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Comparison of the clinical usefulness of different urinary tests for the initial detection of bladder cancer: a systematic review. Curr Urol 2021; 15:22-32. [PMID: 34084118 PMCID: PMC8137038 DOI: 10.1097/cu9.0000000000000012] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Accepted: 01/07/2020] [Indexed: 12/16/2022] Open
Abstract
Objectives: The standard initial approach in patients with hematuria or other symptoms suggestive of bladder cancer (BC) is a combination of cystoscopy and urine cytology (UC); however, UC has low sensitivity particularly in low-grade tumors. The aim of the present review was to critically analyze and compare results in the literature of promising molecular urinary tests for the initial diagnosis of BC. Methods: We searched in the Medline and Cochrane Library databases for literature from January 2009 to January 2019, following the PRISMAguidelines. Results: In terms of sensitivity, ImmunoCyt showed the highest mean and median value, higher than UC. All tests analyses showed higher mean and median sensitivity when compared with UC. In terms of specificity, only UroVysion and Microsatellite analyses showed mean and median values similar to those of UC, whereas for all other tests, the specificity was lower than UC. It is evident that the sensitivity of UC is particularly low in low grade BC. Urinary tests mainly had improved sensitivity when compared to UC, and ImmunoCyt and UroVysion had the highest improvement in low grade tumors. Conclusions: Most of the proposed molecular markers were able to improve the sensitivity with similar or lower specificity when compared to UC. However, variability of results among the different studies was strong. Thus, as of now, none of these markers presented evidences so as to be accepted by international guidelines for diagnosis of BC.
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Mattioli S, Seregni E, Caperna L, Botti C, Savelli G, Bombardieri E. BTA-TRAK Combined with Urinary Cytology is a Reliable Urinary Indicator of Recurrent Transitional Cell Carcinoma (TCC) of the Bladder. Int J Biol Markers 2018. [DOI: 10.1177/172460080001500303] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
This study evaluated the diagnostic accuracy of BTA-TRAK in combination with urinary cytology (UC) in the follow-up of patients with a history of transitional cell carcinoma (TCC) of the bladder. The overall sensitivity of BTA-TRAK, UC and the two tests combined for the detection of recurrences was 82.7% (48/58), 84.2% (48/57) and 91.2% (52/57), respectively. BTA and UC showed comparable sensitivity for superficial recurrences (76.7% (33/43) and 78.5% (33/42), respectively) and for invasive recurrences (100% (15/15)); when the two tests were used in combination, the sensitivity for superficial lesions increased to 88% (37/42). BTA-TRAK was more sensitive than UC for G1 recurrences (81.2% (13/16) vs. 68.7% (11/16)), and when the two tests were combined the sensitivity increased to 87.5% (14/16). The sensitivity of the combination was 100% (15/15) for G3 lesions. The differences in urinary BTA-TRAK levels between patients with recurrences and those without evidence of disease were statistically significant (Wilcoxon's test, p<0.05); among patients with recurrences BTA levels were significantly higher in the invasive and poorly differentiated subtypes. In the series of patients studied by us, BTA-TRAK combined with UC was shown to be a non-invasive, accurate test to predict TCC recurrences. Periodic measurement of BTA-TRAK combined with urinary cytology seems to provide additional information for the monitoring of patients treated for TCC; however, due to the presence of false positive and false negative results, this test cannot replace cystoscopy. In a selected group of patients it could, if combined with cytology and ultrasonography and if correctly used and interpreted, orient the timing and indication for cystoscopy.
