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Zhang T, Zhu J, Li Z, Zhao Y, Li Y, Li J, He Q, Geng Y, Lu W, Zhang L, Li Z. The UF-5000 Atyp.C parameter is an independent risk factor for bladder cancer. Sci Rep 2024; 14:12659. [PMID: 38830942 PMCID: PMC11148171 DOI: 10.1038/s41598-024-63572-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Accepted: 05/30/2024] [Indexed: 06/05/2024] Open
Abstract
Bladder carcinoma (BC) accounts for > 90% of all urothelial cancers. Pathological diagnosis through cytoscopic biopsy is the gold standard, whereas non-invasive diagnostic tools remain lacking. The "Atyp.C" parameter of the Sysmex UF-5000 urine particle analyzer represents the ratio of nucleus to cytoplasm and can be employed to detect urinary atypical cells. The present study examined the association between urinary Atyp.C values and BC risk. This two-center, retrospective case-control study identified clinical primary or newly recurrent BC (study period, 2022-2023; n = 473) cases together with controls with urinary tract infection randomly matched by age and sex (1:1). Urinary sediment differences were compared using non-parametric tests. The correlations between urinary Atyp.C levels and BC grade or infiltration were analyzed using Spearman's rank correlation. The BC risk factor odds ratio of Atyp.C was calculated using conditional logistic regression, and potential confounder effects were adjusted using stepwise logistic regression (LR). Primary risk factors were identified by stratified analysis according to pathological histological diagnosis. The mean value of urinary Atyp.C in BC cases (1.30 ± 3.12) was 8.7 times higher than that in the controls (0.15 ± 0.68; P < 0.001). Urinary Atyp.C values were positively correlated with BC pathological grade and invasion (r = 0.360, P < 0.001; r = 0.367, P < 0.001). Urinary Atyp.C was an independent risk factor for BC and closely related with BC pathological grade and invasion. Elevated urinary Atyp.C values was an independent risk factor for BC. Our findings support the use of Atyp.C as a marker that will potentially aid in the early diagnosis and long-term surveillance of new and recurrent BC cases.
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Affiliation(s)
- Tong Zhang
- Department of Clinical Laboratory, Second Hospital, Xi'an Jiaotong University, Xi'an, 710004, China
| | - Jianhong Zhu
- Department of Clinical Laboratory, Second Hospital, Xi'an Jiaotong University, Xi'an, 710004, China
| | - Zhaoxing Li
- Department of Clinical Laboratory, Second Hospital, Xi'an Jiaotong University, Xi'an, 710004, China
| | - Ya Zhao
- Department of Clinical Laboratory, Second Hospital, Xi'an Jiaotong University, Xi'an, 710004, China
| | - Yan Li
- Department of Clinical Laboratory, Second Hospital, Xi'an Jiaotong University, Xi'an, 710004, China
| | - Jing Li
- Department of Clinical Laboratory, Second Hospital, Xi'an Jiaotong University, Xi'an, 710004, China
| | - Qian He
- Department of Clinical Laboratory, Second Hospital, Xi'an Jiaotong University, Xi'an, 710004, China
| | - Yan Geng
- Department of Clinical Laboratory, Second Hospital, Xi'an Jiaotong University, Xi'an, 710004, China
| | - Wei Lu
- Department of Clinical Laboratory, Second Hospital, Xi'an Jiaotong University, Xi'an, 710004, China
| | - Lei Zhang
- Department of Clinical Laboratory, Second Hospital, Xi'an Jiaotong University, Xi'an, 710004, China.
| | - Zhenzhen Li
- Department of Clinical Laboratory, Second Hospital, Xi'an Jiaotong University, Xi'an, 710004, China.
