{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T00:18:41Z","timestamp":1793319521269,"version":"4.5.0"},"reference-count":25,"publisher":"BMJ","issue":"2","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["J Clin Pathol"],"accepted":{"date-parts":[[2020,5,19]]},"published-print":{"date-parts":[[2021,2]]},"abstract":"<jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>Bladder EpiCheck is one of several urinary tests studied to identify bladder tumours and analyses 15 methylation biomarkers determining bladder cancer presence on the basis of methylation profile.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>374 patients diagnosed with high-grade non-muscle invasive bladder cancer were treated and followed for 1\u2009year with voided urine cytology and white-light cystoscopy and biopsies according to European Association of Urology Guidelines. 268 cases were diagnosed with high-grade papillary carcinoma, while 106 cases were carcinoma in situ. Bladder EpiCheck test was performed together with cytology in all cases.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Comparing cytological categories of negative for high-grade urothelial carcinoma (NHGUC) and atypical urothelial cells (AUCs), we found that an EpiScore &lt;60 correlates with NHGUC (p=0.0003, Fisher\u2019s exact test), while comparing AUC and suspicious for high-grade urothelial carcinoma (SHGUC) or SHGUC and high-grade urothelial carcinoma (HGUC) categories, an EpiScore \u226560 correlates with SHGUC and HGUC, respectively (p=0.0031\u2009and p=0.0027, Fisher\u2019s exact test). In each TPS category, we found that sensitivity, specificity, Positive Predicitve Value (PPV) and Negative Predictive Value (NPV) of the Bladder EpiCheck test in HGUC category were higher than those observed in SHGUC group (sensitivity=98%, specificity=100%, NPV=85.7%, PPV=100%\u2009vs sensitivity=86.6%, specificity=52.3%, NPV=84.6%, PPV=56.5%).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Analysing methylation study results, we demonstrated that different TPS cytological categories also carry a distinct molecular signature. Moreover, our results confirm that cytological categories SHGUC and HGUC are different entities also from a molecular point of view and should continue to represent distinct groups in TPS.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/jclinpath-2020-206633","type":"journal-article","created":{"date-parts":[[2020,6,11]],"date-time":"2020-06-11T17:15:42Z","timestamp":1591895742000},"page":"102-105","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":26,"title":["Methylation study of the Paris system for reporting urinary (TPS) categories"],"prefix":"10.1136","volume":"74","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9111-0165","authenticated-orcid":false,"given":"Francesco","family":"Pierconti","sequence":"first","affiliation":[{"name":"Division of Anatomic Pathology and Histology, Catholic University of the Sacred Heart, \u201cAgostino Gemelli\u201d School of Medicine, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maurizio","family":"Martini","sequence":"additional","affiliation":[{"name":"Division of Anatomic Pathology and Histology, Catholic University of the Sacred Heart, \u201cAgostino Gemelli\u201d School of Medicine, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tonia","family":"Cenci","sequence":"additional","affiliation":[{"name":"Division of Anatomic Pathology and Histology, Catholic University of the Sacred Heart, \u201cAgostino Gemelli\u201d School of Medicine, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincenzo","family":"Fiorentino","sequence":"additional","affiliation":[{"name":"Division of Anatomic Pathology and Histology, Catholic University of the Sacred Heart, \u201cAgostino Gemelli\u201d School of Medicine, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emilio","family":"Sacco","sequence":"additional","affiliation":[{"name":"Department of Urology, Catholic University of the Sacred Heart, \u201cAgostino Gemelli\u201d School of