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Affiliation(s)
- S. Mattioli
- Division of Urology, Clinical Institute S. Ambrogio, Milan
| | - E. Seregni
- Division of Nuclear Medicine, National Cancer Institute, Milan - Italy
| | - L. Caperna
- Division of Urology, Clinical Institute S. Ambrogio, Milan
| | - C. Botti
- Division of Nuclear Medicine, National Cancer Institute, Milan - Italy
| | - G. Savelli
- Division of Nuclear Medicine, National Cancer Institute, Milan - Italy
| | - E. Bombardieri
- Division of Nuclear Medicine, National Cancer Institute, Milan - Italy
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Önal B, Han Ü, Yilmaz S, Köybasioglu F, Altuğ U. The use of urinary nuclear matrix protein 22 (NMP22) as a diagnostic adjunct to urine cytology for monitoring of recurrent bladder cancer-institutional experience and review. Diagn Cytopathol 2014; 43:307-14. [DOI: 10.1002/dc.23239] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2013] [Revised: 10/16/2014] [Accepted: 11/09/2014] [Indexed: 12/20/2022]
Affiliation(s)
- Binnur Önal
- Department of Pathology and Cytology; MoH; Ankara Diskapi Teaching and Research Hospital; Ankara Turkey
| | - Ünsal Han
- Department of Pathology and Cytology; MoH; Ankara Diskapi Teaching and Research Hospital; Ankara Turkey
| | - Sinasi Yilmaz
- Department of Pathology and Cytology; MoH; Ankara Diskapi Teaching and Research Hospital; Ankara Turkey
| | - Fulya Köybasioglu
- Department of Pathology and Cytology; MoH; Ankara Diskapi Teaching and Research Hospital; Ankara Turkey
| | - Uğur Altuğ
- Department of Urology; MoH; Ankara Diskapi Teaching and Research Hospital; Ankara Turkey
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Pall M, Iqbal J, Singh SK, Rana SV. CA 19-9 as a serum marker in urothelial carcinoma. Urol Ann 2012; 4:98-101. [PMID: 22629005 PMCID: PMC3355709 DOI: 10.4103/0974-7796.95555] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2011] [Accepted: 05/29/2011] [Indexed: 11/05/2022] Open
Abstract
Introduction: CA 19-9 is a carbohydrate antigen related to Lewis A blood group antigen. It is well-known marker for pancreatic carcinoma and is being investigated for other malignancies including carcinoma bladder. We evaluated the role of serum CA 19-9 as a tumor marker and correlated its level with tumor stage and grade. Materials and Methods: Seventy-five patients with histologically proven urothelial carcinoma were included in this study as case and 25 healthy volunteers as control. Preoperative 5 ml blood sample was collected. Serum level of CA 19-9 was measured using solid-phase enzyme-linked immunosorbent assay kit. The value of CA19-9 was expressed in U/ml and 37 U/ml was taken as cut-off upper value of normal. Results: The range of CA19-9 in patients of urothelial carcinoma was 2 to 122 U/ml with a mean of 26.33±29.28, while in control, it was 8.48±5.01 U/ml (P<0.001). The sensitivity of CA19-9 was 29%. Serum CA19-9 was significantly elevated in invasive disease in comparison with superficial disease (47.17±34.43 vs 16.53±20.13) (P<0.001). Significantly high proportion of patients with invasive disease had value ≥37 U/ml (14/24 [58.3%] vs 8/51 [15.7%]) with P value <0.001. High proportion of high-grade tumor had raised value, 14/34 (41.25%); all patients with metastatic disease had value more than 37 U/ml. Conclusions: Serum CA19-9 is a marker of aggressiveness of urothelial carcinoma and is almost invariably raised in patients with metastatic disease. Thus, it may be used as a prognostic marker but not as a screening tool due to its low sensitivity.
