TY - JOUR
T1 - Methylation study of the Paris system for reporting urinary (TPS) categories
AU - Pierconti, Francesco
AU - Martini, Maurizio
AU - Cenci, Tonia
AU - Fiorentino, Vincenzo
AU - Sacco, Emilio
AU - Bientinesi, Riccardo
AU - Pugliese, Dario
AU - Iacovelli, Roberto
AU - Schinzari, Giovanni
AU - Larocca, Luigi Maria
AU - Bassi, Pierfrancesco
PY - 2021
Y1 - 2021
N2 - Aims Bladder EpiCheck is one of several urinary tests studied to identify bladder tumours and analyses 15 methylation biomarkers determining bladder cancer presence on the basis of methylation profile. Methods 374 patients diagnosed with high-grade non-muscle invasive bladder cancer were treated and followed for 1 year with voided urine cytology and white-light cystoscopy and biopsies according to European Association of Urology Guidelines. 268 cases were diagnosed with high-grade papillary carcinoma, while 106 cases were carcinoma in situ. Bladder EpiCheck test was performed together with cytology in all cases. Results Comparing cytological categories of negative for high-grade urothelial carcinoma (NHGUC) and atypical urothelial cells (AUCs), we found that an EpiScore <60 correlates with NHGUC (p=0.0003, Fisher's exact test), while comparing AUC and suspicious for high-grade urothelial carcinoma (SHGUC) or SHGUC and high-grade urothelial carcinoma (HGUC) categories, an EpiScore ≥60 correlates with SHGUC and HGUC, respectively (p=0.0031 and p=0.0027, Fisher's exact test). In each TPS category, we found that sensitivity, specificity, Positive Predicitve Value (PPV) and Negative Predictive Value (NPV) of the Bladder EpiCheck test in HGUC category were higher than those observed in SHGUC group (sensitivity=98%, specificity=100%, NPV=85.7%, PPV=100% vs sensitivity=86.6%, specificity=52.3%, NPV=84.6%, PPV=56.5%). Conclusions Analysing methylation study results, we demonstrated that different TPS cytological categories also carry a distinct molecular signature. Moreover, our results confirm that cytological categories SHGUC and HGUC are different entities also from a molecular point of view and should continue to represent distinct groups in TPS.
AB - Aims Bladder EpiCheck is one of several urinary tests studied to identify bladder tumours and analyses 15 methylation biomarkers determining bladder cancer presence on the basis of methylation profile. Methods 374 patients diagnosed with high-grade non-muscle invasive bladder cancer were treated and followed for 1 year with voided urine cytology and white-light cystoscopy and biopsies according to European Association of Urology Guidelines. 268 cases were diagnosed with high-grade papillary carcinoma, while 106 cases were carcinoma in situ. Bladder EpiCheck test was performed together with cytology in all cases. Results Comparing cytological categories of negative for high-grade urothelial carcinoma (NHGUC) and atypical urothelial cells (AUCs), we found that an EpiScore <60 correlates with NHGUC (p=0.0003, Fisher's exact test), while comparing AUC and suspicious for high-grade urothelial carcinoma (SHGUC) or SHGUC and high-grade urothelial carcinoma (HGUC) categories, an EpiScore ≥60 correlates with SHGUC and HGUC, respectively (p=0.0031 and p=0.0027, Fisher's exact test). In each TPS category, we found that sensitivity, specificity, Positive Predicitve Value (PPV) and Negative Predictive Value (NPV) of the Bladder EpiCheck test in HGUC category were higher than those observed in SHGUC group (sensitivity=98%, specificity=100%, NPV=85.7%, PPV=100% vs sensitivity=86.6%, specificity=52.3%, NPV=84.6%, PPV=56.5%). Conclusions Analysing methylation study results, we demonstrated that different TPS cytological categories also carry a distinct molecular signature. Moreover, our results confirm that cytological categories SHGUC and HGUC are different entities also from a molecular point of view and should continue to represent distinct groups in TPS.
KW - Aged
KW - Biomarkers, Tumor
KW - Carcinoma, Transitional Cell
KW - Cytodiagnosis
KW - DNA
KW - DNA Methylation
KW - Female
KW - Humans
KW - Male
KW - Middle Aged
KW - Retrospective Studies
KW - Sensitivity and Specificity
KW - Urinary Bladder Neoplasms
KW - carcinoma
KW - urinary bladder
KW - urine
KW - Aged
KW - Biomarkers, Tumor
KW - Carcinoma, Transitional Cell
KW - Cytodiagnosis
KW - DNA
KW - DNA Methylation
KW - Female
KW - Humans
KW - Male
KW - Middle Aged
KW - Retrospective Studies
KW - Sensitivity and Specificity
KW - Urinary Bladder Neoplasms
KW - carcinoma
KW - urinary bladder
KW - urine
UR - http://hdl.handle.net/10807/169424
U2 - 10.1136/jclinpath-2020-206633
DO - 10.1136/jclinpath-2020-206633
M3 - Article
SN - 0021-9746
VL - 74
SP - 102
EP - 105
JO - Journal of Clinical Pathology
JF - Journal of Clinical Pathology
ER -