Clinical study of asymptomatic microhematuria

A statistical survey was performed on 200 patients with asymptomatic microhematuria who visited our hospital between January 1986 and October 1989. Urinalysis, urinary cytology, urinary culture, IVP, echography and cystoscopy were carried out for the evaluation of the origin and nature of the microhematuria. In 92 patients (46%), urological abnormalities were observed. Among them, urological lesions requiring medical and surgical treatments were found in 28 patients (14%) including two malignant cases of bladder tumor. No urologic lesion could be identified in 108 patients (54%). The degree of hematuria was unrelated to the seriousness of its cause. Thirteen of 28 patients (46%) with diseases that required treatment had under 5 red blood cells per high power field on the microscopic urinalysis. Therefore, complete urologic investigation of all patients with any degree of asymptomatic microhematuria is recommended.     

Post-voiding repeated renal ultrasonography for slight hydronephrosis detected during screening for asymptomatic microhematuria*

BACKGROUND: There is not a well established method for further screening of asymptomatic microhematuria found through annual health examinations. However, it is apparent that a large number of examiners are using ultrasonography for screening. When slight hydronephrosis is found through screening, it is difficult to determine whether further examinations, such as intravenous pyelography (IVP), should be performed. In this paper, we discuss the usefulness of post-voiding repeated renal ultrasonography, which was applied to 57 patients with slight hydronephrosis found in a screening. METHODS: Ultrasonography in the kidney and the urinary bladder at the ultrasound laboratory of Toma Hospital was carried out on a total of 1906 patients with asymptomatic microhematuria, which was found by routine annual health examination, from January 1996 to December 1998. Slight hydronephrosis was found in 57 (14 males and 43 females) of 1906 patients and post-voiding repeated renal ultrasonography was carried out on all patients. RESULTS: Slight hydronephrosis had disappeared and IVP was avoided in 22 (38.6%) of 57 patients. Of 35 cases in which slight hydronephrosis persisted after urination, there were no abnormalities on IVP in 32 patients, while abnormalities were found in three patients. Two of these had ureteropelvic junction stenosis and the remaining one had a ureteral stone. CONCLUSION: The results of this study indicate that post-voiding repeated renal ultrasonography is useful for avoiding unnecessary further examination to determine whether upper urinary tract obstruction exists, when slight hydronephrosis is observed upon screening by simultaneous renal and urinary bladder ultrasonography for asymptomatic microhematuria.     

Value of selective upper tract cytology for recognition of upper tract tumors after treatment of superficial bladder cancer

Background: The value of selective upper urinary tract (UT) cytology in patients who are asymptomatic and tumor free at control cystoscopy after being treated for superficial bladder carcinoma has not been studied. The present study was performed to evaluate the value of selective UT cytology in patients who are tumor free at control cystoscopy after being treated for superficial bladder cancer. Methods: Forty‐seven consecutive patients who had undergone definitive surgical treatment for superficial bladder cancer at least 24 months prior and were tumor free at control cystoscopy were evaluated with bladder wash for cytology as well as selective UT urine cytology by catheterization of both ureteral orifices. Of the 47 patients, disease was stage Ta in 30 (63.8%), T1 in 15 (31.9%) and Ta/Tcis in 2 (4.3%). Primary tumor was unifocal in 24 (51.1%) and multifocal in 23 (48.9%) patients. The time elapsed from the initial diagnosis to the last evaluation ranged from 2 to 21 years (mean 5.39). Results: UT cytology was positive in 2 cases. Although, excretory urography (IVP) revealed mild pelvicalicectasis in 1 of these 2 patients, ureterorenoscopy (URS) revealed no abnormality. In the other patient with normal IVP and retrograde pyelography (RGP), URS revealed a ureteral tumor 5 mm in diameter. Although the UT cytology was normal in the remaining 45 patients, IVP revealed right hydronephrosis in 1 patient and URS revealed multiple ureteral tumors. Conclusion: Given the normal appearance of the UT, it is highly unlikely that these patients have tumor in the UT. Thus, during the follow‐up of patients with superficial bladder cancer, it is not useful to perform UT select cytology in the absence of any identifiable filling defects in the upper urinary tract.     

