Which urine marker test provides more diagnostic value in conjunction with standard cytology- ImmunoCyt/uCyt+ or Cytokeratin 20 expression

Evaluation of CK20 expression and UCyt+？ was performed in urine of 90 patients of which 54 with bladder cancer with primary/recurrent diagnosis (low grade urothelial carcinoma (LGUC) = 23/8 patients, high grade urothelial carcinoma (HGUC) = 18/5 patients), and 36 patients as control; except of neoplastic bladder disease patients. For the evaluation of the three tests, CK20 and UCyt+？ tests were combined with urine cytology and compared with each other.The overall sensitivity detected for each tumor marker was as follows: for urine cytology was 75.9% and UCyt+？ was 83.3%, for CK20 70.4%, while the specificity was 66.7% for urine cytology and 86.1% for UCyt+？ and 83.3% for CK20. The sensitivity of cytology and UCyt+？ combination was higher (88.9%) than the sensitivity cytology and CK20 combination (77.8%). The simultaneous use of the three markers, sensitivity was reaching 92.5%.The UCyt+？ test and CK20 expression are valid tools for the performance of adjunctive analyses with conventional cytologic examination.Bladder cancer is the second most common urologic cancer [1]. The majority of patients with newly diagnosed bladder cancers have superficial, low-grade neoplasms that are associated with an excellent prognosis. However, these tumors have a 30% to 70% recurrence rate and may progress to invasive cancers in 10% to 30% of patients; progression greatly increases the risk of metastasis and subsequent mortality [2,3]. For this reason, the early detection of bladder tumors is essential for improved patient prognosis and long-term survival.Cytology is noninvasive and has high specificity but low sensitivity, especially for low-grade tumors. At the same time, it can be a challenging test to perform and is highly dependent on the skills and experience of a trained cytopathologist. Thus, published studies have reported a wide range of sensitivities (15.8%–84.6%) [4-12].Because cystoscopy is invasive and because cytology has poor sensitivity, noninvasive biomarkers have be