Bladder cancer screening: The new selection and prediction model

Acu-URO17 is a highly sensitive and specific bladder cancer biomarker

Objective

This study evaluates the efficacy of Acu-URO17, a highly sensitive and specific immunocytochemistry (ICC) test targeting Keratin 17, in comparison to urine cytology and UroVysion™ fluorescence in situ hybridization (FISH) for detecting bladder cancer cells in voided urine specimens.

Methods

Acupath conducted a large-scale comparison study using 2378 voided urine specimens. Acu-URO17, urine cytology and UroVysion™ FISH were performed on these specimens according to standardized protocols. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were calculated for Acu-URO17 in comparison to urine cytology and UroVysion™ FISH.

Results

In cases diagnosed with high-grade urothelial cancer via urine cytology, Acu-URO17 demonstrated a sensitivity of 96% and a specificity of 82%. When compared to UroVysion™ FISH results, Acu-URO17 exhibited a sensitivity of 97.1% and a specificity of 77.8%, surpassing the sensitivity of UroVysion™ FISH (57.1%). Notably, Acu-URO17 showed a high NPV of 99.9%, indicating its reliability in confirming negative urine cytology results and risk-stratifying atypical and suspicious cytology results.

Conclusion

The results of this large-scale prospective study support Acu-URO17 as a clinically relevant, non-invasive and cost-effective tool for detecting bladder cancer cells in voided urine specimens. Its high sensitivity, specificity and NPV make it a valuable adjunct to urine cytology and UroVysion™ FISH in the diagnosis and management of urothelial carcinoma (UC).

Urinary markers/metabolites of exposure to chemical carcinogens - New possibilities in preventive oncology

Centuries have passed without tobacco medical evaluation, and similar catastrophes have happened from the Roman Empire to now. We are not aware when, how and how much our body is exposed to chemical carcinogens every day. As a result of such exposure, millions of people fall ill with malignant diseases every year. The objectives of this work are: 1) Determination of the main urinary markers of exposure to the most dangerous chemical carcinogens; 2) Globally raising awareness about necessity of scientific testing chemicals before widespread human use; 3) Introducing the public about ubiquity of: As, Ni, Cr(VI), Cd, Be, and necessity of maximal reducing people's exposure to them. There are well known causal relations between the most dangerous chemical carcinogens and different types of human malignant diseases. Population based studies may determine persons with high concentrations of the urinary markers/metabolites of the most dangerous chemical carcinogens. Then, such selected persons should be removed from such circumstances and/or regularly checked. Better solution is to find out the source(s) of incriminated chemical cancerogens and eliminate or mitigate their emission. These are a kind of (pre)screening (primordial prevention) for persons with high risk of developing malignant diseases causally related to the most dangerous chemical carcinogens.