1
|
Jeong SH, Ku JH. Urinary Markers for Bladder Cancer Diagnosis and Monitoring. Front Cell Dev Biol 2022; 10:892067. [PMID: 35586337 PMCID: PMC9108179 DOI: 10.3389/fcell.2022.892067] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 04/20/2022] [Indexed: 01/08/2023] Open
Abstract
Hematuria is a typical symptom of bladder cancer which enables early detection of bladder cancer. However, reliable diagnostic tools for bladder cancer using urine samples or other non-invasive methods are lacking. Tremendous attempts have been tried and revealed fancy works to convey definitive diagnostic power using urine samples. In this paper, we reviewed urinary markers for bladder cancer and compared their efficacies.
Collapse
Affiliation(s)
- Seung-Hwan Jeong
- Department of Urology, Seoul National University Hospital, Seoul, South Korea
| | - Ja Hyeon Ku
- Department of Urology, Seoul National University Hospital, Seoul, South Korea
- Department of Urology, Seoul National University College of Medicine, Seoul, South Korea
- *Correspondence: Ja Hyeon Ku,
| |
Collapse
|
2
|
Golla V, Chamie K. Oncological Monitoring of NonMuscle Invasive Bladder Cancer (NMIBC). Bladder Cancer 2021. [DOI: 10.1007/978-3-030-70646-3_13] [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]
|
3
|
Carvalho S, Abreu CM, Ferreira D, Lima L, Ferreira JA, Santos LL, Ribeiro R, Grenha V, Martínez-Fernández M, Duenas M, Suárez-Cabrera C, Paramio JM, Diéguez L, Freitas PP, Oliveira MI. Phenotypic Analysis of Urothelial Exfoliated Cells in Bladder Cancer via Microfluidic Immunoassays: Sialyl-Tn as a Novel Biomarker in Liquid Biopsies. Front Oncol 2020; 10:1774. [PMID: 33042825 PMCID: PMC7526084 DOI: 10.3389/fonc.2020.01774] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Accepted: 08/10/2020] [Indexed: 12/29/2022] Open
Abstract
Bladder cancer is the most common malignancy of the urinary tract, having one of the highest recurrence rates and progression from non-muscle to muscle invasive bladder cancer that commonly leads to metastasis. Cystoscopy and urine cytology are the standard procedures for its detection but have limited clinical sensitivity and specificity. Herein, a microfluidic device, the UriChip, was developed for the enrichment of urothelial exfoliated cells from fresh and frozen urine, based on deformability and size, and the cancer-associated glycan Sialyl-Tn explored as a putative bladder cancer urinary biomarker. Spiking experiments with bladder cancer cell lines showed an isolation efficiency of 53%, while clinical sample analyses revealed retention of cells with various morphologies and sizes. in situ immunoassays demonstrated significantly higher number of Sialyl-Tn-positive cells in fresh and frozen voided urine from bladder cancer patients, compared to healthy individuals. Of note, urothelial exfoliated cells from cryopreserved urine sediments were also successfully isolated by the UriChip, and found to express significantly high levels of Sialyl-Tn. Remarkably, Sialyl-Tn expression is correlated with tumor stage and grade. Overall, our findings demonstrate the potential of UriChip and Sialyl-Tn to detect urothelial bladder cancer cells in follow-up and long-term retrospective studies.
Collapse
Affiliation(s)
- Sandra Carvalho
- International Iberian Nanotechnology Laboratory, Department of Life Sciences, Braga, Portugal
| | - Catarina M. Abreu
- International Iberian Nanotechnology Laboratory, Department of Life Sciences, Braga, Portugal
| | - Dylan Ferreira
- Experimental Pathology and Therapeutics Group, Research Center of the Portuguese Institute of Oncology (CI-IPOP), Porto, Portugal
- Porto Comprehensive Cancer Center (P.ccc), Porto, Portugal
| | - Luís Lima
- Experimental Pathology and Therapeutics Group, Research Center of the Portuguese Institute of Oncology (CI-IPOP), Porto, Portugal
- Porto Comprehensive Cancer Center (P.ccc), Porto, Portugal
- School of Health, Polytechnic Institute of Porto, Porto, Portugal
| | - José A. Ferreira
- Experimental Pathology and Therapeutics Group, Research Center of the Portuguese Institute of Oncology (CI-IPOP), Porto, Portugal
- Porto Comprehensive Cancer Center (P.ccc), Porto, Portugal
| | - Lúcio L. Santos
- Experimental Pathology and Therapeutics Group, Research Center of the Portuguese Institute of Oncology (CI-IPOP), Porto, Portugal
- Porto Comprehensive Cancer Center (P.ccc), Porto, Portugal
| | - Ricardo Ribeiro
- Tumor & Microenvironment Group, i3S/INEB, Instituto de Investigação e Inovação em Saúde/Instituto de Engenharia Biomédica, University of Porto, Porto, Portugal
- Faculty of Medicine, Environmental Health Institute, University of Lisbon, Lisbon, Portugal
- Departament of Clinical Pathology, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Vânia Grenha
- Department of Urology, Centro Hospitalar Do Alto Ave, Guimarães, Portugal
| | - Mónica Martínez-Fernández
- Genomes and Disease Lab., Research Center of Molecular Medicine and Chronic Diseases (CIMUS), University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Marta Duenas
- Molecular Oncology Unit, CIEMAT, Madrid, Spain
- CIBERONC, Institute of Biomedical Research, University Hospital “12 de Octubre”, Madrid, Spain
| | - Cristian Suárez-Cabrera
- Molecular Oncology Unit, CIEMAT, Madrid, Spain
- CIBERONC, Institute of Biomedical Research, University Hospital “12 de Octubre”, Madrid, Spain
| | - Jesus M. Paramio
- Molecular Oncology Unit, CIEMAT, Madrid, Spain
- CIBERONC, Institute of Biomedical Research, University Hospital “12 de Octubre”, Madrid, Spain
| | - Lorena Diéguez
- International Iberian Nanotechnology Laboratory, Department of Life Sciences, Braga, Portugal
| | - Paulo P. Freitas
- International Iberian Nanotechnology Laboratory, Department of Nanoelectronics Engineering, Braga, Portugal
| | - Marta I. Oliveira
- International Iberian Nanotechnology Laboratory, Department of Life Sciences, Braga, Portugal
| |
Collapse
|
4
|