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Affiliation(s)
- Mahander Pall
- Department of General Surgery, PGIMER, Chandigarh, India
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Kelly JD, Dudderidge TJ, Wollenschlaeger A, Okoturo O, Burling K, Tulloch F, Halsall I, Prevost T, Prevost AT, Vasconcelos JC, Robson W, Leung HY, Vasdev N, Pickard RS, Williams GH, Stoeber K. Bladder cancer diagnosis and identification of clinically significant disease by combined urinary detection of Mcm5 and nuclear matrix protein 22. PLoS One 2012; 7:e40305. [PMID: 22792272 PMCID: PMC3392249 DOI: 10.1371/journal.pone.0040305] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2012] [Accepted: 06/04/2012] [Indexed: 01/15/2023] Open
Abstract
Background Urinary biomarkers for bladder cancer detection are constrained by inadequate sensitivity or specificity. Here we evaluate the diagnostic accuracy of Mcm5, a novel cell cycle biomarker of aberrant growth, alone and in combination with NMP22. Methods 1677 consecutive patients under investigation for urinary tract malignancy were recruited to a prospective blinded observational study. All patients underwent ultrasound, intravenous urography, cystoscopy, urine culture and cytologic analysis. An immunofluorometric assay was used to measure Mcm5 levels in urine cell sediments. NMP22 urinary levels were determined with the FDA-approved NMP22® Test Kit. Results Genito-urinary tract cancers were identified in 210/1564 (13%) patients with an Mcm5 result and in 195/1396 (14%) patients with an NMP22 result. At the assay cut-point where sensitivity and specificity were equal, the Mcm5 test detected primary and recurrent bladder cancers with 69% sensitivity (95% confidence interval = 62–75%) and 93% negative predictive value (95% CI = 92–95%). The area under the receiver operating characteristic curve for Mcm5 was 0.75 (95% CI = 0.71–0.79) and 0.72 (95% CI = 0.67–0.77) for NMP22. Importantly, Mcm5 combined with NMP22 identified 95% (79/83; 95% CI = 88–99%) of potentially life threatening diagnoses (i.e. grade 3 or carcinoma in situ or stage ≥pT1) with high specificity (72%, 95% CI = 69–74%). Conclusions The Mcm5 immunoassay is a non-invasive test for identifying patients with urothelial cancers with similar accuracy to the FDA-approved NMP22 ELISA Test Kit. The combination of Mcm5 plus NMP22 improves the detection of UCC and identifies 95% of clinically significant disease. Trials of a commercially developed Mcm5 assay suitable for an end-user laboratory alongside NMP22 are required to assess their potential clinical utility in improving diagnostic and surveillance care pathways.
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Affiliation(s)
- John D. Kelly
- Department of Pathology and Cancer Institute, University College London, London, United Kingdom
| | - Tim J. Dudderidge
- Department of Pathology and Cancer Institute, University College London, London, United Kingdom
- The Royal Marsden National Health Service (NHS) Foundation Trust, London, United Kingdom
| | - Alex Wollenschlaeger
- Wolfson Institute for Biomedical Research, University College London, London, United Kingdom
- * E-mail: (AW)
| | - Odu Okoturo
- Department of Medicine, Imperial College London, London, United Kingdom
| | - Keith Burling
- Department of Clinical Biochemistry, Addenbrooke’s Hospital, University of Cambridge, Cambridge, United Kingdom
| | - Fiona Tulloch
- Department of Clinical Biochemistry, Addenbrooke’s Hospital, University of Cambridge, Cambridge, United Kingdom
| | - Ian Halsall
- Department of Clinical Biochemistry, Addenbrooke’s Hospital, University of Cambridge, Cambridge, United Kingdom
| | - Teresa Prevost
- Department of Public Health and Primary Care, Centre for Applied Medical Statistics, University of Cambridge, Institute of Public Health, Cambridge, United Kingdom
| | - Andrew Toby Prevost
- Department of Primary Care and Public Health Sciences, King’s College London, London, United Kingdom
| | - Joana C. Vasconcelos
- Department of Public Health and Primary Care, Centre for Applied Medical Statistics, University of Cambridge, Institute of Public Health, Cambridge, United Kingdom
| | - Wendy Robson
- Department of Urology, Freeman Hospital, Newcastle upon Tyne, United Kingdom
| | - Hing Y. Leung
- Beatson Institute for Cancer Research, University of Glasgow, Bearsden, Glasgow, United Kingdom
| | - Nikhil Vasdev
- Department of Urology, Freeman Hospital, Newcastle upon Tyne, United Kingdom
| | - Robert S. Pickard
- Department of Urology, Freeman Hospital, Newcastle upon Tyne, United Kingdom
| | - Gareth H. Williams
- Department of Pathology and Cancer Institute, University College London, London, United Kingdom
- Wolfson Institute for Biomedical Research, University College London, London, United Kingdom
- * E-mail: (AW)
| | - Kai Stoeber
- Department of Pathology and Cancer Institute, University College London, London, United Kingdom
- Wolfson Institute for Biomedical Research, University College London, London, United Kingdom
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Chade DC, Shariat SF, Godoy G, Meryn S, Dalbagni G. Critical review of biomarkers for the early detection and surveillance of bladder cancer. JOURNAL OF MENS HEALTH 2009. [DOI: 10.1016/j.jomh.2009.07.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Abstract
