title: Hematuria screening test for urinary bladder mucosal infiltration in cervical cancer.
abstract: OBJECTIVE
  To determine the diagnostic performance of hematuria as a screening test for urinary bladder infiltration in cervical cancer patients with a prospective study design.
  
  
  METHODS
  Newly diagnosed cervical 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 for clinical staging. The presence of 3 or more red blood cells (RBCs) per high power field was defined as positive for hematuria. A two-by-two table was used to determine the diagnostic performance of hematuria to detect urinary bladder mucosal infiltration using cystoscopy and biopsy as the gold standard.
  
  
  RESULTS
  A total of 130 were patients included, 54 of which (41.5%) had hematuria. Of these, four patients (3.08%) had pathological report from 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 cancer were 100%, 60.3%, 7.4%, 100%, and 61.5%, respectively. There was no single case of urinary bladder mucosal infiltration in patients initially staged less than stage III.
  
  
  CONCLUSIONS
  Hematuria can be used as a screening test to detect urinary bladder mucosal infiltration of cervical cancer. This can reduce the number of cervical cancer patients who really need to undergo cystoscopy as a staging procedure to less than half and to less than 20% if stage III or more were included without missing a single case of urinary bladder mucosal infiltration.
authors.affiliation: Department of Obstetrics and Gynecology, Faculty of Medicine, Khon Kaen University. Ayuth401@hotmail.com
authors.forename: Ayuth
authors.initials: A
authors.lastname: Chuttiangtum
authors.forename: Banchong
authors.initials: B
authors.lastname: Udomthavornsuk
authors.forename: Bandit
authors.initials: B
authors.lastname: Chumworathayi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000652:urine*; D001706:Biopsy; D002294:Carcinoma, Squamous Cell / Q000209:etiology / Q000556:secondary*; D003558:Cystoscopy; D003950:Diagnostic Techniques, Urological; D005260:Female; D005500:Follow-Up Studies; D006417:Hematuria / Q000175:diagnosis* / Q000209:etiology; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D011446:Prospective Studies; D016482:Urinalysis; D001743:Urinary Bladder / Q000473:pathology*; D001749:Urinary Bladder Neoplasms / Q000175:diagnosis* / Q000209:etiology; D002583:Uterine Cervical Neoplasms / Q000150:complications* / Q000473:pathology
chemical_list: D014408:Biomarkers, Tumor