower, risk ratio of sensitivity was 0.54 (0.43-0.66), P<0.001. However, no significant sensitivity improvement was observed with LBC when compared with traditional cytospin cytology, risk ratio was 1.03 (0.94-1.14), P = 0.524.

Conclusion: Despite LBC having a pooled 58% positive rate for urothelial carcinoma diagnosis in our meta-analysis, no significant improvement in sensitivity was observed based on the studies evaluated. Further research is needed to validate these findings.

No MeSH data available.


Related in: MedlinePlus