OBJECTIVE Carbohydrate antigen 19-9 (CA19-9) is known to be a marker with a high positive rate in pancreatic cancer. There are limited data on the use of CA19-9 as a tumor marker in bladder carcinoma. We tested the expression of CA19-9 in transitional cell carcinoma (TCC) cell lines and bladder cancer patients to determine its usefulness in clinical applications. MATERIAL AND METHODS The expression of CA19-9 was determined in six TCC cell lines and 42 bladder carcinoma tissues using two approaches: immunohistochemistry and enzyme immunoassay (EIA) analysis. EIA was used for testing CA19-9 levels in spent medium of cultured TCC cells and the urine of bladder tumor patients. RESULTS The CA19-9 value was low in spent media of the MGH-U1, MGH-U1R and MGH-U3 cell lines, but high in that of reactivity in MGH-U4 cells, while negative reactivity was found in high-grade MGH-U1 and MGH-U1R cells, both of which were derived from a stage B, grade 3 TCC. High incidences of negative CA19-9 staining were found in high-grade and invasive tumor tissues: 69.6% (16/23) and 70.8% (17/24), respectively. The sensitivity and specificity of urinary CA19-9 for detecting tumor recurrence were 83.3% and 50.8%, respectively. However, urinary tract infection also resulted in a high false-positive rate. CONCLUSION CA19-9 is promising for use as a biomarker for the detection and monitoring of low-grade and low-stage bladder cancer, with the proviso that patients to be tested should be free of infection.
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Affiliation(s)
- Cheng-Keng Chuang
- Division of Uro-oncology, Department of Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
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Shariat SF, Karam JA, Raman JD. Urine cytology and urine-based markers for bladder urothelial carcinoma detection and monitoring: developments and future prospects. Biomark Med 2008; 2:165-80. [DOI: 10.2217/17520363.2.2.165] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Bladder cancer is currently diagnosed using cystoscopy and cytology in patients with suspicious signs and symptoms. These tests are also used to monitor patients with a history of bladder cancer. The recurrence rate for bladder cancer is high, thus necessitating long-term follow-up. Urine cytology has a high sensitivity and specificity for the detection of high-grade urothelial carcinoma, but lacks the sensitivity to detect low-grade tumors. Recently, multiple noninvasive urine-based bladder cancer tests have been developed. Many markers (BTA stat®, BTA TRAK®, ImmunoCyt™, NMP22® and UroVysion™) have already been approved by the US FDA for bladder cancer surveillance, while other markers are still undergoing development, preclinical and clinical investigation. An ideal bladder cancer test would be noninvasive, highly sensitive and specific, inexpensive, easy to perform and yield highly reproducible results. Many of the tests reviewed herein meet some, but not all, of these criteria.
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Affiliation(s)
- Shahrokh F Shariat
- The University of Texas Southwestern Medical Center, Department of Urology, 5323 Harry Hines Boulevard, Dallas, TX 75390-9110, USA
| | - Jose A Karam
- The University of Texas Southwestern Medical Center, Department of Urology, 5323 Harry Hines Boulevard, Dallas, TX 75390-9110, USA
| | - Jay D Raman
- The University of Texas Southwestern Medical Center, Department of Urology, 5323 Harry Hines Boulevard, Dallas, TX 75390-9110, USA
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Lee CT, Hollenbeck B, Wood DP. Ureter, Bladder, Penis, and Urethra. Oncology 2006. [DOI: 10.1007/0-387-31056-8_47] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Lahme S, Bichler KH, Feil G, Zumbrägel A, Götz T. Comparison of cytology and nuclear matrix protein 22 (NMP 22) for the detection and follow-up of bladder-cancer. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2004; 539:111-9. [PMID: 15088900 DOI: 10.1007/978-1-4419-8889-8_9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
Abstract
OBJECTIVES This study was designed to determine the clinical usefulness of the Nuclear Matrix Protein 22 (NMP 22) Test for the detection of bladder cancer in comparison to urine cytology. METHODS One hundred sixty-four patients suffering from or being suspicious for bladder cancer and 64 healthy controls participated in a prospective study. Freshly voided spot urine samples were taken for cytological examination and determination of NMP 22-levels by enzyme-linked immunoassay. RESULTS Sensitivity to the NMP 22 Test according to the tumor grading was (results of cytology in parentheses): GI 25.0% (20.0%), G2 68.2% (59.1%), and G3 100.0% (66.7%); overall sensitivity was 62.5% (45.0%). Sensitivity according to superficial bladder cancer was 46.7% (36.7%), and to invasive bladder cancer 90.0% (70.0%). Specificity was 65.9% (88.9%). CONCLUSIONS NMP 22 is a reliable tool for detecting invasive bladder cancer. Results for the well-differentiated superficial bladder cancer occurring frequently are as poor as those obtained with cytology. In addition, benign lesions such as urolithiasis or urinary tract infection lead to false positive results. Therefore, cystoscopy has to be performed when trying to detect and follow-up bladder cancer.