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Ceyhan E, Mammadov E, Onder SC, Dogan HS, Tekgul S. Fish: A Promising Screening Tool for Malignancy After Augmentation Cystoplasty? J Pediatr Surg 2024; 59:725-730. [PMID: 38065750 DOI: 10.1016/j.jpedsurg.2023.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 11/01/2023] [Accepted: 11/10/2023] [Indexed: 04/08/2024]
Abstract
INTRODUCTION Malignancy after augmentation cystoplasty (AC) is reported up to 5.5 %. We assessed the use of urine fluorescence in situ hybridization (FISH) screening for bladder malignancy after AC. PATIENTS AND METHODS In this study, 36/98 patients under follow-up who have completed tenth year after ileal AC were included prospectively. Twenty-four (66.7 %) patients were tested with FISH initially and overall 28 (77.8 %) patients with conventional cytology (CC). Twenty-four (66.7 %) patients with FISH analysis also had cytology analysis. Blinded from the cytology results, 32 (88.9 %) patients who were consented underwent cystoscopy with random biopsy (native bladder, ileal segment, ileovesical junction). Two patients those were tested with FISH did not consented cystoscopy. This study was registred to the government registry (No: 71146310). RESULTS Mean follow-up time after AC was 15.4 ± 4.8 years. 2/32 (5.6 %) patients were diagnosed with adenocarcinoma in cyctoscopic biopsy. FISH analysis of 3/24 (12.5 %) patients demonstrated abnormal findings consistent with malignancy. Two FISH malignant patients were patients who had adenocarcinoma. The third patient's biopsy was benign and the third year control cystoscopy was normal. 2/4 patients with malignant CC had adenocarcinoma and 2/4 patients had benign biopsy. The sensitivity and specificity of FISH in our series were 100 % and 95 % respectively. Whereas the sensitivity and specificity of CC was 100 % and 91.6 % respectively. CONCLUSION Despite limited number of patients in this study, FISH showed higher specificity than CC in this series. FISH is a promising tool for malignancy screening after AC. TYPE OF STUDY Diagnostic Studies. LEVEL OF EVIDENCE II.
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Affiliation(s)
- Erman Ceyhan
- Hacettepe University Faculty of Medicine, Department of Urology, Ankara, Turkey.
| | - Emin Mammadov
- Hacettepe University Faculty of Medicine, Department of Urology, Ankara, Turkey
| | - Sevgen Celik Onder
- Hacettepe University Faculty of Medicine, Department of Pathology, Ankara, Turkey
| | - Hasan Serkan Dogan
- Hacettepe University Faculty of Medicine, Department of Urology, Division of Pediatric Urology, Ankara, Turkey
| | - Serdar Tekgul
- Hacettepe University Faculty of Medicine, Department of Urology, Division of Pediatric Urology, Ankara, Turkey
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3
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UBC ® Rapid Test-A Urinary Point-of-Care (POC) Assay for Diagnosis of Bladder Cancer with a focus on Non-Muscle Invasive High-Grade Tumors: Results of a Multicenter-Study. Int J Mol Sci 2018; 19:ijms19123841. [PMID: 30513851 PMCID: PMC6321532 DOI: 10.3390/ijms19123841] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Revised: 10/30/2018] [Accepted: 11/29/2018] [Indexed: 02/06/2023] Open
Abstract
Objectives: UBC®Rapid Test measures soluble fragments of cytokeratins 8 and 18 in urine. We present results of a multicenter study using an updated version of UBC®Rapid Test in bladder cancer patients, patients with urinary bladder cancer positive history, and healthy controls. Material and Methods: In total 530 urine samples have been included in this study. Clinical urine samples were used from 242 patients with tumors of the urinary bladder (134 non-muscle-invasive low-grade tumors (NMI-LG), 48 non-muscle-invasive high-grade tumors (NMI-HG), and 60 muscle-invasive high-grade tumors (MI-HG)), 62 patients with non-evidence of disease (NED), and 226 healthy controls. Urine samples were analyzed by the UBC® Rapid point-of-care (POC) assay and evaluated by Concile Omega 100 POC Reader. All statistical analyses have been performed using R version 3.2.3. Results: Elevated levels of UBC® Rapid Test in urine are higher in patients with bladder cancer in comparison to the control group (p < 0.001). The sensitivity for the whole bladder cancer cohort was 53.3% (positive predictive value (PPV) 90.2%, negative predictive value (NPV) 65.2%) and was 38.8% (PPV 78.8%, NPV 72.1%) for non-muscle-invasive low-grade bladder cancer; 75.0% (PPV 72.0%, NPV 94.7%) for non-muscle-invasive high-grade bladder cancer and 68.3% (PPV 74.6%, NPV 91.8%) for muscle-invasive high-grade bladder cancer. The specificity for the statistical calculations was 93.8%. The cut-off value (10 µg/L) was evaluated for the whole patient cohort. The area under the curve of the quantitative UBC® Rapid Test using the optimal threshold obtained by receiver operating characteristics (ROC) analysis was 0.774. Elevated values of UBC®Rapid Test in urine are higher in patients with high-grade bladder cancer in comparison to low-grade tumors and the healthy control group. Conclusions: UBC®Rapid Test has potential to be a clinically valuable urinary protein biomarker for detection of high-grade bladder cancer patients and could be added in the management of NMI-HG tumors. UBC®Rapid results generated in both study centers in the present multicenter study are very similar and reproducible. Furthermore UBC®Rapid Test is standardized and calibrated and thus independent of used batch of test as well as study site.
