PDF(Pubmed)
Abstract：
BACKGROUND: The postoperative complication rate is 30-64% among patients undergoing muscle-invasive and recurrent high-risk non-muscle-invasive bladder cancer surgery. Preoperative risky alcohol use increases the risk. The aim was to evaluate the accuracy of markers for identifying preoperative risky alcohol.
METHODS: Diagnostic test sub-study of a randomized controlled trial (STOP-OP trial), based on a cohort of 94 patients scheduled for major bladder cancer surgery. Identification of risky alcohol use using Timeline Follow Back interviews (TLFB) were compared to the AUDIT-C questionnaire and three biomarkers: carbohydrate-deficient transferrin in plasma (P-CDT), phosphatidyl-ethanol in blood (B-PEth), and ethyl glucuronide in urine (U-EtG).
RESULTS: The correlation between TLFB and AUDIT-C was strong (ρ = 0.75), while it was moderate between TLFB and the biomarkers (ρ = 0.55-0.65). Overall, sensitivity ranged from 56 to 82% and specificity from 38 to 100%. B-PEth showed the lowest sensitivity at 56%, but the highest specificity of 100%. All tests had high positive predictive values (79-100%), but low negative predictive values (42-55%).
CONCLUSIONS: Despite high positive predictive values, negative predictive values were weak compared to TLFB. For now, TLFB interviews seem preferable for preoperative identification of risky alcohol use.
METHODS: Diagnostic test sub-study of a randomized controlled trial (STOP-OP trial), based on a cohort of 94 patients scheduled for major bladder cancer surgery. Identification of risky alcohol use using Timeline Follow Back interviews (TLFB) were compared to the AUDIT-C questionnaire and three biomarkers: carbohydrate-deficient transferrin in plasma (P-CDT), phosphatidyl-ethanol in blood (B-PEth), and ethyl glucuronide in urine (U-EtG).
RESULTS: The correlation between TLFB and AUDIT-C was strong (ρ = 0.75), while it was moderate between TLFB and the biomarkers (ρ = 0.55-0.65). Overall, sensitivity ranged from 56 to 82% and specificity from 38 to 100%. B-PEth showed the lowest sensitivity at 56%, but the highest specificity of 100%. All tests had high positive predictive values (79-100%), but low negative predictive values (42-55%).
CONCLUSIONS: Despite high positive predictive values, negative predictive values were weak compared to TLFB. For now, TLFB interviews seem preferable for preoperative identification of risky alcohol use.
摘要：
背景：在接受肌肉浸润性和复发性高风险非肌层浸润性膀胱癌手术的患者中，术后并发症发生率为30-64％。术前使用危险酒精会增加风险。目的是评估用于识别术前危险酒精的标记物的准确性。
方法：随机对照试验的诊断测试子研究（STOP-OP试验），基于94名计划接受大膀胱癌手术的患者的队列。使用时间轴随访访谈（TLFB）识别危险的酒精使用与AUDIT-C问卷和三个生物标志物进行比较：血浆中碳水化合物缺乏的转铁蛋白（P-CDT），血液中的磷脂酰乙醇（B-PEth），和尿中的乙基葡糖苷酸(U-EtG)。
结果：TLFB和AUDIT-C之间的相关性很强（ρ=0.75），而TLFB和生物标志物之间是中等的（ρ=0.55-0.65）。总的来说,敏感性为56%~82%,特异性为38%~100%.B-PEth的灵敏度最低，为56%，但最高特异性为100%。所有测试均具有较高的阳性预测值（79-100％），但低阴性预测值（42-55％）。
结论：尽管阳性预测值很高，与TLFB相比,阴性预测值较弱.现在,TLFB访谈对于术前识别危险的酒精使用似乎更可取。
方法：随机对照试验的诊断测试子研究（STOP-OP试验），基于94名计划接受大膀胱癌手术的患者的队列。使用时间轴随访访谈（TLFB）识别危险的酒精使用与AUDIT-C问卷和三个生物标志物进行比较：血浆中碳水化合物缺乏的转铁蛋白（P-CDT），血液中的磷脂酰乙醇（B-PEth），和尿中的乙基葡糖苷酸(U-EtG)。
结果：TLFB和AUDIT-C之间的相关性很强（ρ=0.75），而TLFB和生物标志物之间是中等的（ρ=0.55-0.65）。总的来说,敏感性为56%~82%,特异性为38%~100%.B-PEth的灵敏度最低，为56%，但最高特异性为100%。所有测试均具有较高的阳性预测值（79-100％），但低阴性预测值（42-55％）。
结论：尽管阳性预测值很高，与TLFB相比,阴性预测值较弱.现在,TLFB访谈对于术前识别危险的酒精使用似乎更可取。