Wang X, Gu Y, Zhang S, Li G, Liu T, Wang T, Qin H, Jiang B, Zhu L, Li Y, Lei H, Li M, Zhang Q, Yang R, Fang F, Guo H. Unbiased enrichment of urine exfoliated cells on nanostructured substrates for sensitive detection of urothelial tumor cells. Cancer Med 2019; 9:290-301. [PMID: 31709750 PMCID: PMC6943141 DOI: 10.1002/cam4.2655] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Revised: 10/14/2019] [Accepted: 10/14/2019] [Indexed: 12/19/2022] Open
Abstract
Background Early detection of urothelial carcinoma (UC) by noninvasive diagnostic methods with high accuracy is still underscored. This study aimed to develop a noninvasive assay incorporating both enrichment of urine exfoliated cells and immunoassays for UC detection. Methods Polystyrene dishes were exposed to oxygen plasma and modified with 3‐aminopropyltriethoxysilane to prepare amine‐functionalized nanostructured substrates (NS). Performance characterization of NS was evaluated by atomic force microscope and X‐ray photoelectron spectroscopy. Urine exfoliated cells were captured by NS and then immunostained to detect urinary tumor cells (UTCs), which was called UTC assay. The receiver operating characteristic (ROC) curve, area under ROC curve (AUC), and Youden index were used to find the cutoff value of UTC assay. ROC analysis and McNemar test were used to compare the diagnostic accuracy of UTC assay with cytology. Kappa test was used to analyze the agreement of UTC assay and cytology with pathological diagnosis. Results Nanostructured substrates had good cell binding yields of nucleated cells and tumor cells. CK20+CD45−CD11b− cells were considered as UTCs. UTC number ≥ 1 per sample could be considered as a positive result. By AUC and Kappa analysis, UTC assay showed good performance in UC detection. McNemar test demonstrated that UTC assay had a superior sensitivity even in low‐grade subgroup and a similar specificity compared to cytology in UC diagnosis. Conclusions Nanostructured substrates could be used to enrich the exfoliated cells from urine samples. UTC assay with NS has the potential to play a role in UC detection. The value of this assay still needs additional validation by large, multi‐center studies.
Collapse
Affiliation(s)
- Xin Wang
- Department of Urology, Drum Tower Hospital, Medical School of Nanjing University, Institute of Urology, Nanjing University, Nanjing, China
| | - Yuanyuan Gu
- PerMed Biomedicine Institute, Shanghai, China
| | - Shiwei Zhang
- Department of Urology, Drum Tower Hospital, Medical School of Nanjing University, Institute of Urology, Nanjing University, Nanjing, China
| | - Gangqiang Li
- Department of Pathology, Naval Characteristic Medical Center, Shanghai, China
| | - Tianyao Liu
- Department of Urology, Drum Tower Hospital, Medical School of Nanjing University, Institute of Urology, Nanjing University, Nanjing, China
| | - Tianwei Wang
- Department of Urology, Drum Tower Hospital, Medical School of Nanjing University, Institute of Urology, Nanjing University, Nanjing, China
| | - Haixiang Qin
- Department of Urology, Drum Tower Hospital, Medical School of Nanjing University, Institute of Urology, Nanjing University, Nanjing, China
| | - Bo Jiang
- Department of Urology, Drum Tower Hospital, Medical School of Nanjing University, Institute of Urology, Nanjing University, Nanjing, China
| | - Lin Zhu
- PerMed Biomedicine Institute, Shanghai, China
| | - Yajun Li
- PerMed Biomedicine Institute, Shanghai, China
| | - Haozhi Lei
- PerMed Biomedicine Institute, Shanghai, China
| | - Ming Li
- Department of Pathology, The Affiliated Suzhou Municipal Hospital of Nanjing Medical University, Suzhou, China
| | - Qun Zhang
- PerMed Biomedicine Institute, Shanghai, China
| | - Rong Yang
- Department of Urology, Drum Tower Hospital, Medical School of Nanjing University, Institute of Urology, Nanjing University, Nanjing, China
| | - Feng Fang
- Department of Pharmacology, Nanjing Medical University, Nanjing, China
| | - Hongqian Guo
- Department of Urology, Drum Tower Hospital, Medical School of Nanjing University, Institute of Urology, Nanjing University, Nanjing, China
| |
Collapse
|
5
|
Tsai CH, Chen YT, Chang YH, Hsueh C, Liu CY, Chang YS, Chen CL, Yu JS. Systematic verification of bladder cancer-associated tissue protein biomarker candidates in clinical urine specimens. Oncotarget 2018; 9:30731-30747. [PMID: 30112103 PMCID: PMC6089400 DOI: 10.18632/oncotarget.24578] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2017] [Accepted: 02/20/2018] [Indexed: 12/29/2022] Open
Abstract
Bladder cancer biomarkers currently approved by the Food and Drug Administration are insufficiently reliable for use in non-invasive clinical diagnosis. Verification/validation of numerous biomarker candidates for BC detection is a crucial bottleneck for novel biomarker development. A multiplexed liquid chromatography multiple-reaction-monitoring mass spectrometry assay of 122 proteins, including 118 up-regulated tissue proteins, two known bladder cancer biomarkers and two housekeeping gene products, was successfully established for protein quantification in clinical urine specimens. Quantification of 122 proteins was performed on a large cohort of urine specimens representing a variety of conditions, including 142 hernia, 126 bladder cancer, 67 hematuria, and 59 urinary tract infection samples. ANXA3 (annexin A3) and HSPE1 (heat shock protein family E member 1), which showed the highest detection frequency in bladder cancer samples, were selected for further validation. Western blotting showed that urinary ANXA3 and HSPE1 protein levels were higher in bladder cancer samples than in hernia samples, and enzyme-linked immunosorbent assays confirmed a higher urinary concentration of HSPE1 in bladder cancer than in hernia, hematuria and urinary tract infection. Immunohistochemical analyses showed significantly elevated levels of HSPE1 in tumor cells compared with non-cancerous bladder epithelial cells, suggesting that HSPE1 could be a useful tumor tissue marker for the specific detection of bladder cancer. Collectively, our findings provide valuable information for future validation of potential biomarkers for bladder cancer diagnosis.