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Zhou L, Yang K, Li X, Ding Y, Mu D, Li H, Yan Y, Li J, Wang D, Li W, Cong Y, Gao J, Ma K, Xiao Y, Zhang S, Jiang H, Hu W, Wei Q, Jin X, Guan Z, Liu Q, Xu D, Gao X, Jiang Y, Gan W, Sun G, Wang Q, Liu Y, Hou J, Xie L, Song X, Jin F, Feng J, Cai M, Liang Z, Zhang J, Ye D, Qi L, Ma L, Shou J, Dai Y, Shao J, Tian Y, Hong S, Xu T, Kong C, Kang Z, Liu Y, Qu X, Shi B, Zheng S, Lin Y, Xia S, Wei D, Wu J, Fu W, Wang Z, Liang J. Application of fluorescence in situ hybridization in the detection of bladder transitional-cell carcinoma: A multi-center clinical study based on Chinese population. Asian J Urol 2018; 6:114-121. [PMID: 30775255 PMCID: PMC6363605 DOI: 10.1016/j.ajur.2018.06.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Revised: 09/04/2017] [Accepted: 09/27/2017] [Indexed: 11/12/2022] Open
Abstract
Objective To evaluate the diagnostic value of fluorescence in situ hybridization (FISH) in bladder cancer. Methods We enrolled healthy volunteers and patients who were clinically suspected to have bladder cancer and conducted FISH tests and cytology examinations from August 2007 to December 2008. Receiver operating characteristic (ROC) curve analysis was performed and the area under curve (AUC) values were calculated for both the FISH and urine cytology tests. Results A cohort of 988 healthy volunteers was enrolled to establish a reference range for the normal population. A total of 4807 patients with hematuria were prospectively, randomly enrolled for the simultaneous analysis of urine cytology, FISH testing, and a final diagnosis as determined by the pathologic findings of a biopsy or a surgically-excised specimen. Overall, the sensitivity of FISH in detecting transitional-cell carcinoma was 82.7%, while that of cytology was 33.4% (p < 0.001). The sensitivity values of FISH for non-muscle invasive and muscle invasive bladder transitional-cell carcinoma were 81.7% and 89.6%, respectively (p = 0.004). The sensitivity values of FISH for low and high grade bladder cancer were 82.6% and 90.1%, respectively (p = 0.002). Conclusion FISH is significantly more sensitive than voided urine cytology for detecting bladder cancer in patients evaluated for gross hematuria at all cancer grades and stages. Higher sensitivity using FISH was obtained in high grade and muscle invasive tumors.
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Affiliation(s)
- Liqun Zhou
- Department of Urology, Peking University First Hospital, Beijing, China.,Institute of Urology, Peking University, Beijing, China.,National Urological Cancer Center, Beijing, China
| | - Kaiwei Yang
- Department of Urology, Peking University First Hospital, Beijing, China.,Institute of Urology, Peking University, Beijing, China.,National Urological Cancer Center, Beijing, China
| | - Xuesong Li
- Department of Urology, Peking University First Hospital, Beijing, China.,Institute of Urology, Peking University, Beijing, China.,National Urological Cancer Center, Beijing, China
| | - Yi Ding
- Department of Urology, Peking University First Hospital, Beijing, China.,Institute of Urology, Peking University, Beijing, China.,National Urological Cancer Center, Beijing, China
| | - Dawei Mu
- Air Force General Hospital, PLA, Beijing, China
| | - Hanzhong Li
- Department of Urology, Peking Union Medical College Hospital, Beijing, China
| | - Yong Yan
- Department of Urology, Beijing Chao-Yang Hospital, Beijing, China
| | - Jinyi Li
- Department of Urology, Armed-Police General Hospital, Beijing, China
| | - Dongwen Wang
- Department of Urology, Shanxi Medical University First Hospital, Taiyuan, China
| | - Wei Li
- Department of Urology, Hebei Medical University Second Hospital, Shijiazhuang, China
| | - Yulong Cong
- Department of Urology, The General Hospital of the People's Liberation Army, Beijing, China
| | - Jiangping Gao
- Department of Urology, The General Hospital of the People's Liberation Army, Beijing, China
| | - Kewei Ma
- Department of Urology, First Affiliated Hospital of Jilin University, Changchun, China
| | - Yajun Xiao
- Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Sheng Zhang
- Department of Pathology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Hongyi Jiang
- Department of Urology, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Weilie Hu
- Department of Urology, General Hospital of Guangzhou Military Command of PLA, Guangzhou, China
| | - Qiang Wei
- Department of Urology, West China School of Medicine, Chengdu, China
| | - Xunbo Jin
- Department of Urology, Shangdong Province-owned Hospital, Jinan, China
| | - Zhichen Guan
- Department of Urology, Peking University Shenzhen Hospital, Shenzhen, China
| | - Qingyong Liu
- Department of Urology, The Central Hospital of Jinan City, Jinan, China
| | - Danfeng Xu
- Department of Urology, Shanghai Changzheng Hospital, Shanghai, China
| | - Xin Gao
- Department of Urology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Yongguang Jiang
- Department of Urology, Beijing Anzhen Hospital of Capital Medical University, Beijing, China
| | - Weimin Gan
- Department of Urology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Guang Sun
- Department of Urology, The Second Hospital of Tianjin Medical University, Tianjin, China
