Table 3.
Performance of marker combinations in detecting recurrences in patients undergoing surveillance of non-muscle-invasive bladder cancer (NMIBC). Values are given in %. Two ways of considering marker combinations as positive were applied. In the first analysis, every positive marker led to a positive combination. In the second analysis, all markers had to be positive for considering a combination positive. High-risk tumors were defined as tumors showing at least one of the following features: pT1 or higher, G3, carcinoma in situ (Cis). Pos: positive, Sens: sensitivity, Spec: specificity, PPV: positive predictive value, NPV: negative predictive value, FISH: fluorescence in situ hybridization, and NMP22: nuclear matrix protein 22.
| Combination | Criteria for positive combination | n pos | Sensitivity total (sensitivity high risk tumors) | Spec | PPV | NPV total (NPV high risk tumors) | Accuracy |
|---|---|---|---|---|---|---|---|
| 2-Test combinations | |||||||
| Cytology & FISH | ≥1 marker pos | 230 | 80.5 (94.0) | 64.2 | 44.7 | 90.1 (98.8) | 68.5 |
| 2 markers pos | 149 | 63.3 (82.0) | 80.8 | 54.3 | 85.9 (89.6) | 76.2 | |
| Cytology & uCyt | ≥1 marker pos | 252 | 84.4 (92.0) | 59.5 | 42.8 | 91.3 (98.2) | 66.1 |
| 2 markers pos | 115 | 51.6 (66.0) | 86.2 | 57.4 | 82.3 (95.3) | 77.0 | |
| Cytology & NMP22 | ≥1 marker pos | 318 | 86.7 (98.0) | 40.8 | 34.6 | 89.5 (97.7) | 53.0 |
| 2 markers pos | 123 | 53.1 (68.0) | 84.5 | 55.3 | 83.3 (95.0) | 76.2 | |
| FISH & uCyt | ≥1 marker pos | 269 | 86.7 (96.0) | 56.5 | 41.5 | 92.1 (98.2) | 63.7 |
| 2 markers pos | 125 | 53.9 (66.0) | 84.3 | 55.2 | 83.5 (95.2) | 76.2 | |
| FISH & NMP22 | ≥1 marker pos | 330 | 88.3 (96.0) | 39.2 | 33.2 | 90.2 (98.6) | 51.9 |
| 2 markers pos | 141 | 56.3 (74.0) | 80.6 | 51.1 | 83.6 (96.1) | 74.1 | |
| uCyt & NMP22 | ≥1 marker pos | 335 | 89.8 (92.0) | 38.1 | 34.3 | 91.2 (97.2) | 51.8 |
| 2 markers pos | 124 | 46.8 (60.0) | 82.0 | 48.4 | 81.1 (94.4) | 72.7 | |
| 3-Test combinations | |||||||
| Cytology & FISH & uCyt+ | ≥1 marker pos | 282 | 87.5 (96.0) | 52.1 | 39.7 | 92.0 (99.0) | 61.4 |
| 3 markers pos | 101 | 46.1 (62.0) | 88.2 | 58.4 | 81.9 (95.0) | 77.0 | |
| Cytology & FISH & NMP22 | ≥1 marker pos | 338 | 90.6 (98.0) | 37.5 | 34.3 | 91.7 (99.3) | 51.5 |
| 3 markers pos | 104 | 49.2 (66.0) | 88.5 | 60.0 | 82.8 (95.5) | 78.1 | |
| Cytology & uCyt & NMP22 | ≥1 marker pos | 352 | 93.8 (100.0) | 34.7 | 34.1 | 93.8 (100.0) | 50.3 |
| 3 markers pos | 79 | 39.1 (56.0) | 91.2 | 63.3 | 80.7 (94.5) | 77.8 | |
| FISH & uCyt & NMP22 | ≥1 marker pos | 356 | 94.5 (100.0) | 33.8 | 36.0 | 94.5 (100.0) | 49.9 |
| 3 markers pos | 84 | 40.6 (58.0) | 91.0 | 61.9 | 80.9 (94.7) | 77.6 | |
| 4-Test combination | |||||||
| Cytology & FISH & uCyt+ & NMP22 | ≥1 marker pos | 359 | 94.5 (100.0) | 33.1 | 33.7 | 94.4 (100.0) | 49.3 |
| 4 markers pos | 68 | 35.9 (54.0) | 93.3 | 65.7 | 80.1 (94.4) | 78.1 |