Collapse
Affiliation(s)
- Cheng-Han Tsai
- Graduate Institute of Biomedical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Yi-Ting Chen
- Graduate Institute of Biomedical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Molecular Medicine Research Center, College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Department of Biomedical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Department of Nephrology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan
| | - Ying-Hsu Chang
- Division of Urology, Department of Surgery, LinKou Chang Gung Memorial Hospital, Taoyuan, Taiwan.,Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Chuen Hsueh
- Molecular Medicine Research Center, College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Department of Pathology, Chang Gung Memorial Hospital, Linkou, Chang Gung University, College of Medicine, Taoyuan, Taiwan
| | - Chung-Yi Liu
- Division of Urology, Department of Surgery, LinKou Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Yu-Sun Chang
- Graduate Institute of Biomedical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Molecular Medicine Research Center, College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Department of Otolaryngology - Head & Neck Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Chien-Lun Chen
- Department of Urology, Chang Gung Memorial Hospital, Taoyuan, Taiwan.,College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Jau-Song Yu
- Graduate Institute of Biomedical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Molecular Medicine Research Center, College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Liver Research Center, Chang Gung Memorial Hospital, Linkou, Taiwan.,Research Center for Food and Cosmetic Safety, Research Center for Chinese Herbal Medicine, College of Human Ecology, Chang Gung University of Science and Technology, Taoyuan, Taiwan
| |
Collapse
|
6
|
Maas M, Walz S, Stühler V, Aufderklamm S, Rausch S, Bedke J, Stenzl A, Todenhöfer T. Molecular markers in disease detection and follow-up of patients with non-muscle invasive bladder cancer. Expert Rev Mol Diagn 2018; 18:443-455. [DOI: 10.1080/14737159.2018.1469979] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Moritz Maas
- Department of Urolo`gy, University Hospital Tuebingen, Tuebingen, Germany
| | - Simon Walz
- Department of Urolo`gy, University Hospital Tuebingen, Tuebingen, Germany
| | - Viktoria Stühler
- Department of Urolo`gy, University Hospital Tuebingen, Tuebingen, Germany
| | - Stefan Aufderklamm
- Department of Urolo`gy, University Hospital Tuebingen, Tuebingen, Germany
| | - Steffen Rausch
- Department of Urolo`gy, University Hospital Tuebingen, Tuebingen, Germany
| | - Jens Bedke
- Department of Urolo`gy, University Hospital Tuebingen, Tuebingen, Germany
| | - Arnulf Stenzl
- Department of Urolo`gy, University Hospital Tuebingen, Tuebingen, Germany
| | - Tilman Todenhöfer
- Department of Urolo`gy, University Hospital Tuebingen, Tuebingen, Germany
| |
Collapse
|
7
|
Narayan VM, Adejoro O, Schwartz I, Ziegelmann M, Elliott S, Konety BR. The Prevalence and Impact of Urinary Marker Testing in Patients with Bladder Cancer. J Urol 2017; 199:74-80. [PMID: 28859894 DOI: 10.1016/j.juro.2017.08.097] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/18/2017] [Indexed: 11/25/2022]
Abstract
PURPOSE Novel urinary tumor markers for bladder cancer may permit early detection and improved oncologic outcomes but data on use is limited. We sought to identify trends in the application of urinary markers and long-term outcomes of urinary tumor marker use in patients with bladder cancer. MATERIALS AND METHODS Data from the SEER (Surveillance, Epidemiology and End Results)-Medicare database from 2001 to 2011 were used to identify a cohort of 64,450 patients with bladder cancer who underwent urinary marker testing with UroVysion® fluorescence in situ hybridization, or the NMP22® or BTA Stat® test. We assessed the prevalence of urinary marker testing and urine cytology. Characteristics of patients who did and did not undergo urinary marker testing were analyzed by the chi-square test. Urinary marker testing predictors were analyzed with a multivariable logistic regression model and Cox proportional hazards were used to determine unadjusted cancer specific and overall mortality risks. RESULTS The rate of urinary marker testing increased from 17.8% to a peak of 28.2% during the study years (p <0.0001). Predictors of marker use included female gender, younger age and lower Charlson score. Overall and cancer specific survival improved on Kaplan-Meier and Cox proportional hazards analyses with urinary marker testing. CONCLUSIONS Increased urinary marker testing was documented over all stages and grades of bladder cancer, and in certain patient and provider variables. This increase may have contributed to improved overall and cancer specific survival. Additional investigation is necessary to further characterize this benefit.