| | - Qing Wang
- Department of Urology, People's Hospital of Xinjiang Uygur Autonomous Region, Wulumuqi, China
| | - Yanhui Liu
- Department of Urology, Guangdong General Hospital, Guangzhou, China
| | - Jianquan Hou
- Department of Urology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Liping Xie
- Department of Urology, The First Hospital of Zhejiang Province, Hangzhou, China
| | - Xishuang Song
- Department of Urology, The First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Fengshuo Jin
- Department of Urology, Daping Hospital, Research Institute of Surgery, Third Military Medical University, Chongqing, China
| | - Jiafu Feng
- Department of Urology, Mianyang Central Hospital, Mianyang, China
| | - Ming Cai
- Department of Urology, General Hospital of PLA General Staff Headquarters, Beijing, China
| | - Zhaozhao Liang
- Department of Urology, First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Jie Zhang
- Department of Urology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Dingwei Ye
- Department of Urology, Fudan University Shanghai Cancer Center, Shanghai, China
| | - Lin Qi
- Department of Urology, Xiangya Hospital of Central South University, Changsha, China
| | - Lulin Ma
- Department of Urology, Peking University Third Hospital, Beijing, China
| | - Jianzhong Shou
- Department of Urology, Cancer Hospital of Chinese Academy of Medical Sciences, Beijing, China
| | - Yuping Dai
- Department of Urology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Jianyong Shao
- Department of Urology, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Ye Tian
- Department of Urology, Beijing Friendship Hospital of Capital Medical University, Beijing, China
| | - Shizhe Hong
- Department of Urology, Wenzhou Central Hospital, Wenzhou, China
| | - Tao Xu
- Department of Urology, Peking University People's Hospital, Beijing, China
| | - Chuize Kong
- Department of Urology, The First Hospital of China Medical University, Shenyang, China
| | - Zefeng Kang
- Department of Urology, Qinghai Province People's Hospital, Xining, China
| | - Yuexin Liu
- Department of Urology, Beijing Tongren Hospital of Capital Medical University, Beijing, China
| | - Xun Qu
- Department of Urology, Qilu Hospital of Shandong University, Jinan, China
| | - Benkang Shi
- Department of Urology, Qilu Hospital of Shandong University, Jinan, China
| | - Shaobin Zheng
- Department of Urology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Yi Lin
- Department of Urology, Tianjing Medical University General Hospital, Tianjin, China
| | - Shujie Xia
- Department of Urology, Shanghai General Hospital, Shanghai, China
| | - Dong Wei
- Department of Urology, Beijing Hospital, Beijing, China
| | - Jianbo Wu
- Department of Urology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Weiling Fu
- Department of Urology, Southwest Hospital, Chongqing, China
| | - Zhiping Wang
- Department of Urology, Lanzhou University Second Hospital, Lanzhou, China
| | - Jianbo Liang
- Department of Urology, The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
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Gleichenhagen J, Arndt C, Casjens S, Meinig C, Gerullis H, Raiko I, Brüning T, Ecke T, Johnen G. Evaluation of a New Survivin ELISA and UBC ® Rapid for the Detection of Bladder Cancer in Urine. Int J Mol Sci 2018; 19:ijms19010226. [PMID: 29324722 PMCID: PMC5796175 DOI: 10.3390/ijms19010226] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Revised: 12/20/2017] [Accepted: 01/08/2018] [Indexed: 12/21/2022] Open
Abstract
Urine-based biomarkers for non-invasive diagnosis of bladder cancer are urgently needed. No single marker with sufficient sensitivity and specificity has been described so far. Thus, a combination of markers appears to be a promising approach. The aim of this case-control study was to evaluate the performance of an in-house developed enzyme-linked immunosorbent assay (ELISA) for survivin, the UBC®Rapid test, and the combination of both assays. A total of 290 patients were recruited. Due to prior bladder cancer, 46 patients were excluded. Urine samples were available from 111 patients with bladder cancer and 133 clinical controls without urologic diseases. Antibodies generated from recombinant survivin were utilized to develop a sandwich ELISA. The ELISA and the UBC®Rapid test were applied to all urine samples. Receiver operating characteristic (ROC) analysis was used to evaluate marker performance. The survivin ELISA exhibited a sensitivity of 35% with a specificity of 98%. The UBC®Rapid test showed a sensitivity of 56% and a specificity of 96%. Combination of both assays increased the sensitivity to 66% with a specificity of 95%. For high-grade tumors, the combination showed a sensitivity of 82% and a specificity of 95%. The new survivin ELISA and the UBC®Rapid test are both able to detect bladder cancer, especially high-grade tumors. However, the performance of each individual marker is moderate and efforts to improve the survivin assay should be pursued. A combination of both assays confirmed the benefit of using marker panels. The results need further testing in a prospective study and with a high-risk population.
