Efficiency And Safety Of Hydroxycamptothecin And Pirarubicin Bladder Irrigation In Prevention Of Recurrence Of Bladder Tumor-a Meta Analysis And Diagnostic Value Of Fluorescence In Situ Hybridization For Upper Urinary Tract Urothelial Carcinoma

Objective: To evaluate the effectiveness and safety ofhydroxycamptothecin and pirarubicin bladder irrigation in prevention ofrecurrence of bladder tumor.Methods: The literatures were searched from PubMed, EMBASE, theCochrane Library, CNKI, and Wanfang. The data were extracted, the qualityof studies was evaluated according to the Cochrane systematic reviewguideline and meta-analysis was performed using Stata12software.Results: A total of13articles were in accordance with the criteria,involving1122cases, including530cases receiving the treatment ofhydroxycamptothecin bladder irrigation and592cases receiving pirarubicin.Meta analysis of13studies showed that hydroxycamptothecin had less effectin prevention of recurrence of bladder tumor compared with the pirarubicinbladder irrigation, RR=1.446,95%CI(1.152,1.815)(P=0.001), but a lowerincidence of haematuria events, RR=0.453,95%CI(0.252,0.816)(P=0.008).Conclusions: Pirarubicin bladder irrigation is more recommended forprevention of the recurrence of bladder tumor after taking into account theconditions of patients. However, more strictly-designed multi-centeredrandomized controlled trials with high quality in large-scale are needed toconfirm this result. Objective: To evaluate the diagnostic value of fluorescence in situhybridization (FISH) for upper urinary tract urothelial carcinoma.Methods: Databases including PubMed, the Cochrane Library, CNKIand WanFang Data were searched to collect the diagnostic trials on FISH forupper urinary tract urothelial carcinoma. The data of the included trials wereextracted, the methodological quality was evaluated in accordance with thequality assessment of diagnostic accuracy studies (QUADAS), and thenmeta-analysis was conducted using Meta-Disc1.4software. The weightedsensitivity and specficity were aggregated, as well as the summary receiveroperating characteristic (SROC) curve. Further, the area under the curve (AUC)was calculated to evaluate the value of FISH in diagnosis of upper urinarytract urothelial carcinoma.Results: A total of11articles were in accordance with the criteria,involving902cases. Heterogeneity, except for threshold effects, was foundwithin these studies. A meta-analysis was performed using the random effectmodel. Pooled accuracy indicators like sensitivity, specificity, positivelikelihood ratio, negative likelihood ratio and diagnostic odds ratio of FISHwere82%[95%CI(0.78，0.86）)、95%[95%CI（0.93，0.96）]、10.37[95%CI（5.06，21.26）]、0.21[95%C（I0.14，0.30）]、59.26[95%C（I22.97，152.87）],respectively, and the AUC was0.9368.Conclusion: With high sensitivity and specificity, FISH can be used asan optional noninvasive method for the diagnosis of upper urinary tracturothelial carcinoma.