Collapse
Affiliation(s)
- Vikram M Narayan
- Department of Urology, University of Minnesota, Minneapolis, Minnesota
| | | | - Ian Schwartz
- Department of Urology, University of Minnesota, Minneapolis, Minnesota
| | | | - Sean Elliott
- Department of Urology, University of Minnesota, Minneapolis, Minnesota
| | | |
Collapse
|
8
|
Shi HB, Yu JX, Yu JX, Feng Z, Zhang C, Li GY, Zhao RN, Yang XB. Diagnostic significance of microRNAs as novel biomarkers for bladder cancer: a meta-analysis of ten articles. World J Surg Oncol 2017; 15:147. [PMID: 28774300 PMCID: PMC5543742 DOI: 10.1186/s12957-017-1201-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Accepted: 07/08/2017] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Previous studies have revealed the importance of microRNAs' (miRNAs) function as biomarkers in diagnosing human bladder cancer (BC). However, the results are discordant. Consequently, the possibility of miRNAs to be BC biomarkers was summarized in this meta-analysis. METHODS In this study, the relevant articles were systematically searched from CBM, PubMed, EMBASE, and Chinese National Knowledge Infrastructure (CNKI). The bivariate model was used to calculate the pooled diagnostic parameters and summary receiver operator characteristic (SROC) curve in this meta-analysis, thereby estimating the whole predictive performance. STATA software was used during the whole analysis. RESULTS Thirty-one studies from 10 articles, including 1556 cases and 1347 controls, were explored in this meta-analysis. In short, the pooled sensitivity, area under the SROC curve, specificity, positive likelihood ratio, diagnostic odds ratio, and negative likelihood ratio were 0.72 (95%CI 0.66-0.76), 0.80 (0.77-0.84), 0.76 (0.71-0.81), 3.0 (2.4-3.8), 8 (5.0-12.0), and 0.37 (0.30-0.46) respectively. Additionally, sub-group and meta-regression analyses revealed that there were significant differences between ethnicity, miRNA profiling, and specimen sub-groups. These results suggested that Asian population-based studies, multiple-miRNA profiling, and blood-based assays might yield a higher diagnostic accuracy than their counterparts. CONCLUSIONS This meta-analysis demonstrated that miRNAs, particularly multiple miRNAs in the blood, might be novel, useful biomarkers with relatively high sensitivity and specificity and can be used for the diagnosis of BC. However, further prospective studies with more samples should be performed for further validation.
Collapse
Affiliation(s)
- Hong-Bin Shi
- Department of Urology, Ningxia People's Hospital, No. 301 North Zhengyuan Street, Jinfeng District, Yinchuan, 750021, Ningxia, China
| | - Jia-Xing Yu
- Ningxia Medical University, Yinchuan, 750004, Ningxia, China
| | - Jian-Xiu Yu
- Ningxia Medical University, Yinchuan, 750004, Ningxia, China
| | - Zheng Feng
- Department of Urology, General Hospital of Ningxia Medical University, Yinchuan, 750004, Ningxia, China
| | - Chao Zhang
- Department of Urology, General Hospital of Ningxia Medical University, Yinchuan, 750004, Ningxia, China
| | - Guang-Yong Li
- Department of Urology, General Hospital of Ningxia Medical University, Yinchuan, 750004, Ningxia, China
| | - Rui-Ning Zhao
- Department of Urology, General Hospital of Ningxia Medical University, Yinchuan, 750004, Ningxia, China
| | - Xiao-Bo Yang
- Department of Urology, Ningxia People's Hospital, No. 301 North Zhengyuan Street, Jinfeng District, Yinchuan, 750021, Ningxia, China.
| |
Collapse
|
9
|
Xu S, Gu G, Ni Q, Li N, Yu K, Li X, Liu C. The expression of AEG-1 and Cyclin D1 in human bladder urothelial carcinoma and their clinicopathological significance. Int J Clin Exp Med 2015; 8:21222-21228. [PMID: 26885058 PMCID: PMC4723903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2015] [Accepted: 11/08/2015] [Indexed: 06/05/2023]
Abstract
OBJECTIVE Astrocyte elevated gene-1 (AEG-1) and Cyclin D1 is associated with tumorigenesis and progression. The aim of this study is to investigate the expression of AEG-1 and Cyclin D1 in human bladder urothelial carcinoma (BUC) and explore their clinical and pathological significance. METHODS The expression of AEG-1 and Cyclin D1 protein were detected in 85 cases of human BUC and 16 cases of tumor-adjacent tissues by the immunohistochemical method. RESULTS The positive expression level of AEG-1 was 61.2% in human BUC which was higher than that in tumor-adjacent tissues (18.8%), P=0.002. The high expression of AEG-1 protein was correlated with the recurrence group (P=0.004). The positive rate of AEG-1 protein in superficial carcinoma group was lower than that of invasive cancer group (P=0.014). The positive expression level of Cyclin D1 was 56.5% in BUC, which was higher than that in tumor-adjacent tissues (12.5%). P=0.001. The high expression of Cyclin D1 protein was correlated with the recurrence group (P=0.024). The positive rate of Cyclin D1 protein in low grade group was lower than that of high grade group (P=0.001). The positive rate of Cyclin D1 protein in superficial carcinoma group was lower than that of invasive carcinoma group, (P=0.012). AEG-1 protein was positively correlated with Cyclin D1 protein (r=0.567, P<0.001). The log-rank test statistical analysis suggested that patients with higher AEG-1 or Cyclin D1 expression had shorter overall survival time, while patients with lower AEG-1 or Cyclin D1 expression had better survival. CONCLUSION Overexpression of AEG-1 and Cyclin D1 are markedly correlated with TNM stage and recurrence of BUC. Cyclin D1 are markedly correlated with grade of BUC. Detection of AEG-1 and Cyclin D1 may be helpful to evaluate prognosis and infiltrative capability of BUC.