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Affiliation(s)
- Jan Gleichenhagen
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-University Bochum (IPA), 44789 Bochum, Germany.
| | - Christian Arndt
- Department of Urology, Lukaskrankenhaus Neuss, 41464 Neuss, Germany.
| | - Swaantje Casjens
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-University Bochum (IPA), 44789 Bochum, Germany.
| | - Carmen Meinig
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-University Bochum (IPA), 44789 Bochum, Germany.
| | - Holger Gerullis
- University Hospital for Urology, Klinikum Oldenburg, 26133 Oldenburg, Germany.
| | - Irina Raiko
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-University Bochum (IPA), 44789 Bochum, Germany.
| | - Thomas Brüning
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-University Bochum (IPA), 44789 Bochum, Germany.
| | - Thorsten Ecke
- Department of Urology, HELIOS Hospital, 15526 Bad Saarow, Germany.
| | - Georg Johnen
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-University Bochum (IPA), 44789 Bochum, Germany.
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Ecke TH, Weiß S, Stephan C, Hallmann S, Barski D, Otto T, Gerullis H. UBC ® Rapid Test for detection of carcinoma in situ for bladder cancer. Tumour Biol 2017; 39:1010428317701624. [PMID: 28468590 DOI: 10.1177/1010428317701624] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
UBC® Rapid Test is a test that detects fragments of cytokeratins 8 and 18 in urine. We present results of a multicentre study measuring UBC® Rapid Test in bladder cancer patients and healthy controls with focus on carcinoma in situ (CIS) and high-grade bladder cancer. From our study with N = 452 patients, we made a stratified sub-analysis for carcinoma in situ of the urinary bladder. Clinical urine samples were used from 87 patients with tumours of the urinary bladder (23 carcinoma in situ, 23 non-muscle-invasive low-grade tumours, 21 non-muscle-invasive high-grade tumours and 20 muscle-invasive high-grade tumours) and from 22 healthy controls. The cut-off value was defined at 10.0 µg/L. Urine samples were analysed by the UBC® Rapid Test point-of-care system (concile Omega 100 POC reader). Pathological levels of UBC Rapid Test in urine are higher in patients with bladder cancer in comparison to the control group (p < 0.001). Sensitivity was calculated at 86.9% for carcinoma in situ, 30.4% for non-muscle-invasive low-grade bladder cancer, 71.4% for nonmuscle-invasive high grade bladder cancer and 60% for muscle-invasive high-grade bladder cancer, and specificity was 90.9%. The area under the curve of the quantitative UBC® Rapid Test using the optimal threshold obtained by receiveroperated curve analysis was 0.75. Pathological values of UBC® Rapid Test in urine are higher in patients with high-grade bladder cancer in comparison to low-grade tumours and the healthy control group. UBC® Rapid Test has potential to be more sensitive and specific urinary protein biomarker for accurate detection of high-grade patients and could be added especially in the diagnostics for carcinoma in situ and non-muscle-invasive high-grade tumours of urinary bladder cancer.
