A New Scoring System to Differentiate Bladder Cancer from Intravesical Prostatic Protrusion in the Bladder Neck: BCa-IPP Score

Ali Kaan Yildiz; Cagri Oktem; Bugra Bilge Keseroglu; Turgay Kacan; Berat Cem Ozgur; Omer Gokhan Doluoglu; Tolga Karakan

doi:10.2174/0115734056241577231023064014

A New Scoring System to Differentiate Bladder Cancer from Intravesical Prostatic Protrusion in the Bladder Neck: BCa-IPP Score

Curr Med Imaging. 2023 Nov 10. doi: 10.2174/0115734056241577231023064014. Online ahead of print.

Authors

Ali Kaan Yildiz¹, Cagri Oktem², Bugra Bilge Keseroglu¹, Turgay Kacan¹, Berat Cem Ozgur², Omer Gokhan Doluoglu², Tolga Karakan¹

Affiliations

¹ Department of Urology, Ankara City Hospital, Ankara, Turkey.
² Department of Urology, University of Medical Sciences, Ankara Training and Research Hospital, Ankara, Turkey.

PMID: 37957923
DOI: 10.2174/0115734056241577231023064014

Abstract

Objective: The aim of this study was to explore the criteria that can predict bladder cancer among the lesions that could not be differentiated from intravesical prostate protrusion (IPP) and to create a scoring system using these criteria.

Methods: A retrospective analysis was made of patients with an ultrasound report indicating lesions in the bladder neck, for which differentiation between bladder cancer and IPP could not be determined. A total of 174 patients diagnosed with bladder cancer (n=102) or benign prostate lesion (n=72) according to the biopsy results were enrolled in the study. Hemoglobin, prostate-specific antigen (PSA), prostate volume (PV), bladder wall thickness (BWT), lesion height (LH), and the ratio of lesion width to base (LW/B) were compared between the two groups.

Results: ROC analysis revealed an AUC value >0.7 for all factors, and the best cut-off value was identified for each factor. In the multivariate analysis, by determining a score for each factor according to the ORs, the BCa-IPP scoring system was developed to provide a total score in the range of minimum 0 and maximum 15. In the ROC analysis, the AUC value was 0.954 (95% CI: 0.923-0.986) for the BCa-IPP score. The best cut-off value was found to be 10, with sensitivity of 0.93 and specificity of 0.85.

Conclusion: Using simple laboratory and ultrasound findings, the BCa-IPP scoring system was created, which was seen to have high predictive value and can be easily applied in the clinic. The BCa-IPP scoring system is a non-invasive test that can be successfully applied for the differentiation of bladder cancer from benign lesions.

Keywords: benign; bladder; cancer; hematuria; prostate; ultrasound..