Collapse
Affiliation(s)
- Songtao Xu
- Department of Urology, The First Affiliated Hospital of Luohe Medical College56 East People Road, Luohe 462300, Henan, P. R. China
- Department of Clinical, Luohe Medical CollegeLuohe 462002, Henan, P. R. China
| | - Guojian Gu
- Department of Pathology, The First People’s Hospital of Taicang58 South Changsheng Street, Taicang 215400, Jiangsu, P. R. China
| | - Qingfeng Ni
- Department of Ultrasound, The First People’s Hospital of Taicang58 South Changsheng Street, Taicang 215400, Jiangsu, P. R. China
| | - Nan Li
- Department of Clinical, Luohe Medical CollegeLuohe 462002, Henan, P. R. China
| | - Kangkang Yu
- Department of Clinical, Luohe Medical CollegeLuohe 462002, Henan, P. R. China
| | - Xianjia Li
- Department of Foundation, Luohe Medical CollegeNo. 148 Daxue Road, Luohe 462002, Henan, P. R. China
| | - Chang Liu
- Department of Foundation, Luohe Medical CollegeNo. 148 Daxue Road, Luohe 462002, Henan, P. R. China
| |
Collapse
|
10
|
Ather MH, Nazim SM. New and contemporary markers of prognosis in nonmuscle invasive urothelial cancer. Korean J Urol 2015; 56:553-64. [PMID: 26279824 PMCID: PMC4534429 DOI: 10.4111/kju.2015.56.8.553] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Accepted: 07/09/2015] [Indexed: 11/29/2022] Open
Abstract
Nonmuscle invasive (NMI) urothelial cancer (UC) is associated with varied biological potential. It is characterized by frequent recurrence and progression, which thus worsens the oncological outcome. Nearly three-quarters of NMI UCs recur within 5 years, whereas half can progress during follow-up. Progression is particularly seen in T1 and carcinoma in situ (CIS). Undoubtedly, NMI UC is one of the most expensive cancers to manage. The European Organisation for Research and Treatment of Cancer (EORTC) risk calculator is a commonly used tool for assessing the recurrence and progression potential of a newly diagnosed cancer. The parameters used in the assessment are tumor size and number, pathological stage and grade of the cancer, presence of CIS, and prior recurrence rate. The main advantages of the EORTC tool are its ease of use and the lack of need to run expensive molecular tests. However, reproducibility of pathologic stage and grade is modest, which is a concern to clinicians. Molecular markers have potential for predicting the clinical outcome of NMI UC, given that clinico-pathologic variables are not sufficient for prediction of prognosis in an individual. Significant work has been done in the past 2 decades in understanding the molecular biology of bladder cancer; however, the translational value of this knowledge remains poor. The role for molecular markers in predicting recurrence seems limited because multifocal disease and incomplete treatment are probably more important for recurrence than the molecular features of a resected tumor. Urinary markers have very limited value in prognostication of bladder cancer and are used (mainly as an adjunct to cytology) for detection and surveillance of urothelial cell cancer recurrence. Prediction of progression with molecular markers holds considerable promise. Nevertheless, the contemporary value of molecular markers over clinico-pathologic indexes is limited.
Collapse
Affiliation(s)
- M Hammad Ather
- Department of Surgery, Aga Khan University, Karachi, Pakistan
| | - Syed M Nazim
- Department of Surgery, Aga Khan University, Karachi, Pakistan
| |
Collapse
|
11
|
Guo B, Che T, Shi B, Guo L, Zhang Z, Li L, Cai C, Chen Y. Interaction network analysis of differentially expressed genes and screening of cancer marker in the urine of patients with invasive bladder cancer. Int J Clin Exp Med 2015; 8:3619-3628. [PMID: 26064257 PMCID: PMC4443091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2014] [Accepted: 02/12/2015] [Indexed: 06/04/2023]
Abstract
OBJECTIVE To detect the expression profile of bladder cancer and to delineate the interaction network of these genes in invasive bladder cancer. METHODS A total of 126 differentially expressed genes were identified, and input into STRING online database to delineate interaction network. The network data were screened with central nodes. The expression of genes with the most evident change in the exfoliated cells of urine was detected. RNA markers with over-expression in stage Ta tumor and/or T1 to T4 tumors but low expression in blood or inflammatory cells were characterized. RESULTS On the basis of assay of 21,639 whole-genome oligonucleotide microarray, a total of 126 differentially expressed genes were identified, of which 69 had up-regulated expression and 57 had down-regulated expression. STRING screening showed there were interactions among 103 genes in the bladder cancer which formed a complex network. A total of 23 central nodes were screened with Cytoscape and are involved in multiple signaling pathways related to tumorigenesis. The test specificity was 80% for the 30 control patients with urinary tract infections. The combination of BLCA-4 and HOXA13 could distinguish between low and high grade tumors, with specificity and sensitivity of 80%. CONCLUSION The interaction network of differentially expressed genes, especially the central nodes of this network, can provide evidence for the early diagnosis and molecular targeted therapy of invasive bladder cancer, and combined detection of IGF-1, hTERT, BLCA-4 and HOXA13 genes is helpful to evaluate BTCC at different stages.
Collapse
Affiliation(s)
- Baihong Guo
- Department of Urology, People’s Hospital of Gansu ProvinceLanzhou 730000, China
| | - Tuanjie Che
- School of Life Science, Lanzhou UniversityLanzhou 730000, China
| | - Baoguang Shi
- Department of Urology, People’s Hospital of Gansu ProvinceLanzhou 730000, China
| | - Lijun Guo
- Department of Urology, People’s Hospital of Gansu ProvinceLanzhou 730000, China
| | - Zhihua Zhang
- Department of Urology, People’s Hospital of Gansu ProvinceLanzhou 730000, China
| | - Lin Li
- School of Life Science, Lanzhou UniversityLanzhou 730000, China
| | - Chuanyong Cai
- School of Life Science, Lanzhou UniversityLanzhou 730000, China
| | - Yirong Chen
- Department of Urology, People’s Hospital of Gansu ProvinceLanzhou 730000, China
| |
Collapse
|
12
|
Epigenetic regulation of Elf5 is associated with epithelial-mesenchymal transition in urothelial cancer. PLoS One 2015; 10:e0117510. [PMID: 25629735 PMCID: PMC4309403 DOI: 10.1371/journal.pone.0117510] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2014] [Accepted: 12/29/2014] [Indexed: 01/11/2023] Open
Abstract
E74-like factor 5 (Elf5) has been associated with tumor suppression in breast cancer. However, its role in urothelial cancer (UC) is completely unknown. Immunohistochemistry (IHC) and methylation specific PCR (MSP) were done to detect Elf5 expression level and its promoter methylation. Results revealed that low expression of Elf5 on protein and mRNA levels were associated with tumor progression, early relapse and poor survival. In vitro, down-regulation of Elf5 can increase epithelial-mesenchymal transition (EMT). Aberrant Elf5 methylation was identified as major mechanism for Elf5 gene silence. Accordingly, restoration of Elf5 by infection or demethylating treatment effectively reversed EMT processes. In conclusion, we identified Elf5 as a novel biomarker of UC on several biological levels and established a causative link between Elf5 and EMT in UC.
