Use of heterogenous and monospecific antisera for the diagnosis of bladder cancer

Increased immunodetection of acidic fibroblast growth factor in bladder cancer, detectable in urine

Acidic fibroblast growth factor is a regulatory peptide involved in cell proliferation, differentiation and motility. We used a polyclonal antiserum raised against purified native bovine acidic fibroblast growth factor, with no cross-reactivity for basic fibroblast growth factor to detect acidic fibroblast growth factor in tissue extracts and urine samples by means of a competitive enzyme immunoassay. Histochemical analysis was also performed on 10 specimens of normal urothelium and 50 of bladder cancer. Acidic fibroblast growth factor immunoreactive material was found in normal urothelium (1.77 +/- 2 ng./gm. tissue) and was increased more than 10-fold in patients with transitional cell carcinoma of the bladder (20.36 +/- 12 ng./gm. tissue). Immunohistochemical analysis localized immunoreactivity in the epithelial compartment of bladder tumors. Acidic fibroblast growth factor was assayed in urine from 579 individuals comprising a control group (114) and patients with benign prostatic hypertrophy (133), carcinoma of the prostate (96) or transitional cell carcinoma of the bladder (236). There was a significant difference in the frequency of urinary acidic fibroblast growth factor detection among the patients with invasive transitional cell carcinoma, the control group (p < 0.001) and the patients with prostatic disease (p < 0.01). The sensitivity was 72% and the specificity was 91%. Furthermore, the frequency of acidic fibroblast growth factor detection by enzyme immunoassay in the urine and the intensity of immunostaining was correlated with the stage of the disease. These data strongly suggest that acidic fibroblast growth factor is a potential marker for bladder tumors that may be of use in the noninvasive followup of patients with bladder cancer. We present a simple and reliable enzyme immunoassay for the detection of acidic fibroblast growth factor in voided urine that might be useful to quantitate this marker.

A new 180 kDa. urine protein marker associated with bladder cancer

We surveyed the tumor-related proteins present in the urine specimens of 118 bladder cancer patients to seek a possible marker enabling future diagnosis and prognosis of this disease. We identified a protein of 180 kDa. by sodium dodecyl sulfate polyacrylamide gel electrophoresis in urine samples subjected to prior adsorption by protein-A conjugated to a sepharose bead. This protein appears to be a glycoprotein because it binds to concanavalin A-conjugated sepharose and can be eluted by alpha-methyl D-mannoside. It does not react immunochemically with antibodies prepared against either carcinoembryonic antigen or epidermal growth factor receptor, both of which have an apparent molecular weight close to 180 kDa. We found this protein in the urine of 74.3% of the patients with transitional cell carcinoma. It was not present in age-matched controls, patients with benign prostatic hyperplasia or patients with 10 other cancers. There was 1 false positive result in a patient with prostate cancer. It does not appear to be associated with urinary tract infection, blood contamination, premedication or anesthesia.

Two-dimensional immunoelectrophoretic analysis of urinary ultraconcentrates: antigenic differences between bladder cancer positive patients, normal individuals, and patients with urinary tract infections

Urine ultraconcentrates (100-fold) from bladder cancer patients, patients suffering from urinary tract infection, and normal individuals were analyzed using polyacrylamide gel electrophoresis (PAGE) and two-dimensional immunoelectrophoresis. A combined sample of normal urine was resolved into 1 to 3 protein bands by PAGE, whereas a single concentrated bladder cancer urine was resolved into 10-12 protein bands. Yet, this same concentrated urine sample was resolved into 17-20 antigen peaks by two-dimensional immunoelectrophoresis (2DIEP) against antihuman serum. A significant (P less than 0.05) increase was observed in the relative antigen concentration when comparing 2DIEP profiles of bladder cancer urines to normal controls. A significant increase in the relative antigen concentration and the number of antigen peaks was also found when comparing immunoelectrophoretic patterns obtained from ultraconcentrated urine specimens of bladder cancer positive urine and normal controls using a rabbit antibladder cancer urine antisera (P less than 0.002 and P less than 0.02, respectively). In addition, significant (P less than 0.02) antigenic differences were found when comparing concentrated urine samples from bladder cancer positive individuals to those with urinary tract infection. The bladder cancer group demonstrated 8/9 positive results for relative antigen concentrations greater than 3.0. Fifteen of 16 normal or urinary tract infected individuals combined had relative antigen concentrations less than 3.0. These differences were highly significant (P less than 0.001). No differences were found between concentrated bladder cancer and normal urine specimens tested against rabbit antinormal urine antisera.

Methods of early diagnosis in genitourinary cancer

The commonly employed methods for the early detection of urologic cancers remain the traditional techniques of a carefully performed history and physical examination. Newer developments include, among others, prostate-specific antigen and monoclonal antibodies in prostate cancer, flow cytometry in bladder cancer, computerized axial tomography (CAT) scanning in renal cancer, and ultrasound in testicular cancer. These and other new diagnostic techniques, with further testing and wider use, will hopefully permit the earlier diagnosis of genitourinary cancer.

Preliminary identification of a tumor-associated glycoprotein in bilharzial bladder cancer urine

A tumor-associated antigen was preliminarily identified in urine from bilharzial (squamous-cell carcinoma) bladder cancer patients. Monospecific rabbit antisera were made by immunization with concentrated bladder cancer urine and exhaustive absorption with insoluble normal human serum and urine. The urine tumor-associated antigen was identical to an antigen from 3M KCl bladder tumor extract by immunodiffusion. The antigen in urine was found in nine of 10 bladder cancer patients and was absent from normal urine and serum by immunodiffusion and immunoelectrophoresis. The antigen was a concanavalin-A-binding glycoprotein which was anodal on immunoelectrophoresis. It was stable up to 2 years at -20 degrees C and did not cross-react with carcinoembryonic antigen or with Schistosoma haematobium antigens.

Urinary proteins as biological markers: bladder cancer diagnosis versus urinary tract infection

Urine specimens from normal individuals, and from patients with bladder cancer, bladder papillomas and urinary tract infections were assayed for the presence of bladder tumor-related antigens. Ten-fold concentrated urine specimens were reacted in Ouchterlony gel diffusion against various anti-human monospecific antisera. With these antisera urine specimens from normal individuals were distinguished from those from patients with bladder carcinoma as well as bladder papilloma. However, the urine samples from individuals with urinary tract infections showed significant reactivity with many of the monospecific antisera as did specimens from patients with bladder cancer and bladder papilloma. Thus, investigations involved in the assay of bladder cancer biological markers should take the proteinuria associated with urinary tract infection into consideration. The potential importance of detecting tumor-specific components for early diagnosis and treatment of bladder neoplasms is stressed.