Immunocytology in the assessment of patients with asymptomatic hematuria

Painless hematuria has remained a diagnostic challenge in daily urological practice. Key problem in the assessment of these patients is the discrimination between malignant and non-malignant conditions. In this prospective study the role of immunocytology in the evaluation of patients with hematuria was investigated. Ucyt is a commercially available immunocytological assay based upon microscopical detection of tumor-associated antigens on the membrane of urothelial cells by immunofluorescence. Between October 2000 and July 2007, 301 consecutive patients with a first episode of painless hematuria without prior transitional cell carcinoma were included. Urine samples were obtained from all patients and examined cytologically and immunocytologically. Clinical assessment by physical examination, laboratory tests, endoscopy and imaging in 228 cases with microhematuria and 66 cases with gross hematuria yielded bladder cancer in 10 (4.6%) and 17 (27%) patients, respectively. Clinical workup demonstrated that composition of both groups was entirely different. Sensitivity of cystoscopy and immunocytology was similar in both groups. Furthermore, a negative finding in cystoscopy and immunocytology virtually excluded the presence of urothelial cancer. However, while predictive values of immunocytology were clearly superior to cytology in gross hematuria, cytology performed better in the microhematuria cohort. Combination of cystoscopy and immunocytology yield 100% sensitivity in the assessment of patients with painless hematuria. Based upon performance characteristics the authors recommend to replace urine cytology by a more sensitive marker like immunocytology in gross hematuria. In patients with microhematuria immunocytology could be used to select for patients at risk for urothelial cancer and thus spare negative patients from further examinations.     

A prospective analysis of 1,930 patients with hematuria to evaluate current diagnostic practice

PURPOSE: The commonly accepted diagnostic algorithm for hematuria includes excretory urography (IVP) and cystoscopy. Some have suggested that ultrasound of the upper urinary tract is adequate and that cystoscopy is not necessary in younger patients with microscopic hematuria. We ascertain whether a less intensive algorithm could be adopted while retaining diagnostic efficacy. MATERIALS AND METHODS: A total of 1,930 patients were enrolled prospectively in the study at a hematuria clinic between October 1994 and March 1997. Evaluation consisted of basic demographics, history and examination, routine blood tests, urinalysis and cytology. All patients underwent plain abdominal radiography, renal ultrasound, IVP and flexible cystoscopy. RESULTS: A total of 1,194 males and 736 females with a mean age of 58 years (range 17 to 96) were included in the study. Overall, 61% of patients had no basis found for hematuria, 12% had bladder cancer, 13% had urinary tract infection and 2% had stones. Kidney and upper tract tumors were noted in 14 patients (0.7%), including 4 who presented with microscopic hematuria. If only ultrasound or IVP had been performed 4 of these cases would have been missed. Of 982 patients presenting with microscopic hematuria 51 had cancer. Bladder cancer was found in 7 patients younger than 40 years. CONCLUSIONS: Our findings suggest that cystoscopy cannot be safely avoided even in younger patients with microscopic hematuria. Only a combination of ultrasound and IVP detected all upper tract tumors.     

The value of using urinary red cell volume distribution curve of patients with positive urinary occult blood detected in a mass examination

PURPOSE: We investigated the usefulness of the urinary red blood cell volume distribution curve (RVDC) for screening patients who are positive for asymptomatic urinary occult blood on mass examination. SUBJECTS AND METHODS: The subjects were 200 individuals over 40 years old (44 men with a median age of 53.4 years and 156 women with a median age of 57.2 years) who were positive for urinary occult blood on mass examination between January 1993 and December 1994. The subjects were classified into three groups based on the pattern of their RVDC. Group NG showed a nonglomerular pattern, group M showed a mixed pattern, and group G showed a glomerular pattern. The urological examinations performed included DIP, ultrasound of the kidney and urinary bladder and urethrocystoscopy. To investigate the prognosis, a questionnaire was sent to all subjects in September 1999 in which they were asked about the state of their disease during the period since the initial examination. RESULTS: Group G consisted of 192 patients, or almost all of the subjects (96%). There were five patients (2.5%) who had serious urological diseases, including two with bladder cancer, and all were found in Groups NG and M. During the period from initial examination until the prognosis survey (mean of 5.7 year), one patient in group G developed both bladder and ureteral cancer. The CVDC showed a mixed pattern when this patient was discovered. CONCLUSION: RVDC was useful for screening patients who were found to be positive for urinary occult blood on mass examination. When the RVDC shows a non-glomerular or mixed pattern, detailed urological examination including endoscopy is necessary.     