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Affiliation(s)
- Sven Lahme
- Department of Urology, University of Tuebingen, Germany
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Simon MA, Lokeshwar VB, Soloway MS. Current bladder cancer tests: unnecessary or beneficial? Crit Rev Oncol Hematol 2003; 47:91-107. [PMID: 12900004 DOI: 10.1016/s1040-8428(03)00074-x] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Bladder cancer is currently diagnosed using cystoscopy and cytology in patients with suspicious signs and symptoms. These same tests are used to monitor patients with a history of bladder cancer for recurrence. The recurrence rate for bladder cancer is high, thus necessitating long-term follow-up. Urine cytology requires an experienced cytopathologist and is costly. It has high specificity, but low sensitivity for low-grade bladder tumors. Recently many non-invasive bladder cancer tests, utilizing markers found in the urine, have been developed. The FDA has approved several of these for the use is bladder cancer diagnosis, and many others are undergoing development and investigation. An ideal bladder cancer test would be non-invasive, highly sensitive and specific, inexpensive, easy to perform, and yield highly reproducible results. Many of the tests reviewed meet some, but not all, of these criteria.
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Affiliation(s)
- Michael A Simon
- Scott Department of Urology, Baylor College of Medicine, 6560 Fannin Street, Suite 2100, Houston, TX 77030-2769, USA.
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LOKESHWAR VINATAB, SOLOWAY MARKS. CURRENT BLADDER TUMOR TESTS: DOES THEIR PROJECTED UTILITY FULFILL CLINICAL NECESSITY? J Urol 2001. [DOI: 10.1016/s0022-5347(05)66428-2] [Citation(s) in RCA: 154] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- VINATA B. LOKESHWAR
- From the Departments of Urology and Cell Biology and Anatomy, University of Miami School of Medicine, Miami, Florida
| | - MARK S. SOLOWAY
- From the Departments of Urology and Cell Biology and Anatomy, University of Miami School of Medicine, Miami, Florida
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KONETY BADRINATHR, NGUYEN THUSUONGT, BRENES GILBERT, SHOLDER ARNOLD, LEWIS NANCY, BASTACKY SHELDON, POTTER DOUGLASM, GETZENBERG ROBERTH. CLINICAL USEFULNESS OF THE NOVEL MARKER BLCA-4 FOR THE DETECTION OF BLADDER CANCER. J Urol 2000. [DOI: 10.1016/s0022-5347(05)67269-2] [Citation(s) in RCA: 69] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- BADRINATH R. KONETY
- From the Departments of Urology, Pathology and Pharmacology, University of Pittsburgh Medical Center, University of Pittsburgh Cancer Institute and Spinal Cord Injury Program, Health South Harmarville Rehabilitation Hospital, Pittsburgh, Pennsylvania
| | - THU-SUONG T. NGUYEN
- From the Departments of Urology, Pathology and Pharmacology, University of Pittsburgh Medical Center, University of Pittsburgh Cancer Institute and Spinal Cord Injury Program, Health South Harmarville Rehabilitation Hospital, Pittsburgh, Pennsylvania
| | - GILBERT BRENES
- From the Departments of Urology, Pathology and Pharmacology, University of Pittsburgh Medical Center, University of Pittsburgh Cancer Institute and Spinal Cord Injury Program, Health South Harmarville Rehabilitation Hospital, Pittsburgh, Pennsylvania
| | - ARNOLD SHOLDER
- From the Departments of Urology, Pathology and Pharmacology, University of Pittsburgh Medical Center, University of Pittsburgh Cancer Institute and Spinal Cord Injury Program, Health South Harmarville Rehabilitation Hospital, Pittsburgh, Pennsylvania
| | - NANCY LEWIS
- From the Departments of Urology, Pathology and Pharmacology, University of Pittsburgh Medical Center, University of Pittsburgh Cancer Institute and Spinal Cord Injury Program, Health South Harmarville Rehabilitation Hospital, Pittsburgh, Pennsylvania
