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Bladder cancer is the fourth most common cancer in men and ninth most common cancer in women.
Tests generally appear in the order most useful for common clinical situations
| Test name: Urinalysis, Complete |
| ARUP #: 0020350 |
| Methodology: Reflective Photometry/Microscopic by Yellow IRIS |
| Use: Confirm hematuria |
| Limitations: Time-sensitive test |
| Test name: Cytology, Urologic |
| ARUP #: 8209704 |
| Methodology: Routine Cytopathologic Evaluation |
| Use: Diagnose urothelial carcinoma in patients with signs and/or symptoms of bladder cancer (eg, hematuria, irritative voiding symptoms) Monitor noninvasively for urothelial carcinoma in conjunction with cystoscopy in patients previously diagnosed with bladder cancer to identify residual or recurring bladder cancer |
| Limitations: Voided urine cytology or the examination of urinary sediment for cancer cells provides suboptimal results because of low sensitivity for early-stage and low-grade bladder cancer |
| Test name: UroVysion™ FISH |
| ARUP #: 8100600 |
| Methodology: Fluorescence in situ Hybridization/Automated Image Analysis or Manual Screening |
| Use: Monitor noninvasively for urothelial carcinoma in conjunction with cystoscopy in patients with previously diagnosed bladder cancer to identify residual or recurring urothelial carcinoma Use in conjunction with and not in lieu of current standard diagnostic procedures as an aid for initial diagnosis of bladder carcinoma in patients with hematuria Detect aneuploidy for chromosomes 3, 7, 17 and loss (deletion) of the 9p21 locus in urine specimens |
| Limitations: If result is negative but symptoms of recurrent urothelial carcinoma still exist, additional clinical studies to exclude recurrent urothelial carcinoma should be pursued The Vysis® UroVysion™ kit is designed to detect genetic abnormality associated with most urothelial cancers, but some are not detected If result is positive in the absence of clinical documentation of recurrent urothelial carcinoma within the bladder, the source may be from another site (eg, ureter, kidney, urethra, prostate); further clinical evaluation recommended to exclude these sites as the source of the abnormal cells |
| Test name: Bladder Tumor Associated Antigen |
| ARUP #: 8100500 |
| Methodology: Qualitative Immunoassay |
| Use: Monitor noninvasively for urothelial carcinoma in conjunction with cystoscopy in patients with previously diagnosed bladder cancer to identify residual or recurring bladder cancer Detect bladder tumor associated antigen hCFH (human complement factor H) using qualitative immunoassay from urine |
| Limitations: Results should not be interpreted as absolute evidence for the presence or absence of bladder cancer False-positive results can occur with any disease causing endogenous hCFH to leak into the bladder (eg, renal stones, nephritis, renal cancer, urinary tract infections, cystitis, recent trauma to the bladder or urinary tract) BTA stat® is not approved as a screening test for bladder cancer |
| Test name: NMP22® |
| ARUP #: 0080281 |
| Methodology: Quantitative Enzyme Immunoassay |
| Use: Identify urothelial carcinoma in conjunction with cystoscopy in patients previously diagnosed with bladder cancer Use in conjunction with (not in lieu of) current standard diagnostic procedures for post-surgery management of patients with transitional cell carcinoma (TCC) of the bladder to identify those patients with occult or rapidly recurring TCC Determine how aggressively patients should be monitored cystoscopically after surgical treatment |
| Limitations: Values obtained with different assay methods should not be used interchangeably; ARUP uses the Matritech NMP22® Test Kit, which is an enzyme immunoassay (EIA) method Elevated result cannot not be interpreted as evidence of malignant disease in the urinary tract without confirmation by other diagnostic procedures False elevations may occur in patients
Does not replace cystoscopic follow-up for tumor recurrence NMP22® test is not cleared as a screening test for bladder cancer |
| Test name: CD8 by Immunohistochemistry |
| ARUP #: 2003520 |
| Methodology: Immunohistochemistry |
| Use: Aid in histologic diagnosis of bladder cancer Stained and returned to client pathologist for interpretation; consultation available if needed |
| Test name: Ki-67 Tissue Assay, Paraffin |
| ARUP #: 0049270 |
| Methodology: Immunohistochemistry |
| Use: Aid in histologic diagnosis of bladder cancer Stained and resulted by ARUP |
| Test name: p16 by Immunohistochemistry |
| ARUP #: 2004064 |
| Methodology: Immunohistochemistry |
| Use: Aid in histologic diagnosis of bladder cancer Stained and returned to client pathologist for interpretation; consultation available if needed |
| Test name: p21 (Waf1/Cip 1) by Immunohistochemistry |
| ARUP #: 2004067 |
| Methodology: Immunohistochemistry |
| Use: Aid in histologic diagnosis of bladder cancer Stained and returned to client pathologist for interpretation; consultation available if needed |
| Test name: p27 (Kip1) by Immunohistochemistry |
| ARUP #: 2004070 |
| Methodology: Immunohistochemistry |
| Use: Aid in histologic diagnosis of bladder cancer Stained and returned to client pathologist for interpretation; consultation available if needed |
| Test name: p53 Tissue Assay, Paraffin |
| ARUP #: 0049250 |
| Methodology: Immunohistochemistry |
| Use: Aid in histologic diagnosis of bladder cancer Stained and resulted by ARUP |
| Test name: p63 by Immunohistochemistry |
| ARUP #: 2004073 |
| Methodology: Immunohistochemistry |
| Use: Aid in histologic diagnosis of bladder cancer Stained and returned to client pathologist for interpretation; consultation available if needed |
| Test name: Keratin 903 (K903) High Molecular Weight by Immunohistochemistry |
| ARUP #: 2003978 |
| Methodology: Immunohistochemistry |
| Use: Aid in histologic diagnosis of bladder cancer Stained and returned to client pathologist for interpretation; consultation available if needed |
| Test name: Cytokeratin 5,6 (CK 5,6) by Immunohistochemistry |
| ARUP #: 2003851 |
| Methodology: Immunohistochemistry |
| Use: Aid in histologic diagnosis of bladder cancer Stained and returned to client pathologist for interpretation; consultation available if needed |
| Test name: Cytokeratin 7 (CK 7) by Immunohistochemistry |
| ARUP #: 2003854 |
| Methodology: Immunohistochemistry |
| Use: Aid in histologic diagnosis of bladder cancer Stained and returned to client pathologist for interpretation; consultation available if needed |
| Test name: Cytokeratin 20 (CK 20) by Immunohistochemistry |
| ARUP #: 2003848 |
| Methodology: Immunohistochemistry |
| Use: Aid in histologic diagnosis of bladder cancer Stained and returned to client pathologist for interpretation; consultation available if needed |