Qualitative and quantitative detection of urinary human complement factor H-related protein (BTA stat and BTA TRAK) and fragments of cytokeratins 8, 18 (UBC rapid and UBC IRMA) as markers for transitional cell carcinoma of the bladder

OBJECTIVE: To evaluate the role of BTA stat, BTA TRAK, UBC Rapid, UBC IRMA and voided urinary cytology in the detection of bladder transitional cell carcinoma (TCC). METHODS: The study included 78 patients with TCC of the bladder (group A), 62 patients with a history of bladder TCC without tumor recurrence at the time of examination (B, control group), 20 patients with other malignancy of the urinary tract (C), 38 patients with non-malignant urinary tract diseases (D), 10 patients with urinary tract infection (E) and 10 healthy volunteers (F). Except in group F, voided urine was collected before cystoscopy or cystectomy. RESULTS: The specificity and sensitivity in bladder cancer detection were 87.1 and 74.4%, respectively with BTA stat, 79.3 and 48.7%, respectively with UBC Rapid, 100 and 33.3%, respectively with cytology, 72.6 and 75.6%, respectively with BTA TRAK, 64.5 and 70.5%, respectively with UBC IRMA. CONCLUSIONS: The BTA stat and BTATRAK tests are superior to UBC Rapid, UBC IRMA and urinary cytology in detection of bladder TCC. In daily practice however cytology remains the best adjunct to cystoscopy because of its high sensitivity in Tis and 100% specificity. Cystoscopy cannot be replaced by any of evaluated methods.     

Value of microhematuria, urine cytology, TPA and neopterin in the after care of patients with bladder tumors

Tumor recurrences were observed 70 times in 715 cystoscopies performed in 253 patients. The sensitivity of microhematuria to detect a tumor recurrence was 61%, the specificity 84%. The sensitivity of microhematuria increased to 90% in Tis and T2 tumors. Urine cytology showed a specificity of 100% and a sensitivity of only 43%. The specificity and sensitivity of TPA was only 58% and 41%, respectively, the latter increased to 80% in Tis. 60 patients with proven tumor recurrence showed an increase of neopterin with higher tumor stage. In tumors of stage T2 and Tis serum neopterin was raised in 90% and urine neopterin in 75%. Based on these results cystoscopy, exfoliative urinary cytology and urine analysis are obligatory in the follow-up of patients with superficial bladder cancer. Because of the low specificity (29-41%) TPA and neopterin are not suitable for follow-up.     

Is it necessary to perform urine cytology in screening patients with haematuria?

All patients with gross haematuria and those older than 50 years with microscopic haematuria need investigations to rule out the presence of a urological malignancy. OBJECTIVE: To study the role of urine cytology in the evaluation of patients with haematuria. METHODS: Two hundred and eighty-five patients were evaluated. All patients underwent evaluation including urine cytology, flexible cystoscopy, ultrasonography and/or IVU. RESULTS: The mean age of the patients was 62.4 years. Sixty-five percent had gross and 35% microscopic haematuria. Fifty-five tumours were discovered (19.2%); of these 48 were transitional cell carcinomas, 3 renal cell carcinomas and 3 carcinomas of the prostate. Thirty-seven urinary cytologies were abnormal. The overall sensitivity of urinary cytology was 42.4% and specificity 94.3%. Of 18 patients with positive cytology, all were found to have transitional cell carcinomas on cystoscopy or imaging. Of 19 patients with suspicious cytologies, only 6 were found to have tumours. The remaining 13 patients had no evidence of tumour on combined upper tract imaging (IVU and ultrasound) or on rigid cystoscopy and bladder biopsy. Whilst all the other investigation modalities contributed to diagnoses (and/or exclusion of tumours), no additional tumours were discovered solely by urinary cytology. A moderate cost saving could be made without compromising diagnostic accuracy. CONCLUSION: Our study suggests that performing routine urine cytology is not relevant in the investigation of patients with haematuria, its role is at best supportive.     

NMP22与BTA stat检测在膀胱肿瘤诊断中的应用

目的评价NMP22和BTAstat诊断膀胱肿瘤的价值.方法对82例临床怀疑膀胱肿瘤的患者,在膀胱镜检查前将尿样分为3份,分别进行NMP22、BTAstat和脱落细胞学检测,分析比较3种方法的敏感性、特异性和阳性预测价值.结果82例中病理证实膀胱肿瘤32例,其他疾病50例.NMP22诊断膀胱肿瘤敏感性为87.5%,与BTAstat(65.6%)、细胞学(21.9%)比较,差别有显著性意义(P<0.05).3种方法诊断特异性分别为84.0%、64.0%和100.0%.阳性预测值分别为77.8%、53.9%和100.0%.结论NMP22是一种简单、敏感、非侵袭性的早期诊断膀胱肿瘤的肿瘤标记物.     

