Table 2.
Diagnostic accuracy of urinary cytology in isolation and urinary cytology in combination with CT urogram or renal/bladder ultrasonography to diagnose bladder cancer and upper tract urothelial cancer
| Test | Patient cohort | Diagnostic accuracy, % | ||||
|---|---|---|---|---|---|---|
| Sensitivity (95% CI) | Specificity (95% CI) | PPV (95% CI) | NPV (95% CI) | ROC | ||
| Positive/atypical urine cytology | All patients | 43.5 (29.8–57.9) | 95.7 (93.7–97.2) | 47.6 (33.0–62.5) | 94.9 (92.8–96.6) | 0.713 (0.615–0.811) |
| VH | 44.2 (30.0–59.0) | 94.7 (92.0– 96.7) | 51.4 (35.6–67.0) | 93.0 (90.0– 95.4) | 0.722 (0.619–0.825) | |
| High risk bladder cancer | 57.7 (38.7–75.3) | 94.9 (92.8–96.6) | 35.7 (22.4–50.7) | 97.9 (96.3–98.9) | 0.688 (0.567–0.769) | |
| Positive urine cytology | All patients | 38.2 (23.2–55.0) | 98.4 (97.0–99.3) | 61.9 (40.7–80.4) | 95.9 (93.9–97.4) | 0.856 (0.747–0.964) |
| Atypical urine cytology | All patients | 6.0 (5.3–33.4) | 96.7 (94.8–98.0) | 19.0 (6.3–38.9) | 95.9 (93.9–97.4) | 0.570 (0.433–0.707 |
| Positive/atypical urinary cytology or suspicious CTU suggestive of bladder cancer or UTUC | All patients | 90.2 (78.8–96.9) | 94.9 (91.9–97.0) | 71.2 (58.0–82.2) | 98.6 (96.7–99.6) | 0.849 (0.773–0.924) |
| VH | 92.3 (81.2–98.0) | 94.4 (91.1–96.8) | 72.0 (58.7–83.1) | 98.7 (96.8–99.7) | 0.854 (0.778–0.930) | |
| Positive/atypical urinary cytology or suspicious RBUS suggestive of bladder cancer or UTUC | All patients | 66.7 (34.5–90.5) | 96.7 (94.0–98.5) | 42.9 (19.8–68.3) | 98.8 (96.8–99.7) | 0.708 (0.535–0.882) |
| VH | 66.7 (34.5–90.5) | 96.6 (92.3–98.9) | 60.0 (30.0–85.4) | 97.4 (93.5–99.4) | 0.787 (0.597–0.977) | |
CTU, CT urogram; NPV, negative predictive value; PPV, positive predictive value; RBUS, renal/bladder ultrasonography; ROC, receiver‐operating characteristic; UTUC, upper tract urothelial cancer; VH, visible haematuria.