Preoperative pyuria predicts the presence of high-grade bladder carcinoma in patients with bladder tumors.

Autor:	Poletajew S; Second Department of Urology, Centre of Postgraduate Medical Education, Warsaw, Poland., Gajewska D; Department of Urology and Urological Oncology, Pomeranian Medical University, Szczecin, Poland., Kaczmarek K; Department of Urology and Urological Oncology, Pomeranian Medical University, Szczecin, Poland., Krajewski W; Department of Urology and Oncological Urology, Wrocław Medical University, Wrocław, Poland., Łykowski M; Second Department of Urology, Centre of Postgraduate Medical Education, Warsaw, Poland., Sondka-Migdalska J; I Department of Urology, Medical University in Łódź, Łódź, Poland., Borowik M; Department of Urology, University of Warmia and Mazury, Olsztyn, Poland., Buraczyński P; Department of Urology and Urologic Oncology, Medical University of Lublin, Lublin, Poland., Dzięgała M; Department of Urology and Oncological Urology, Wrocław Medical University, Wrocław, Poland., Przudzik M; Department of Urology, University of Warmia and Mazury, Olsztyn, Poland., Słojewski M; Department of Urology and Urological Oncology, Pomeranian Medical University, Szczecin, Poland., Kryst P; Second Department of Urology, Centre of Postgraduate Medical Education, Warsaw, Poland.
Jazyk:	angličtina
Zdroj:	Central European journal of urology [Cent European J Urol] 2020; Vol. 73 (4), pp. 423-436. Date of Electronic Publication: 2020 Dec 03.
DOI:	10.5173/ceju.2020.0289
Abstrakt:	Introduction: Preoperative identification of high-grade bladder cancer presence can optimize patient management. The aim of this study was to assess the association between preoperative pyuria and the pathological features of bladder cancer. Material and Methods: This retrospective analysis enrolled 943 patients undergoing transurethral resection of a bladder tumor. Patients were divided into two study groups based on the presence of pyuria in preoperative urine analysis, defined as the presence of >5 leukocytes in the high power field. Pyuria status as a potential predictive factor was then confronted with pathological features based on standard microscopic examination of the surgical specimen. Results: Among 943 recruited patients, 294 (31.2%) presented with pyuria. Patients with pyuria were older (71 vs. 68 years, p <0.05), had higher rates of large (≥3 cm) tumors (37% vs. 26%, p <0.05), and more frequently presented concomitant hematuria (58% vs. 24%, p <0.05). In case of recurrent tumors patients with pyuria more often received intravesical chemotherapy in the past (4.8% vs. 1.4%, p <0.05). Regarding oncological data, patients with pyuria had significantly higher tumor stage and grade. On multivariable analysis pyuria was independently associated with high-grade tumors (OR 1.97, 95% CI 1.45-2.67). Specificity and negative predictive value of pyuria as a biomarker of high-grade tumors were 76% and 68%, respectively. Conclusions: Preoperative pyuria can be regarded as a predictor of the presence of high-grade bladder carcinoma in patients with bladder tumors. Competing Interests: The authors declare no conflicts of interest. (Copyright by Polish Urological Association.)
Databáze:	MEDLINE
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