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Affiliation(s)
- Thorsten H Ecke
- 1 Department of Urology, HELIOS Hospital Bad Saarow, Bad Saarow, Germany
| | - Sarah Weiß
- 2 Department of Urology, Charité University Hospital, Berlin, Germany
| | - Carsten Stephan
- 2 Department of Urology, Charité University Hospital, Berlin, Germany.,3 Berlin Institute for Urological Research, Berlin, Germany
| | - Steffen Hallmann
- 1 Department of Urology, HELIOS Hospital Bad Saarow, Bad Saarow, Germany
| | - Dimitri Barski
- 4 Department of Urology, Lukas Hospital Neuss, Neuss, Germany
| | - Thomas Otto
- 4 Department of Urology, Lukas Hospital Neuss, Neuss, Germany
| | - Holger Gerullis
- 5 University Hospital for Urology, Klinikum Oldenburg, School of Medicine and Health Sciences, Carl von Ossietzky University, Oldenburg, Germany
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Lin T, Liu Z, Liu L, Yang L, Han P, Zhang P, Wei Q. Prospective evaluation of fluorescence in situ hybridization for diagnosing urothelial carcinoma. Oncol Lett 2017; 13:3928-3934. [PMID: 28529600 DOI: 10.3892/ol.2017.5926] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2016] [Accepted: 01/31/2017] [Indexed: 02/05/2023] Open
Abstract
Urothelial carcinoma (UC) is the most common type of cancer of the bladder and upper urinary tract, and is characterized by a high risk of recurrence and progression. Urine fluorescence in situ hybridization (FISH) is a technique that detects genetic aberrations in exfoliated cells in the urine, with specific probes for chromosomes 3, 7 and 17 and the p16 gene. To evaluate the diagnostic value of FISH in UC, 119 patients from November 2010 to June 2012 with suspected UC were recruited into a prospective, cross-sectional study and were followed up for 12-30 months. These patients received voided urine cytology and FISH tests, and underwent cystoscopy and/or ureteroscopy as a reference standard. The final diagnoses confirmed 73 patients with UC, located in the bladder, upper urinary tracts or the two. The sensitivity of FISH for detecting UC was superior to cytology, irrespective of tumor grade and stage: Overall, 80.8 vs. 32.9% (P<0.001); low grade, 75.8 vs. 12.1% (P<0.001); high grade, 85 vs. 50% (P<0.005); non-muscle-invasive, 81.1 vs. 28.3% (P<0.001) and muscle-invasive, 80 vs. 45% (P<0.05), respectively. The specificities of the two tests were similar; overall, the specificity was 89.1% for cytology vs. 100% for FISH, and no significant difference was observed between the methods. Notably, FISH exhibited 100% sensitivity for cytologically non-diagnostic UC, but 33.3% specificity. In conclusion, FISH is a reliable and non-invasive diagnostic tool for bladder and upper urinary tract UC, particularly in patients with low-grade or early stage tumors.
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Affiliation(s)
- Tianhai Lin
- Department of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P.R. China.,Institute of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P.R. China.,Department of Translational Molecular Pathology, University of Texas M.D. Cancer Center, Houston, TX 77030, USA
| | - Zhenhua Liu
- Department of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P.R. China.,Institute of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P.R. China
| | - Liangren Liu
- Department of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P.R. China.,Institute of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P.R. China
| | - Lu Yang
- Department of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P.R. China.,Institute of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P.R. China
| | - Ping Han
- Department of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P.R. China.,Institute of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P.R. China
| | - Peng Zhang
- Department of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P.R. China.,Institute of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P.R. China
| | - Qiang Wei
- Department of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P.R. China.,Institute of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P.R. China
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Frantzi M, Latosinska A, Flühe L, Hupe MC, Critselis E, Kramer MW, Merseburger AS, Mischak H, Vlahou A. Developing proteomic biomarkers for bladder cancer: towards clinical application. Nat Rev Urol 2015; 12:317-30. [PMID: 26032553 DOI: 10.1038/nrurol.2015.100] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Clinical use of proteomic biomarkers has the potential to substantially improve the outcomes of patients with bladder cancer. An unmet clinical need evidently exists for noninvasive biomarkers, which might enable improvements in both the diagnosis and prognosis of patients with bladder cancer, as well as improved monitoring of patients for the presence of recurrence. Urine is considered the optimal noninvasive source of proteomic biomarkers in patients with bladder cancer. Currently, a number of single-protein biomarkers have been detected in urine and tissue using a variety of proteomic techniques, each having specific conceptual considerations and technical implications. Promising preclinical data are available for several of these proteins; however, the combination of single urinary proteins into multimarker panels might better encompass the molecular heterogeneity of bladder cancer within this patient population, and prove more effective in clinical use.