| | - SHELDON BASTACKY
- From the Departments of Urology, Pathology and Pharmacology, University of Pittsburgh Medical Center, University of Pittsburgh Cancer Institute and Spinal Cord Injury Program, Health South Harmarville Rehabilitation Hospital, Pittsburgh, Pennsylvania
| | - DOUGLAS M. POTTER
- From the Departments of Urology, Pathology and Pharmacology, University of Pittsburgh Medical Center, University of Pittsburgh Cancer Institute and Spinal Cord Injury Program, Health South Harmarville Rehabilitation Hospital, Pittsburgh, Pennsylvania
| | - ROBERT H. GETZENBERG
- From the Departments of Urology, Pathology and Pharmacology, University of Pittsburgh Medical Center, University of Pittsburgh Cancer Institute and Spinal Cord Injury Program, Health South Harmarville Rehabilitation Hospital, Pittsburgh, Pennsylvania
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Konety BR, Nguyen TS, Brenes G, Sholder A, Lewis N, Bastacky S, Potter DM, Getzenberg RH. Clinical usefulness of the novel marker BLCA-4 for the detection of bladder cancer. J Urol 2000; 164:634-9. [PMID: 10953114 DOI: 10.1097/00005392-200009010-00004] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE Previous studies at our laboratory identified 6 bladder cancer specific nuclear matrix proteins termed BLCA-1 to 6. We recently developed an immunoassay that detects the bladder cancer specific nuclear matrix protein BLCA-4. We analyzed urine samples from patients with bladder cancer, those with spinal cord injury and normal volunteers to determine the BLCA-4 level in these 3 groups. MATERIALS AND METHODS Urine samples obtained from 51 normal controls, and 54 patients with bladder cancer and 202 with spinal cord injury were tested for BLCA-4. We evaluated the association of BLCA-4 level with tumor grade and stage, urine cytology and bladder cancer history in the nonspinal cord injured population. Similarly we compared parameters associated with BLCA-4, such as spinal cord injury duration, catheterization, history of urinary tract infection, smoking and urine culture, in spinal cord injured patients. RESULTS We established a normal cutoff point of 13 optical density units per microg. protein for the BLCA-4 assay. The BLCA-4 level was less than the cutoff in all 51 normal controls, while in 53 of the 55 urine samples (96.4%) of patients with bladder cancer and 38 of the 202 (19%) of spinal cord injured patients urinary BLCA-4 was greater than the cutoff. There was no correlation of any individual factors studied in these cases, including urinary tract infection and urinary BLCA-4. CONCLUSIONS Elevated urinary BLCA-4 levels may accurately identify bladder cancer and distinguish these patients from normal individuals. There is no correlation of urinary BLCA-4 with a history of urinary tract infection, smoking, catheterization or cystitis considered independently. Urinary BLCA-4 determination appears to have high potential as a test for screening and monitoring bladder cancer in the general population and in groups at high risk for the disease, such as those with spinal cord injury.
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Affiliation(s)
- B R Konety
- Department of Urology, Pathology and Pharmacology, University of Pittsburgh Medical Center, Rehabilitation Hospital, PA, USA
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RAMAKUMAR SANJAY, BHUIYAN JALALUDDIN, BESSE JENNIFERA, ROBERTS STEVENG, WOLLAN PETERC, BLUTE MICHAELL, O'KANE DENNISJ. COMPARISON OF SCREENING METHODS IN THE DETECTION OF BLADDER CANCER. J Urol 1999. [DOI: 10.1016/s0022-5347(01)61899-8] [Citation(s) in RCA: 235] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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