Microscopic hematuria

Asymptomatic microhematuria is not a rare phenomenon among apparently healthy individuals, and the incidence of such hematuria increases significantly with age. Some investigators report that the cause of hematuria is renal glomerular disease in more than 50% of patients, and urological malignancies in 1.0%–13%. On initial examination, urine sediments must be searched for evidence of renal glomerular disease, such as RBC casts and dysmorphic RBCs. If the patients were diagnosed to have glomerular disease, follow-up studies, without any extended examination or therapy are recommended, because their prognosis is usually favorable. The next step is to perform thorough urological examinations, including urine cytology, cystoscopy, abdominal ultrasound, and intravenous pyelography, to detect serious underlying disease. Even if no significant findings were observed after the extensive urological examinations, careful follow-up studies should be performed at 6–12-month intervals for 3 years, using the same methods.     

Strategies for asymptomatic microscopic hematuria: a prospective study of 1,034 patients

To establish strategies for treatment of asymptomatic microscopic hematuria we conducted a prospective study of 1,034 patients with this disease. The patients were examined by cystoscopy, urine cytology, abdominal ultrasound and excretory urography. On initial examination 30 highly significant lesions, including 24 cases of urological malignancies, 195 moderately significant lesions and 246 insignificant lesions were detected. In the remaining 563 patients no underlying lesion could be found. Of the 246 patients with insignificant lesions and 563 with unexplained asymptomatic microscopic hematuria followup was done in 421 at 6-month intervals for more than 1 year. A diagnosis became clear within 3 years in 22 patients, including 3 cases of bladder carcinoma and 1 of prostatic carcinoma.     

Primary carcinoma in a diverticulum of the bladder: a report of two cases

Two cases of carcinoma in a diverticulum of the bladder were experienced. The first case was of a 50-year-old male who presented in February, 1981, complaining of asymptomatic microhematuria. The excretory urogram revealed a diverticulum in the left lateral aspect of the bladder which was causing shift of the lower ureter to the median side. The cytology report of voided urine was class III. Diverticulectomy was performed and pathologic findings was a transitional cell carcinoma, grade 1, stage 0. The patient has been free of recurrence for the past 54 months. The second case was of a 67-year-old male with the chief complaint of pollakiuria. Non-papillary tumor in a diverticulum of the bladder was found by cystoscopy and computed tomography. Tumor biopsy and urinary diversion by ileal conduit were performed in the usual manner. The pathologic finding was transitional cell carcinoma of grade 11 malignancy. The patient died of intestinal obstruction on January, 19, 1984, about 15 months after the surgery. The 117 cases of carcinoma in a diverticulum of the bladder we found in the Japanese literature are reviewed briefly.     

Initial evaluation of the diagnostic performance of the new urinary bladder cancer antigen test as a tumor marker for transitional cell carcinoma of the bladder

PURPOSE: We evaluated the diagnostic performance of the new noninvasive bladder cancer test on voided urine samples from patients with transitional cell carcinoma compared to symptomatic and asymptomatic controls. MATERIALS AND METHODS: Urinary bladder cancer antigen was measured in urine from 86 patients with active transitional cell carcinoma of the bladder (group 1), 76 patients free of transitional cell carcinoma as confirmed by cystoscopy at followup (group 2), 25 patients with other benign urological diseases (group 3), 25 patients with other malignant pathological conditions (group 4) and 30 healthy subjects free of urological diseases (group 5). RESULTS: Mean urinary bladder cancer antigen concentrations were 104.84, 4.57, 11.79, 48.87 and 1.38 microg/l, for groups 1 to 5, respectively, which was statistically different (p = 0.00005) except for groups 1 and 4 (p = 0.187). Sensitivity was 87.0% (95% confidence interval 79.2 to 92.7) and specificity was 86.8% (77.1 to 93.5%), and both were optimized by receiver operating characteristics plot analysis at a threshold value of 9.74 microg/l using asymptomatic (group 2) compared to known cancer (group 1) cases. CONCLUSIONS: Urinary bladder cancer antigen might have a role as a potential tumor marker for diagnosing transitional cell carcinoma of the bladder.     

