Nomograms including the UBC® Rapid test to detect primary bladder cancer based on a multicentre dataset
Meisl, Christina J. (Charité - Universitätsmedizin Berlin. Department of Urology)
Karakiewicz, Pierre I. (University of Montreal. Department of Surgery)
Einarsson, Roland (IDL Biotech)
Koch, Stefan (Brandenburg Medical School Theodor Fontane)
Hallmann, Steffen (HELIOS Hospital Bad Saarow. Department of Urology)
Weiß, Sarah (HELIOS Hospital Bad Saarow. Department of Urology)
Hemdan, Tammer (Uppsala University. Department of Surgical Sciences)
Malmström, Per-Uno (Uppsala University. Department of Surgical Sciences)
Styrke, Johan (Umeå University. Department of Surgical and Perioperative Sciences. Urology and Andrology)
Sherif, Amir (Umeå University. Department of Surgical and Perioperative Sciences. Urology and Andrology)
Hasan, Mudhar N. (Danderyd Hospital. Department of Urology)
Pichler, Renate (Medical University Innsbruck. Department of Urology)
Tulchiner, Gennadi (Medical University Innsbruck. Department of Urology)
Palou, Juan (Institut d'Investigació Biomèdica Sant Pau)
Rodríguez Faba, Óscar (Institut d'Investigació Biomèdica Sant Pau)
Hennenlotter, Jörg (University Hospital Tübingen. Department of Urology)
Stenzl, Arnulf (University Hospital Tübingen. Department of Urology)
Ritter, René (Diakonie-Klinikum Stuttgart. Department of Urology)
Niegisch, Günter (Heinrich Heine University Düsseldorf. Department of Urology. Faculty of Medicine)
Grunewald, Camilla M. (Heinrich Heine University Düsseldorf. Department of Urology. Faculty of Medicine)
Schlomm, Thorsten (Charité - Universitätsmedizin Berlin. Department of Urology)
Friedersdorff, Frank (Evangelisches Krankenhaus Königin Elisabeth Herzberge. Department of Urology)
Barski, Dimitri (Rheinland Klinikum Neuss. Department of Urology)
Otto, Thomas (University of Duisburg-Essen. Medical Faculty)
Gössl, Andreas (HELIOS Hospital Krefeld. Department of Urology)
Arndt, Christian (HELIOS Hospital Krefeld. Department of Urology)
Esuvaranathan, Kesavan (National University Hospital. Department of Urology)
Kesavan, Nisha R. (National University Hospital. Department of Urology)
Zhijiang, Zang (National University Hospital. Department of Urology)
Kramer, Mario W. (University Hospital Schleswig-Holstein Campus Lübeck. Department of Urology)
Hennig, Martin J.P. (University Hospital Schleswig-Holstein Campus Lübeck. Department of Urology)
Ecke, Thorsten H. (HELIOS Hospital Bad Saarow. Department of Urology)
Universitat Autònoma de Barcelona

Date:	2022
Abstract:	Objectives: To evaluate the clinical utility of the urinary bladder cancer antigen test UBC 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 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 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 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 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 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 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.
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	Bladder cancer ; Diagnosis ; Logistic model ; Nomogram ; UBC Rapid test ; Urothelial cancer ; #uroonc ; #BladderCancer ; #blcsm
Published in:	BJU International, Vol. 130 Núm. 6 (december 2022) , p. 754-763, ISSN 1464-410X

DOI: 10.1111/bju.15677
PMID: 34928524

10 p, 556.3 KB

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