title: Diagnostic Value of Liquid-Based Cytology in Urothelial Carcinoma Diagnosis: A Systematic Review and Meta-Analysis.
abstract: OBJECTIVE
  To evaluate the value of liquid-based cytology (LBC) in the diagnosis of urothelial carcinoma.
  
  
  METHODS
  Diagnostic studies were searched for the diagnostic value of LBC in urothelial carcinoma in PubMed, Embase, Cochrane Library, Web of Science, CBM and CNKI. The latest retrieval date was September 2014. The data were extracted and the quality of the included studies was independently assessed by 2 reviewers. Stata 13 software was used to perform the statistical analysis. The research was conducted in compliance with the PRISMA statement.
  
  
  RESULTS
  Nineteen studies, which included 8293 patients, were evaluated. The results of the meta-analysis showed that the pooled sensitivity and specificity of LBC were 0.58 (0.51-0.65) and 0.96 (0.93-0.98), respectively. The diagnostic odds ratio (DOR) was 31 (18-56) and the area under the curve (AUC) of summary receiver operating characteristic (SROC) was 0.83 (0.80-0.86). The post-test probability was 80% when a positive diagnosis was made. Compared with high grade urothelial carcinoma (HGUC), the sensitivity of detecting low-grade urothelial carcinoma (LGUC) was significantly lower, risk ratio of sensitivity was 0.54 (0.43-0.66), P<0.001. However, no significant sensitivity improvement was observed with LBC when compared with traditional cytospin cytology, risk ratio was 1.03 (0.94-1.14), P = 0.524.
  
  
  CONCLUSIONS
  Despite LBC having a pooled 58% positive rate for urothelial carcinoma diagnosis in our meta-analysis, no significant improvement in sensitivity was observed based on the studies evaluated. Further research is needed to validate these findings.
authors.affiliation: Gansu Nephro-Urological Clinical Center, Institute of Urology, Department of Urology, Key Laboratory of Urological Disease of Gansu Province, Lanzhou University Second Hospital, Lanzhou 730000, China.
authors.forename: You
authors.initials: Y
authors.lastname: Luo
authors.affiliation: Gansu Nephro-Urological Clinical Center, Institute of Urology, Department of Urology, Key Laboratory of Urological Disease of Gansu Province, Lanzhou University Second Hospital, Lanzhou 730000, China.
authors.forename: Dong-Li
authors.initials: DL
authors.lastname: She
authors.affiliation: Gansu Nephro-Urological Clinical Center, Institute of Urology, Department of Urology, Key Laboratory of Urological Disease of Gansu Province, Lanzhou University Second Hospital, Lanzhou 730000, China.
authors.forename: Hu
authors.initials: H
authors.lastname: Xiong
authors.affiliation: Gansu Nephro-Urological Clinical Center, Institute of Urology, Department of Urology, Key Laboratory of Urological Disease of Gansu Province, Lanzhou University Second Hospital, Lanzhou 730000, China.
authors.forename: Li
authors.initials: L
authors.lastname: Yang
authors.affiliation: Gansu Nephro-Urological Clinical Center, Institute of Urology, Department of Urology, Key Laboratory of Urological Disease of Gansu Province, Lanzhou University Second Hospital, Lanzhou 730000, China.
authors.forename: Sheng-Jun
authors.initials: SJ
authors.lastname: Fu
mesh_terms: D002295:Carcinoma, Transitional Cell / Q000175:diagnosis* / Q000473:pathology / Q000652:urine; D002498:Centrifugation; D003584:Cytological Techniques; D006801:Humans; D016017:Odds Ratio; D012107:Research Design; D012680:Sensitivity and Specificity; D012996:Solutions; D013194:Staining and Labeling; D014556:Urine / Q000166:cytology*; D014571:Urologic Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000652:urine
chemical_list: D012996:Solutions