Medicine, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Riccardo","family":"Bientinesi","sequence":"additional","affiliation":[{"name":"Department of Urology, Catholic University of the Sacred Heart, \u201cAgostino Gemelli\u201d School of Medicine, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dario","family":"Pugliese","sequence":"additional","affiliation":[{"name":"Department of Urology, Catholic University of the Sacred Heart, \u201cAgostino Gemelli\u201d School of Medicine, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"Iacovelli","sequence":"additional","affiliation":[{"name":"Department of Oncology, Catholic University of the Sacred Heart, \u201cAgostino Gemelli\u201d School of Medicine, Rome, Italy, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Schinzari","sequence":"additional","affiliation":[{"name":"Department of Oncology, Catholic University of the Sacred Heart, \u201cAgostino Gemelli\u201d School of Medicine, Rome, Italy, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luigi Maria","family":"Larocca","sequence":"additional","affiliation":[{"name":"Division of Anatomic Pathology and Histology, Catholic University of the Sacred Heart, \u201cAgostino Gemelli\u201d School of Medicine, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pier Francesco","family":"Bassi","sequence":"additional","affiliation":[{"name":"Department of Urology, Catholic University of the Sacred Heart, \u201cAgostino Gemelli\u201d School of Medicine, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2020,6,11]]},"reference":[{"key":"2025092510380977000_74.2.102.1","doi-asserted-by":"publisher","DOI":"10.1152\/japplphysiol.00238.2010"},{"key":"2025092510380977000_74.2.102.2","doi-asserted-by":"crossref","unstructured":"Rosenthal DL , Wojcik EM , Kurtycz DFI . The Paris system for reporting urinary cytology. Cham, Switzerland: Springer International Publishing AG, 2016.","DOI":"10.1007\/978-3-319-22864-8"},{"key":"2025092510380977000_74.2.102.3","doi-asserted-by":"crossref","first-page":"639","DOI":"10.1016\/j.eururo.2019.08.016","article-title":"European Association of Urology Guidelines on Non-muscle-invasive Bladder Cancer (TaT1 and Carcinoma In Situ) - 2019 Update","volume":"76","author":"Babjuk","year":"2019","journal-title":"Eur Urol"},{"key":"2025092510380977000_74.2.102.4","doi-asserted-by":"crossref","unstructured":"Pierconti F , Raspollini MR , Martini M , et al . Pd-L1 expression in bladder primary in situ urothelial carcinoma: evaluation in BCG-unresponsive patients and BCG responders. Virchows Arch 2020.","DOI":"10.1007\/s00428-020-02755-2"},{"key":"2025092510380977000_74.2.102.5","doi-asserted-by":"crossref","first-page":"200","DOI":"10.1002\/cncy.21957","article-title":"The risk of malignancy of atypical urothelial cells of undetermined significance in patients treated with chemohyperthermia or electromotive drug administration","volume":"126","author":"Pierconti","year":"2018","journal-title":"Cancer Cytopathol"},{"key":"2025092510380977000_74.2.102.6","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1016\/j.euo.2018.06.011","article-title":"Performance of the bladder EpiCheck\u2122 methylation test for patients under surveillance for non-muscle-invasive bladder cancer: results of a multicenter, prospective, blinded clinical trial","volume":"1","author":"Witjes","year":"2018","journal-title":"Eur Urol Oncol"},{"key":"2025092510380977000_74.2.102.7","doi-asserted-by":"crossref","first-page":"959","DOI":"10.1111\/bju.14673","article-title":"Diagnostic accuracy, clinical utility and influence on decision-making of a methylation urine biomarker test in the surveillance of non-muscle-invasive bladder cancer","volume":"123","author":"D'Andrea","year":"2019","journal-title":"BJU Int"},{"key":"2025092510380977000_74.2.102.8","doi-asserted-by":"publisher","DOI":"10.4161\/epi.25927"},{"key":"2025092510380977000_74.2.102.9","doi-asserted-by":"crossref","first-page":"958","DOI":"10.1016\/j.euf.2019.06.002","article-title":"The emerging role of stereotactic ablative radiotherapy for primary renal cell carcinoma: a systematic review and meta-analysis","volume":"5","author":"Correa","year":"2019","journal-title":"Eur