Clinical importance of microhematuria as an initial sign of bladder tumor

To investigate the role of microhematuria for the diagnosis of bladder tumor, the retrospective study of 156 patients with bladder tumor was done. Among the 156 cases, asymptomatic microhematuria was observed in 15 cases (9.6%) as an initial sign of the disease. According to the process to the final diagnosis, these 15 cases were classified into 4 groups; the Group 1 comprised 4 patients who consulted the urologist just after health examination; the Group 2 comprised 6 patients who consulted the urologist by the introduction of the general practitioner; the Group 3 comprised 2 patients who disregarded the sign and consulted the urologist after the appearance of symptoms; the Group 4 comprised 3 patients whose general practitioner overlooked the sign and who consulted the urologist after the appearance of the symptoms. The mean duration between the initial sign and the final diagnosis of each group was 2, 2, 8 and 62 months, respectively. Three of the 5 patients (60%) in groups 3 and 4 were treated by total cystectomy, while only 2 of the 10 patients (20%) in groups 1 and 2 totally cystectomized. High grade tumor was observed more frequently in groups 3 and 4 than in groups 1 and 2. Since the negative rate of urinary cytologic examinations of these 15 cases was 33.3%, cystoscopic examination was necessary for screening of bladder tumor.     

多色荧光原位杂交在预测非肌层浸润性膀胱癌复发中的应用

目的 探讨荧光原位杂交(FISH)技术在判断膀胱癌复发的应用.方法 对20例正常人和51例非肌层浸润性膀胱癌患者术后行FISH检测,根据正常人检测结果建立阈值,分析膀胱癌患者FISH结果与膀胱癌复发的相关性.结果 平均随访21个月,22例患者发生肿瘤复发,其中FISH呈阳性19例(86%),呈阴性3例(14%);29例未复发FISH呈阳性16例(55%),呈阴性13例(45%).可见54%FISH检测阳性患者和19%FISH检测阴性患者出现了肿瘤复发.FISH检测呈阳性较呈阴性患者的膀胱癌复发概率大(P<0.05).结论 FISH在预测非肌层浸润性膀胱癌术后复发风险的判断中起重要作用.     

Untersuchungen zur Rolle der Immunzytologie in der Abklärung von Patienten mit asymptomatischer Mikrohämaturie

INTRODUCTION: Discriminating between malignant and nonmalignant conditions remains a challenge in the evaluation of patients with asymptomatic microhematuria. In this prospective study the role of immunocytology in the assessment microhematuria was studied. MATERIAL AND METHODS: uCyt(R) is a commercially available immunocytological assay based on microscopical detection of tumor-associated antigens in urothelial cells by immunofluorescence. Between September 2000 and December 2006, 222 consecutive patients with newly diagnosed painless microhematuria without prior transitional cell carcinoma were included. All urine samples were examined cytologically and immunocytologically. A total of 211 samples (95%) were assessable. RESULTS: Clinical examination by physical examination, cystoscopy, laboratory tests, and imaging yielded bladder cancer in ten cases (4%). Further diagnoses were BPH (27%), cystitis (including IC) (12%), urolithiasis (9%), urethral or ureteral strictures (6%), papilloma (2%), and"further conditions" (16%). In 52 patients (23%) reasons for hematuria were not identified. Immunocytology was positive in 8 of 10 bladder tumors (80%) and negative in 178 patients with non-tumor-related hematuria (89%). CONCLUSIONS: The high sensitivity and good specificity of immunocytology is comparable with that reported in the literature despite a very low disease prevalence in this population. If assessment of these patients would have only been based on immunocytology, 180 costly and invasive diagnostic procedures would have been saved, with only 29 individuals (14%) undergoing these examinations unnecessarily. The authors conclude that these findings justify further investigation of this issue.     

Diagnostic yield of repeat evaluation for asymptomatic microscopic hematuria after negative initial workup

PurposeThe American Urological Association guideline for asymptomatic microhematuria recommends in patients with a negative initial workup, repeat workup should be considered for those with persistent/recurrent microhematuria. However, there is little data on the yield of repeat evaluation. Our hypothesis was that repeat workup yields a low detection rate of urologic malignancy.Materials and MethodsWe retrospectively reviewed all patients at our institution who underwent microhematuria workup with cystoscopy and upper tract imaging from May 2010 to June 2016. Microhematuria was defined as ≥3 RBCs/HPF on a properly collected specimen in the absence of a benign cause. Demographics, age, smoking history, history of radiation, and findings on repeat cystoscopy and imaging were collected. Our primary endpoint was a new diagnosis of urologic malignancy.ResultsOur initial cohort included 1,332 patients, of whom 21 were diagnosed with urothelial carcinoma and 7 with suspicious renal masses on initial workup. A total of 637 patients with negative initial workup had persistent/recurrent microhematuria. Repeat cystoscopy was performed in 161 (25%) patients at a median of 39 months, and repeat upper tract imaging was performed in 317 (50%) patients at a median of 39 months. Overall, repeat cystoscopy revealed new bladder cancer in 2 (1.2%) patients and repeat imaging revealed new suspicious renal mass in 4 (1.3%) patients.ConclusionsWe observed a low number of newly diagnosed malignancies among patients with persistent/recurrent asymptomatic microhematuria who had a prior negative workup. Additional research is required to determine the utility of a repeat AMH workup.     