Collapse
|
13
|
Schmitz-Dräger BJ, Droller M, Lokeshwar VB, Lotan Y, Hudson MA, van Rhijn BW, Marberger MJ, Fradet Y, Hemstreet GP, Malmstrom PU, Ogawa O, Karakiewicz PI, Shariat SF. Molecular markers for bladder cancer screening, early diagnosis, and surveillance: the WHO/ICUD consensus. Urol Int 2014; 94:1-24. [PMID: 25501325 DOI: 10.1159/000369357] [Citation(s) in RCA: 120] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Due to the lack of disease-specific symptoms, diagnosis and follow-up of bladder cancer has remained a challenge to the urologic community. Cystoscopy, commonly accepted as a gold standard for the detection of bladder cancer, is invasive and relatively expensive, while urine cytology is of limited value specifically in low-grade disease. Over the last decades, numerous molecular assays for the diagnosis of urothelial cancer have been developed and investigated with regard to their clinical use. However, although all of these assays have been shown to have superior sensitivity as compared to urine cytology, none of them has been included in clinical guidelines. The key reason for this situation is that none of the assays has been included into clinical decision-making so far. We reviewed the current status and performance of modern molecular urine tests following systematic analysis of the value and limitations of commercially available assays. Despite considerable advances in recent years, the authors feel that at this stage the added value of molecular markers for the diagnosis of urothelial tumors has not yet been identified. Current data suggest that some of these markers may have the potential to play a role in screening and surveillance of bladder cancer. Well-designed protocols and prospective, controlled trials will be needed to provide the basis to determine whether integration of molecular markers into clinical decision-making will be of value in the future.
Collapse
|
14
|
Qi F, Liu Y, Zhao R, Zou X, Zhang L, Li J, Wang Y, Li F, Zou X, Xia Y, Wang X, Xing L, Li C, Lu J, Tang J, Zhou F, Liu C, Gui Y, Cai Z, Sun X. Quantitation of rare circulating tumor cells by folate receptor α ligand-targeted PCR in bladder transitional cell carcinoma and its potential diagnostic significance. Tumour Biol 2014; 35:7217-23. [PMID: 24771263 DOI: 10.1007/s13277-014-1894-0] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2014] [Accepted: 03/25/2014] [Indexed: 01/22/2023] Open
Abstract
Numerous attempts for detection of circulating tumor cells (CTC) have been made to develop reliable assays for early diagnosis of cancers. In this study, we validated the application of folate receptor α (FRα) as the tumor marker to detect CTC through tumor-specific ligand PCR (LT-PCR) and assessed its utility for diagnosis of bladder transitional cell carcinoma (TCC). Immunohistochemistry for FRα was performed on ten bladder TCC tissues. Enzyme-linked immunosorbent assay (ELISA) for FRα was performed on both urine and serum specimens from bladder TCC patients (n = 64 and n = 20, respectively) and healthy volunteers (n = 20 and n = 23, respectively). Western blot analysis and qRT-PCR were performed to confirm the expression of FRα in bladder TCC cells. CTC values in 3-mL peripheral blood were measured in 57 bladder TCC patients, 48 healthy volunteers, and 15 subjects with benign urologic pathologies by the folate receptor α ligand-targeted PCR. We found that FRα protein was overexpressed in both bladder TCC cells and tissues. The levels of FRα mRNA were also much higher in bladder cancer cell lines 5637 and SW780 than those of leukocyte. Values of FRα were higher in both serum and urine specimens of bladder TCC patients than those of control. CTC values were also higher in 3-mL peripheral blood of bladder TCC patients than those of control (median 26.5 Cu/3 mL vs 14.0 Cu/3 mL). Area under the receiver operating characteristic (ROC) curve for bladder TCC detection was 0.819, 95 % CI (0.738-0.883). At the cutoff value of 15.43 Cu/3 mL, the sensitivity and the specificity for detecting bladder cancer are 82.14 and 61.9 %, respectively. We concluded that quantitation of CTCs through FRα ligand-PCR could be a promising method for noninvasive diagnosis of bladder TCC.
Collapse
Affiliation(s)
- Fuming Qi
- Department of Urological Surgery, Shenzhen Second People's Hospital, The First Affiliated Hospital of Shenzhen University, Shenzhen, China
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
15
|
Sapre N, Anderson PD, Costello AJ, Hovens CM, Corcoran NM. Gene-based urinary biomarkers for bladder cancer: An unfulfilled promise? Urol Oncol 2014; 32:48.e9-17. [DOI: 10.1016/j.urolonc.2013.07.002] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2013] [Revised: 07/01/2013] [Accepted: 07/01/2013] [Indexed: 01/05/2023]
|
16
|
Wadhwa N, Jatawa SK, Tiwari A. Republished: non-invasive urine based tests for the detection of bladder cancer. Postgrad Med J 2013; 89:352-7. [PMID: 23686844 DOI: 10.1136/postgradmedj-2012-200812rep] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Bladder cancer is the fourth most frequently diagnosed malignant neoplasm and cause of cancer-related deaths in men and eighth in women. Patients with bladder cancer undergo repeated cystoscopic examinations of the bladder to monitor for tumour recurrence which is invasive, costly and lacks accuracy. Therefore, the development of non-invasive urine based tests for the early detection of bladder cancer would be of tremendous benefit to both patients and healthcare systems. A number of urine based markers are available for the early diagnosis of bladder cancer. The diagnosis of bladder cancer relies on identifying malignant cells in the urine. All urinary markers have a higher sensitivity as compared with cytology but they score lower in specificity. Many soluble and cell based markers have been developed. Only two of the soluble and cell based markers have obtained the Food and Drug Administration approval. In the current review, the most recent literature of urinary markers is summarised. This article reports some of the more prominent urine markers and new technologies used nowadays.