Urol Focus"},{"key":"2025092510380977000_74.2.102.10","doi-asserted-by":"publisher","DOI":"10.1038\/sj.onc.1207758"},{"key":"2025092510380977000_74.2.102.11","doi-asserted-by":"publisher","DOI":"10.1016\/S1535-6108(02)00049-1"},{"key":"2025092510380977000_74.2.102.12","doi-asserted-by":"publisher","DOI":"10.1016\/S1535-6108(02)00049-1"},{"key":"2025092510380977000_74.2.102.13","doi-asserted-by":"crossref","first-page":"509","DOI":"10.1111\/cyt.12448","article-title":"An institutional experience with the Paris system: a paradigm shift from ambiguous terminology to more objective criteria for reporting urine cytology","volume":"28","author":"Roy","year":"2017","journal-title":"Cytopathology"},{"key":"2025092510380977000_74.2.102.14","doi-asserted-by":"crossref","first-page":"184","DOI":"10.1111\/cyt.12505","article-title":"The Paris system for urine cytology in upper tract urothelial specimens: a comparative analysis with biopsy and surgical resection","volume":"29","author":"Zheng","year":"2018","journal-title":"Cytopathology"},{"key":"2025092510380977000_74.2.102.15","doi-asserted-by":"publisher","DOI":"10.1002\/cncy.21449"},{"key":"2025092510380977000_74.2.102.16","doi-asserted-by":"crossref","first-page":"811","DOI":"10.1002\/cncy.21764","article-title":"The positive predictive value of \"suspicious for high-grade urothelial carcinoma\" in urinary tract cytology specimens: A single-institution study of 665 cases","volume":"124","author":"Joudi","year":"2016","journal-title":"Cancer Cytopathol"},{"key":"2025092510380977000_74.2.102.17","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1002\/dc.23639","article-title":"Accuracy and reproducibility of nuclear\/cytoplasmic ratio assessments in urinary cytology specimens","volume":"45","author":"Layfield","year":"2017","journal-title":"Diagn Cytopathol"},{"key":"2025092510380977000_74.2.102.18","doi-asserted-by":"publisher","DOI":"10.1111\/cyt.12050"},{"key":"2025092510380977000_74.2.102.19","doi-asserted-by":"publisher","DOI":"10.1002\/cncy.21278"},{"key":"2025092510380977000_74.2.102.20","doi-asserted-by":"publisher","DOI":"10.4103\/0974-7796.68857"},{"key":"2025092510380977000_74.2.102.21","doi-asserted-by":"publisher","DOI":"10.1309\/AJCPPRZLG9KT9AXL"},{"key":"2025092510380977000_74.2.102.22","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1186\/1742-6413-3-28","article-title":"Malignant atypical cell in urine cytology: a diagnostic dilemma","volume":"3","author":"Bhatia","year":"2006","journal-title":"Cytojournal"},{"key":"2025092510380977000_74.2.102.23","doi-asserted-by":"crossref","first-page":"e371","DOI":"10.1016\/j.clgc.2016.02.009","article-title":"Prognostic value of gene methylation and clinical factors in non-muscle-invasive upper tract urothelial carcinoma after radical nephroureterectomy","volume":"14","author":"Xing","year":"2016","journal-title":"Clin Genitourin Cancer"},{"key":"2025092510380977000_74.2.102.24","first-page":"645","article-title":"Identification of a methylation hotspot in the death receptor Fas\/CD95 in bladder cancer","volume":"40","author":"Watson","year":"2012","journal-title":"Int J Oncol"},{"key":"2025092510380977000_74.2.102.25","doi-asserted-by":"publisher","DOI":"10.1159\/000108297"}],"container-title":["Journal of Clinical Pathology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/jclinpath-2020-206633","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,25]],"date-time":"2025-09-25T17:38:25Z","timestamp":1758821905000},"score":1,"resource":{"primary":{"URL":"https:\/\/jcp.bmj.com\/lookup\/doi\/10.1136\/jclinpath-2020-206633"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,6,11]]},"references-count":25,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2021,1,19]]},"published-print":{"date-parts":[[2021,2]]}},"alternative-id":["10.1136\/jclinpath-2020-206633"],"URL":"https:\/\/doi.org\/10.1136\/jclinpath-2020-206633","relation":{},"ISSN":["0021-9746","1472-4146"],"issn-type":[{"value":"0021-9746","type":"print"},{"value":"1472-4146","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,6,11]]}}}