Hematuria Screening Test for Urinary Bladder Mucosal Infiltration in Cervical Cancer

Abstract

<br/><b>Objective</b>: To determine the diagnostic performance of hematuria as a screening test for urinary bladderinfiltration in cervical cancer patients with a prospective study design. Materials and <br/><b>Methods</b>: Newly diagnosedcervical cancer patients at Srinagarind hospital from 14 June 2011 to 30 April 2012 were enrolled in this study.We collected midstream urine samples for urinalysis from every patient before routine cystoscopic exam forclinical staging. The presence of 3 or more red blood cells (RBCs) per high power field was defined as positivefor hematuria. A two-by-two table was used to determine the diagnostic performance of hematuria to detecturinary bladder mucosal infiltration using cystoscopy and biopsy as the gold standard. <br/><b>Result</b>: A total of 130 werepatients included, 54 of which (41.5%) had hematuria. Of these, four patients (3.08%) had pathological reportfrom cystoscopic biopsy confirmed metastatic squamous cell carcinoma. The sensitivity, specificity, PPV, NPV,and accuracy of hematuria as a screening test to detect urinary bladder mucosal infiltration of cervical cancerwere 100%, 60.3%, 7.4%, 100%, and 61.5%, respectively. There was no single case of urinary bladder mucosalinfiltration in patients initially staged less than stage III. <br/><b>Conclusions</b>: Hematuria can be used as a screening testto detect urinary bladder mucosal infiltration of cervical cancer. This can reduce the number of cervical cancerpatients who really need to undergo cystoscopy as a staging procedure to less than half and to less than 20% ifstage III or more were included without missing a single case of urinary bladder mucosal infiltration.