A new method has been found for detecting upper urinary tract transitional cell carcinoma by a team of researchers working Kingston, Ontario, Canada. This method checks for fibrinogen/fibrin degradation products. It appears to be more effective and accurate when compared to standard urinary cytology. The Researchers compared the efficacy of two types of rapid urine tests with urine cytology in establishing the diagnosis of transitional cell carcinoma in patients with suspected malignancy of the upper urinary tract.
A study was conducted on a sample number of patients with abnormalities of the upper urinary tract that were highly suspicious of malignancy provided urine samples. These samples were tested using two rapid urine tests, one that tested for fibrinogen/fibrin degradation products and one that tested for bladder tumor antigen BTA. The samples were also examined cytologically. The overall sensitivity of the fibrinogen/fibrin test was 100%, and the accuracy was 83%. The sensitivity of the BTA test was 50%, and the accuracy 62%. In comparison, the sensitivity of the cytology exam was 29%, and accuracy was 59%.
Based on these results, the authors concluded that cytology lacks sensitivity for the diagnosis of upper tract transitional cell carcinoma. The rapid urine fibrinogen/fibrin test appears to have better diagnostic characteristics than cytology, but further evaluation of these tests is warranted.