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Affiliation(s)
- Maria Frantzi
- Biotechnology Division, Biomedical Research Foundation Academy of Athens, 4 Soranou Ephessiou Street, 115 27 Athens, Greece
| | - Agnieszka Latosinska
- Biotechnology Division, Biomedical Research Foundation Academy of Athens, 4 Soranou Ephessiou Street, 115 27 Athens, Greece
| | - Leif Flühe
- Mosaiques Diagnostics GmbH, Rotenburger Strasse 20, 30659 Hannover, Germany
| | - Marie C Hupe
- Department of Urology and Urological Oncology, Hannover Medical School, Carl-Neuberg-Strasse 1, 30625 Hannover, Germany
| | - Elena Critselis
- Biotechnology Division, Biomedical Research Foundation Academy of Athens, 4 Soranou Ephessiou Street, 115 27 Athens, Greece
| | - Mario W Kramer
- Department of Urology and Urological Oncology, Hannover Medical School, Carl-Neuberg-Strasse 1, 30625 Hannover, Germany
| | - Axel S Merseburger
- Department of Urology and Urological Oncology, Hannover Medical School, Carl-Neuberg-Strasse 1, 30625 Hannover, Germany
| | - Harald Mischak
- BHF Glasgow Cardiovascular Research Centre, University of Glasgow, 126 University Avenue, Glasgow G12 8TA, UK
| | - Antonia Vlahou
- Biotechnology Division, Biomedical Research Foundation Academy of Athens, 4 Soranou Ephessiou Street, 115 27 Athens, Greece
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Bonberg N, Pesch B, Behrens T, Johnen G, Taeger D, Gawrych K, Schwentner C, Wellhäußer H, Kluckert M, Leng G, Nasterlack M, Oberlinner C, Stenzl A, Brüning T. Chromosomal alterations in exfoliated urothelial cells from bladder cancer cases and healthy men: a prospective screening study. BMC Cancer 2014; 14:854. [PMID: 25412927 PMCID: PMC4247705 DOI: 10.1186/1471-2407-14-854] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2014] [Accepted: 11/08/2014] [Indexed: 12/28/2022] Open
Abstract
Background Chromosomal instability in exfoliated urothelial cells has been associated with the development of bladder cancer. Here, we analyzed the accumulation of copy number variations (CNVs) using fluorescence in situ hybridization in cancer cases and explored factors associated with the detection of CNVs in tumor-free men. Methods The prospective UroScreen study was designed to investigate the performance of UroVysion™ and other tumor tests for the early detection of bladder cancer in chemical workers from 2003–2010. We analyzed a database compiling CNVs of chromosomes 3, 7, and 17 and at 9p21 that were detected in 191,434 exfoliated urothelial cells from 1,595 men. We assessed the accumulation of CNVs in 1,400 cells isolated from serial samples that were collected from 18 cancer cases up to the time of diagnosis. A generalized estimating equation model was applied to evaluate the influence of age, smoking, and urine status on CNVs in cells from tumor-free men. Results Tetrasomy of chromosomes 3, 7 and 17, and DNA loss at 9p21 were the most frequently observed forms of CNV. In bladder cancer cases, we observed an accumulation of CNVs that started approximately three years before diagnosis. During the year prior to diagnosis, cells from men with high-grade bladder cancer accumulated more CNVs than those obtained from cases with low-grade cancer (CNV < 2: 7.5% vs. 1.1%, CNV > 2: 16-17% vs. 9-11%). About 1% of cells from tumor-free men showed polysomy of chromosomes 3, 7, or 17 or DNA loss at 9p21. Men aged ≥50 years had 1.3-fold more cells with CNVs than younger men; however, we observed no further age-related accumulation of CNVs in tumor-free men. Significantly more cells with CNVs were detected in samples with low creatinine concentrations. Conclusions We found an accumulation of CNVs during the development of bladder cancer starting three years before diagnosis, with more altered cells identified in high-grade tumors. Also, a small fraction of cells with CNVs were exfoliated into urine of tumor-free men, mainly exhibiting tetraploidy or DNA loss at 9p21. Whether these cells are preferentially cleared from the urothelium or are artifacts needs further exploration.
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Affiliation(s)
| | - Beate Pesch
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-Universität Bochum (IPA), Buerkle-de-la-Camp-Platz 1, 44789 Bochum, Germany.