Collapse
Affiliation(s)
- Neha Wadhwa
- School of Biotechnology, Rajiv Gandhi Proudyogiki Vishwavidyalaya, State Technological University of Madhya Pradesh, Airport Bypass Road, Bhopal 462033, Madhya Pradesh.
| | | | | |
Collapse
|
17
|
|
18
|
Urquidi V, Rosser CJ, Goodison S. Molecular diagnostic trends in urological cancer: biomarkers for non-invasive diagnosis. Curr Med Chem 2012; 19:3653-63. [PMID: 22680923 DOI: 10.2174/092986712801661103] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2011] [Revised: 01/17/2012] [Accepted: 01/25/2012] [Indexed: 11/22/2022]
Abstract
The early detection of urological cancers is pivotal for successful patient treatment and management. The development of molecular assays that can diagnose disease accurately, or that can augment current methods of evaluation, would be a significant advance. Ideally, such molecular assays would be applicable to non-invasively obtained body fluids, enabling not only diagnosis of at risk patients, but also asymptomatic screening, monitoring disease recurrence and response to treatment. The advent of advanced proteomics and genomics technologies and associated bioinformatics development is bringing these goals into focus. In this article we will discuss the promise of biomarkers in urinalysis for the detection and clinical evaluation of the major urological cancers, including bladder, kidney and prostate. The development of urine-based tests to detect urological cancers would be of tremendous benefit to both patients and the healthcare system.
Collapse
Affiliation(s)
- V Urquidi
- Cancer Research Institute, MD Anderson Cancer Center Orlando, 6900 Lake Nona Blvd, Orlando, FL 32827, USA
| | | | | |
Collapse
|
19
|
Urquidi V, Goodison S, Cai Y, Sun Y, Rosser CJ. A candidate molecular biomarker panel for the detection of bladder cancer. Cancer Epidemiol Biomarkers Prev 2012; 21:2149-58. [PMID: 23097579 DOI: 10.1158/1055-9965.epi-12-0428] [Citation(s) in RCA: 67] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Bladder cancer is among the five most common malignancies worldwide, and due to high rates of recurrence, one of the most prevalent. Improvements in noninvasive urine-based assays to detect bladder cancer would benefit both patients and health care systems. In this study, the goal was to identify urothelial cell transcriptomic signatures associated with bladder cancer. METHODS Gene expression profiling (Affymetrix U133 Plus 2.0 arrays) was applied to exfoliated urothelia obtained from a cohort of 92 subjects with known bladder disease status. Computational analyses identified candidate biomarkers of bladder cancer and an optimal predictive model was derived. Selected targets from the profiling analyses were monitored in an independent cohort of 81 subjects using quantitative real-time PCR (RT-PCR). RESULTS Transcriptome profiling data analysis identified 52 genes associated with bladder cancer (P ≤ 0.001) and gene models that optimally predicted class label were derived. RT-PCR analysis of 48 selected targets in an independent cohort identified a 14-gene diagnostic signature that predicted the presence of bladder cancer with high accuracy. CONCLUSIONS Exfoliated urothelia sampling provides a robust analyte for the evaluation of patients with suspected bladder cancer. The refinement and validation of the multigene urothelial cell signatures identified in this preliminary study may lead to accurate, noninvasive assays for the detection of bladder cancer. IMPACT The development of an accurate, noninvasive bladder cancer detection assay would benefit both the patient and health care systems through better detection, monitoring, and control of disease.
Collapse
Affiliation(s)
- Virginia Urquidi
- Cancer Research Institute, M.D. Anderson Cancer Center Orlando, Orlando, FL, USA
| | | | | | | | | |
Collapse
|
20
|
Methylation markers for urine-based detection of bladder cancer: the next generation of urinary markers for diagnosis and surveillance of bladder cancer. Adv Urol 2012; 2012:503271. [PMID: 22761614 PMCID: PMC3385670 DOI: 10.1155/2012/503271] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2012] [Accepted: 04/16/2012] [Indexed: 12/31/2022] Open
Abstract
Cancer of the urinary bladder is the fifth most common neoplasm in the industrialized countries. Diagnosis and surveillance are dependent on invasive evaluation with cystoscopy and to some degree cytology as an adjunct analysis. Nomuscle invasive bladder cancer is characterized by frequent recurrences after resection, and up to 30% will develop an aggressive phenotype. The journey towards a noninvasive test for diagnosing bladder cancer, in order to replace or extend time between cystoscopy, has been ongoing for more than a decade. However, only a handful of tests that aid in clinical decision making are commercially available. Recent reports of DNA methylation in urine specimens highlight a possible clinical use of this marker type, as high sensitivities and specificities have been shown. This paper will focus on the currently available markers NMP22, ImmunoCyt, and UroVysion as well as novel DNA methylation markers for diagnosis and surveillance of bladder cancer.
Collapse
|
21
|
Wadhwa N, Jatawa SK, Tiwari A. Non-invasive urine based tests for the detection of bladder cancer. J Clin Pathol 2012; 65:970-5. [PMID: 22685259 DOI: 10.1136/jclinpath-2012-200812] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Bladder cancer is the fourth most frequently diagnosed malignant neoplasm and cause of cancer-related deaths in men and eighth in women. Patients with bladder cancer undergo repeated cystoscopic examinations of the bladder to monitor for tumour recurrence which is invasive, costly and lacks accuracy. Therefore, the development of non-invasive urine based tests for the early detection of bladder cancer would be of tremendous benefit to both patients and healthcare systems. A number of urine based markers are available for the early diagnosis of bladder cancer. The diagnosis of bladder cancer relies on identifying malignant cells in the urine. All urinary markers have a higher sensitivity as compared with cytology but they score lower in specificity. Many soluble and cell based markers have been developed. Only two of the soluble and cell based markers have obtained the Food and Drug Administration approval. In the current review, the most recent literature of urinary markers is summarised. This article reports some of the more prominent urine markers and new technologies used nowadays.