Comparative evaluation of the nuclear matrix protein,fibronectin, urinary bladder cancer antigen and voided urine cytology in the detection of bladder tumors

PURPOSE: We evaluate the diagnostic efficacy of nuclear matrix protein-22 (NMP22, Matritech, Newton, Massachusetts), fibronectin and urinary bladder cancer antigen (UBC, IDL Biotech, Borlange, Sweden) compared with voided urine cytology in the detection of bladder cancer. MATERIALS AND METHODS: A total of 168 patients provided a single voided urine sample for NMP22, fibronectin an ideal monoclonal for urinary bladder cancer and cytology before cystoscopy. Cystoscopy was done for all patients as the reference standard for identification of bladder cancer. Biopsy of any suspicious lesion was performed for histopathological examination. Of the 168 cases 100 were histologically diagnosed as bladder cancer, whereas the remaining 68 had benign urological disorders. A group of 47 healthy volunteers were also enrolled in this study. Voided urine was evaluated by NMP22, fibronectin and UBC, and their values were expressed relative to mg. creatinine. RESULTS: The optimal threshold values for NMP22, fibronectin and UBC were calculated by receiver operator characteristics curves as 27 units per mg. creatinine, 198 mg./mg. creatinine and 13 ng./mg. creatinine, respectively. The levels and positive rates of the 3 parameters were significantly higher in the malignant group compared to either the benign group or normal controls. Of the entire group NMP22, fibronectin and UBC were positive in 93.2%, 91% and 68.2%, respectively in bladder cancer cases with positive cytology. Moreover, these positive rates were significantly higher in bilharzial bladder cancer cases (58.8%, 67.5%, 58.8%, respectively) compared to nonbilharzial cases (35.6%, 36.3%, 31.1%). Overall sensitivity and specificity were 85% and 91.3% for NMP22, 83% and 82.6% for fibronectin, 67% and 80.8% for UBC and 44% and 100% for voided urine cytology. Combined sensitivity of voided urine cytology with the 3 biomarkers together was higher than either combined sensitivity of voided urine cytology with 1 of the biomarkers or than that of the biomarker alone. CONCLUSIONS: Our data indicate that NMP22 and fibronectin had superior sensitivities compared to UBC and voided urine cytology, while NMP22 and voided urine cytology had the highest specificities. The combined use of markers increased the sensitivity of cytology from 44% to 95.3%. The higher sensitivities of markers in bilharzial than nonbilharzial bladder cancer highlight their clinical use in screening patients with urinary bilharziasis.     

膀胱肿瘤抗原联合尿脱落细胞学检查在膀胱肿瘤诊断中的价值

目的探讨膀胱肿瘤抗原(BTA)联合尿脱落细胞学检查在膀胱肿瘤诊断中的应用价值。方法收集2018年9月至2019年9月本院经膀胱镜检查或手术后病检确诊的膀胱肿瘤(37例)及非膀胱肿瘤(32例)患者的尿液标本.分别行尿脱落细胞学及BTA检测并进行相关分析。结果①尿BTA诊断前列腺肿瘤的灵敏度(81.08%)高于尿脱落细胞学(59.46%),但其特异度(62.50%)和阳性预测值(71.43%)均低于尿脱落细胞学的特异性(96.87%)和阳性预测值(95.65%),差异均有统计学意义(P<0.05)。两者联合检查的灵敏度(97.30%)高于单独尿BTA检查(81.08%)和单独尿脱落细胞学检查(59.46%),联合检查的阴性预测值(95.24%)及诊断符合率(81.16%)均高于单独检查(P<0.05);②BTA表达水平和灵敏度与肿瘤病理分级、分期无明显相关性(P>0.05)。结论BTA联合尿脱落细胞学检测可提高对膀胱肿瘤的检出率.具有较高的临床应用价值。