Background: Urinary bladder cancer (UBC) is a highly prevalent disease and is associated with substantial morbidity, mortality and cost. This paper aims to explore the combination role of DAPK methylation in urinary sediment and B ultrasound in diagnosing recurrent UBC. Methods: A total of 1021 cases of primary UBC undergone electrocision of bladder tumor through urethra were included and were subjected to follow up every 3 month within 2 years. B ultrasound, DAPK methylation in urinary

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... , examination of exfoliated cells in urine and cystoscopy were performed during the follow up. The data recorded in follow up were subjected to chi-square test and Kappa test. ROC was drawn to evaluate the diagnostic role of each parameter in recurrent UBC. Results: Among the 1021 patients, 115 patients were found with recurrent UBC by cystoscopy and biopsy two years after the operation, and failed to complete the follow up, thus the effective number of follow up was 906. The cystoscopy results were not only consistent with that of B ultrasound (Kappa = 0.785, P < 0.05), but also agreed with that of DAPK methylation in urinary sediment and combination of B ultrasound with DAPK methylation (Kappa = 0.517, P < 0.05, Kappa = 0.593, P < 0.05). ROC curve indicated that the area under curve of combination of B ultrasound with DAPK methylation was 0.922 (sensitivity, 92.86%; specificity, 91.63%; Youden index, 0.845) with negative prediction value of 99.4% which suggested that the recurrent risk would be low in case negative results were obtained. Conclusion: Those data supported that combination of DAPK methylation with B ultrasound has high performance in diagnosing recurrent UBC.