Collapse
Affiliation(s)
- Neha Wadhwa
- School of Biotechnology, Rajiv Gandhi Proudyogiki Vishwavidyalaya, State Technological University of Madhya Pradesh, Bhopal, Madhya Pradesh.
| | | | | |
Collapse
|
22
|
Urquidi V, Chang M, Dai Y, Kim J, Wolfson ED, Goodison S, Rosser CJ. IL-8 as a urinary biomarker for the detection of bladder cancer. BMC Urol 2012; 12:12. [PMID: 22559832 PMCID: PMC3404900 DOI: 10.1186/1471-2490-12-12] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2012] [Accepted: 05/04/2012] [Indexed: 12/27/2022] Open
Abstract
Background Current urine-based assays for bladder cancer (BCa) diagnosis lack accuracy, so the search for improved biomarkers continues. Through genomic and proteomic profiling of urine, we have identified a panel of biomarkers associated with the presence of BCa. In this study, we evaluated the utility of three of these biomarkers, interleukin 8 (IL-8), Matrix metallopeptidase 9 (MMP-9) and Syndecan in the diagnosis of BCa through urinalysis. Methods Voided urines from 127 subjects, cancer subjects (n = 64), non-cancer subjects (n = 63) were analyzed. The protein concentrations of IL-8, MMP-9, and Syndecan were assessed by enzyme-linked immunosorbent assay (ELISA). Data were also compared to a commercial ELISA-based BCa detection assay (BTA-Trak©) and urinary cytology. We used the area under the curve of a receiver operating characteristic (AUROC) to compare the performance of each biomarker. Results Urinary protein concentrations of IL-8, MMP-9 and BTA were significantly elevated in BCa subjects. Of the experimental markers compared to BTA-Trak©, IL-8 was the most prominent marker (AUC; 0.79; 95% confidence interval [CI], 0.72-0.86). Multivariate regression analysis revealed that only IL-8 (OR; 1.51; 95% CI, 1.16-1.97, p = 0.002) was an independent factor for the detection of BCa. Conclusions These results suggest that the measurement of IL-8 in voided urinary samples may have utility for urine-based detection of BCa. These findings need to be confirmed in a larger, prospective cohort.
Collapse
Affiliation(s)
- Virginia Urquidi
- Cancer Research Institute, Anderson Cancer Center Orlando, FL 32827, USA
| | | | | | | | | | | | | |
Collapse
|
23
|
Issaq HJ, Waybright TJ, Veenstra TD. Cancer biomarker discovery: Opportunities and pitfalls in analytical methods. Electrophoresis 2011; 32:967-75. [PMID: 21449066 DOI: 10.1002/elps.201000588] [Citation(s) in RCA: 92] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2010] [Revised: 11/23/2010] [Accepted: 11/23/2010] [Indexed: 12/17/2022]
Abstract
Many diseases result in specific and characteristic changes in the chemical and biochemical profiles of biological fluids and tissues prior to development of clinical symptoms. These changes are often useful diagnostic and prognostic biomarkers. Identifying biomarkers that can be used for the early detection of cancer will result in more efficient treatments, reduction in suffering, and lower mortality rates. An ideal screening test should be non-invasive with high sensitivity and specificity. Proteomic and metabolomic analyses of biological samples can reveal changes in abundance levels of metabolites and proteins that when validated and confirmed through clinical trials can function as clinical tests for early detection, diagnosis, monitoring disease progression, and predicting therapeutic response. While the past decade has seen great advancements in proteomics and metabolomics research producing potential biomarkers for cancer, most of the identified biomarkers have failed to replace existing clinical tests. To become a clinically approved test, a potential biomarker should be confirmed and validated using hundreds of specimens and should be reproducible, specific, and sensitive. A search of the scientific and medical literature indicates that many studies report the discovery of potential biomarkers without proper validation and/or they do not meet the above criteria. In this manuscript, we will discuss the successes and the pitfalls of biomarker research and comment on study and experimental design, which in most cases is lacking, resulting in suboptimal biomarkers.
Collapse
Affiliation(s)
- Haleem J Issaq
- Laboratory of Proteomics and Analytical Technologies, Advanced Technology Program, SAIC-Frederick, NCI-Frederick, 1050 Boyles Street, Frederick, MD 21702, USA.
| | | | | |
Collapse
|
24
|
Sagnak L, Ersoy H, Gucuk O, Ozok U, Topaloglu H. Diagnostic Value of a Urine-Based Tumor Marker for Screening Lower Urinary Tract in Low-Risk Patients with Asymptomatic Microscopic Hematuria. Urol Int 2011; 87:35-41. [DOI: 10.1159/000325376] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2010] [Accepted: 02/09/2011] [Indexed: 11/19/2022]
|
25
|
Kehinde EO, Al-Mulla F, Kapila K, Anim JT. Comparison of the sensitivity and specificity of urine cytology, urinary nuclear matrix protein-22 and multitarget fluorescence in situ hybridization assay in the detection of bladder cancer. ACTA ACUST UNITED AC 2010; 45:113-21. [PMID: 21091091 DOI: 10.3109/00365599.2010.533694] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE This study aimed to compare the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of urine cytology, BladderChek® nuclear matrix protein-22 (NMP22) and UroVysion™ fluorescence in situ hybridization (FISH) tests in patients with newly diagnosed bladder cancer, those with recurrent bladder cancer, and those with bladder cancer but in remission during surveillance. MATERIAL AND METHODS Voided urine samples obtained from 178 patients with suspected or known bladder cancer about to undergo diagnostic or surveillance cystoscopy and 25 control subjects without the disease were divided into four and used for urine culture and cytology, NMP22 BladderChek and UroVysion FISH tests. The sensitivity, specificity, PPV and NPV for each test were calculated. Comparison was made between the ability of each test to detect bladder cancer in the three category of patients listed. RESULTS Of the 178 patients with bladder cancer, 43 were newly diagnosed, 58 had recurrent disease and 77 were in remission. The sensitivity of each test in newly diagnosed patients was: urine cytology 28%, NMP22 88% and FISH 80%; and in patients with recurrent disease: urine cytology 33%, NMP22 57% and FISH 85%. The mean specificity for urine cytology, NMP22 and FISH was 95%, 67% and 48%, respectively. CONCLUSION Of the tests used in the study for detection of bladder cancer, NMP22 appeared to be most cost-effective and rapid, with relatively high sensitivity and specificity in all categories of patients. The NMP22 test may be considered a new gold standard for the assessment of patients with known or suspected bladder cancer.
Collapse
Affiliation(s)
- Elijah O Kehinde
- Division of Urology, Department of Surgery, Faculty of Medicine, Kuwait University, Kuwait.
| | | | | | | |
Collapse
|