Systematic review on oncologic outcomes on adjuvant endovesical treatment for non-muscle invasive bladder cancer in patients with solid organ transplant

原文： 2022 年发布于 J Endourol 36 卷第 4 期 346.e17-346.e26  浏览量：249次

作者： Simonet M. Dominguez Gutierrez A. Territo A. Prudhomme T. Campi R. Andras I. Baboudjian M. Hevia V. Boissier R.

作者单位： Department of Urology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria. Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX. Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria Department of Urology, The Jikei University School of Medicine, Tokyo, Japan. Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX Department of Urology, Weill Cornell Medical College, New York, NY Department of Urology, Second Faculty of Medicine, Charles University, Prag, Czech Republic Institute for Urology and Reproductive Health, I.M. Sechenov First Moscow State Medical University, Moscow, Russia Division of Urology, Department of Special Surgery, Jordan University Hospital, The University of Jordan, Amman, Jordan European Association of Urology research foundation, Arnhem, The Netherlands. Electronic address: sfshariat@gmail.com.

归属分类：膀胱肿瘤治疗及预后证据

DOI： 10.1016/j.euros.2021.06.011

关键词： bladder cancer incidence meta-analyses metformin treatment outcome commercial or financial relationships that could be construed as a potential conflict of interest.

INTRODUCTION: There is a need for sensitive and specific biomarkers for detecting recurrences in patients with non-muscle invasive bladder cancer (NMIBC) on surveillance. Xpert bladder cancer (BC) monitor is the latest rapid in vitro qualitative test that detects expression of 5 mRNAs using a GeneXpert instrument. The primary aim of this review was to systematically review and pool the data regarding the diagnostic performance of Xpert BC in patients with NMIBC. METHODS: Systematic literature search using 4 electronic databases (PubMed, EMbase, Scopus and Web of science) was performed. Pooled sensitivity, specificity and diagnostic odds ratio (DOR) were estimated using DerSimonian-Laird random-effects model. Standard Preferred Reporting Items for Systematic reviews and Meta-analysis guidelines were followed and the study protocol was registered with PROSPERO (CRD42021249762). RESULTS: In this review, 11 prospective studies with 2,896 patients were included. Pooled sensitivity and specificity for Xpert BC were 73% (95% confidence interval (CI) 65%-80%) and 77% (95% CI 69%-84%) respectively. Area under curve (AUC) for Xpert BC monitor was 0.81 (0.78-0.84) respectively. Subgroup analysis from 7 studies for patients with high-grade recurrence revealed sensitivity, specificity and AUC of 0.86 (0.77-0.92), 0.78 (0.75-0.81) and 0.87 (0.84-0.90) respectively. Similar analysis for patients with low-grade recurrence revealed sensitivity, specificity and AUC of 0.58 (0.47-0.68), 0.79 (0.75-0.82) and 0.79 (0.75-0.82) respectively. CONCLUSION: Xpert BC monitor has overall acceptable diagnostic accuracy. Sensitivity is higher for high-grade disease for detecting recurrences in patients with NMIBC on surveillance.