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Horstmann M, Banek S, Gakis G, Todenhöfer T, Aufderklamm S, Hennenlotter J, Stenzl A, Schwentner C. Prospective evaluation of fluorescence-guided cystoscopy to detect bladder cancer in a high-risk population: results from the UroScreen-Study. SPRINGERPLUS 2014; 3:24. [PMID: 24478941 PMCID: PMC3905106 DOI: 10.1186/2193-1801-3-24] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/20/2013] [Accepted: 01/03/2014] [Indexed: 11/17/2022]
Abstract
Objective To prospectively evaluate the role of fluorescence-guided cystoscopy in a high-risk bladder cancer population undergoing screening based on a multi-marker panel of urine-tests (UroScreen-study). Patients and methods UroScreen was conducted as a validation study for tumor markers within the frame of a health surveillance program of workers with occupational exposure to aromatic amines. Voluntary annual screens were done in 1,609 men. Cytology, quantitative NMP22® assay, and UroVysion (FISH) were applied to 7091 urine samples. Subjects with at least one positive urine-based tumor marker and/or persisting microscopic hematuria were offered fluorescence-guided (PDD) instead of white light cystoscopy. In case of suspicious findings histopathological evaluation by transurethral biopsy was performed. Data were statistically summarized and compared to tumors found by the standard algorithm of the screening study. Results Twenty-two subjects with a mean age of 58 years (39–72) underwent PDD cystoscopy. Of those 3 had positive NMP22 tests, 14 positive FISH tests and 9 suspicious cytologies. Two had persisting microscopic hematuria only. PDD cystoscopy revealed enhanced unifocal fluorescence in 14. All had subsequent transurethral biopsy or resection. In total, 1 urothelial carcinoma (pTaG1, low grade) was diagnosed. In the other participants urothelial cancer of the bladder was ruled out. Chronic cystitis was revealed in 8 of 14 biopsies. No higher detection rate was found using PDD than with the standard algorithm of the UroScreen study in which 17 tumors were detected by white light cystoscopy. Conclusion The use of PDD does not lead to a higher cancer detection rate in a high-risk screening population. Larger sample sizes may be needed to ultimately asses the value of PDD for bladder cancer screening.
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Affiliation(s)
- Marcus Horstmann
- Department of Urology, Friedrich Schiller University, Jena, Germany ; Department of Urology, Eberhard Karls University, Tübingen, Germany
| | - Severine Banek
- Department of Urology, Eberhard Karls University, Tübingen, Germany
| | - Georgios Gakis
- Department of Urology, Eberhard Karls University, Tübingen, Germany
| | | | | | | | - Arnulf Stenzl
- Department of Urology, Eberhard Karls University, Tübingen, Germany
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Screening for bladder cancer with urinary tumor markers in chemical workers with exposure to aromatic amines. Int Arch Occup Environ Health 2013; 87:715-24. [PMID: 24129706 DOI: 10.1007/s00420-013-0916-3] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2013] [Accepted: 10/02/2013] [Indexed: 02/07/2023]
Abstract
PURPOSE To validate urinary markers for the early detection of bladder cancer (BC) in chemical workers. METHODS UroScreen was conducted as a validation study for tumor markers within the frame of a health surveillance program of the German Social Accident Insurance for active or retired workers with former exposure to aromatic amines. From 2003 to 2010, 1,609 men took part in voluntary annual screens. Cytology, the quantitative NMP22(®) assay, and UroVysion™ were applied to 7,091 urine samples. RESULTS Fifteen out of 21 tumors were detected following test positivity. The UroVysion/NMP22 panel detected 14 out of 21 tumors versus 8 tumors with cytology alone (sensitivity 66.7 vs. 44.4 %, specificity 94.5 vs. 98.5 %). The sensitivity of the panel increased to 85.7 % in samples collected ≤12 months before diagnosis and when papillomas were excluded, compared to 58.3 % with cytology. About 3 % of NMP22 tests were false-positive. UroVysion results overlapped with cytology due to the preselection of atypical cells. NMP22 was less and UroVysion more frequently positive in diluted urine samples. Leukocytes confounded NMP22 but not UroVysion. The low incidence of BC in this study population yielded low positive predictive values of the markers and high costs per tumor detected with screening. CONCLUSIONS UroVysion in combination with NMP22 detected more cases than cytology alone, at the expense of a lower specificity. High costs per detected case resulted from a lower BC incidence than in the past when levels of occupational exposure to aromatic amines were higher. Currently, it cannot be recommended to apply these markers for screening in asymptomatic workers. The increase in sensitivity is not balanced by the high costs of UroVysion and the false-positive tests of NMP22.
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