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The value of bladder mapping and prostatic urethra biopsies for detection of carcinoma in situ (CIS)
Skåne University Hospital, Sweden .
Helsingborg County Hospital, Sweden .
Helsingborg County Hospital, Sweden .
Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Urology in Östergötland.
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2012 (English)In: BJU International, ISSN 1464-4096, E-ISSN 1464-410X, Vol. 110, no 2B, E41-E45 p.Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES To assess the value of bladder mapping and prostatic urethra biopsies for detection of urothelial carcinoma in situ (CIS). CIS of the urinary bladder is a flat high-grade lesion of the mucosa associated with a significant risk of progression to muscle-invasive disease. CIS is difficult to identify on cystoscopy, and definite diagnosis requires histopathology. Traditionally, if CIS is suspected, multiple cold-cup biopsies are taken from the bladder mucosa, and resection biopsies are obtained from the prostatic urethra in males. This approach is often called bladder mapping (BMAP). The accuracy of BMAP as a diagnostic tool is not known. PATIENTS AND METHODS Male patients with bladder cancer scheduled for cystectomy underwent cold-cup bladder biopsies (sidewalls, posterior wall, dome, trigone), and resection biopsies were taken from the prostatic urethra. After cystectomy, the surgical specimen was investigated in a standardised manner and subsequently compared with the BMAP biopsies for the presence of CIS. RESULTS The histopathology reports of 162 patients were analysed. CIS was detected in 46% of the cystoprostatectomy specimens, and multiple (greater than= 2) CIS lesions were found in 30%. BMAP (cold-cup bladder biopsies + resection biopsies from the prostatic urethra) provided sensitivity of 51% for any CIS, and 55% for multiple CIS lesions. The cold-cup biopsies for CIS in the bladder mucosa showed sensitivity and specificity of 46% and 89%, respectively. CONCLUSION Traditional cold-cup biopsies are unreliable for detecting CIS in bladder mucosa and negative findings must be interpreted with caution.

Place, publisher, year, edition, pages
Wiley , 2012. Vol. 110, no 2B, E41-E45 p.
Keyword [en]
bladder cancer; carcinoma in situ (CIS); bladder mapping; biopsies; prostatic urethra
National Category
Clinical Medicine
URN: urn:nbn:se:liu:diva-109957DOI: 10.1111/j.1464-410X.2011.10654.xISI: 000208881100006PubMedID: 22035276ScopusID: 2-s2.0-84863553119OAI: diva2:741930
Available from: 2014-08-29 Created: 2014-08-29 Last updated: 2014-10-29Bibliographically approved

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Jahnson, Staffan
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Division of Clinical SciencesFaculty of Health SciencesDepartment of Urology in ÖstergötlandExperimental Pathology
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