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Kobayashi G, Hayashi T, Sentani K, Uraoka N, Shibata J, Nobuhiro R, Saito Y, Ishida K, Kaneko Y, Ikeda K, Hanamoto M, Nose H, Arihiro K, Hinata N, Oue N. Dual immunocytochemical staining of annexin A10 and p53 in low-grade and papillary urothelial carcinoma contributes to improvement of diagnostic accuracy in urine cytology. Cancer Cytopathol 2023; 131:548-560. [PMID: 37300383 DOI: 10.1002/cncy.22727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 03/05/2023] [Accepted: 03/29/2023] [Indexed: 06/12/2023]
Abstract
BACKGROUND Urothelial carcinoma (UC) is a common type of human cancer and, although urine cytology is a useful method for identifying high-grade UC (HGUC), its ability to diagnose low-grade UC (LGUC) is limited. The authors previously reported that annexin A10 (ANXA10) expression was strongly linked to both papillary and early stage LGUC and was inversely correlated with p53 expression in upper tract UC (UTUC) and bladder UC. However, it remains largely unknown whether ANXA10 is useful as a diagnostic marker for urine cytology. METHODS In this study, the authors used 104 biopsy and 314 urine cytology samples to investigate the efficacy of ANXA10 and p53 expression by immunohistochemistry and immunocytochemistry. RESULTS In immunohistochemistry analysis, expression levels of ANXA10 and p53 were either weak or absent in noncancerous tissues, whereas ANXA10 overexpression was observed patients with LGUC, and strong expression of p53 was identified in patients with HGUC. In immunocytochemistry analysis, sensitivity was not good for the detection of UC, especially UTUC, by cytology alone, but it was improved by combining cytology with ANXA10 and p53 to detect both bladder UC and UTUC. Receiver operating characteristic curve analysis also confirmed the diagnostic superiority of cytology combining ANXA10 and p53 for the detection of all UCs, including both HGUC and LGUC (area under the curve, 0.84). CONCLUSIONS To the authors' knowledge, this is the first report that the combination of ANXA10 and p53 has potential application as a diagnostic immunomarker for improving the diagnostic accuracy of urine cytology.
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Affiliation(s)
- Go Kobayashi
- Department of Pathology, Kure-Kyosai Hospital, Federation of National Public Service Personnel Mutual Aid Associations, Hiroshima, Japan
| | - Tetsutaro Hayashi
- Department of Urology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Kazuhiro Sentani
- Department of Molecular Pathology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Naohiro Uraoka
- Department of Pathology, Kure-Kyosai Hospital, Federation of National Public Service Personnel Mutual Aid Associations, Hiroshima, Japan
| | - Jun Shibata
- Department of Pathology, Kure-Kyosai Hospital, Federation of National Public Service Personnel Mutual Aid Associations, Hiroshima, Japan
| | - Ryosuke Nobuhiro
- Department of Pathology, Kure-Kyosai Hospital, Federation of National Public Service Personnel Mutual Aid Associations, Hiroshima, Japan
| | - Yoichi Saito
- Department of Pathology, Kure-Kyosai Hospital, Federation of National Public Service Personnel Mutual Aid Associations, Hiroshima, Japan
| | - Katsunari Ishida
- Department of Anatomical Pathology, Hiroshima University Hospital, Hiroshima, Japan
| | - Yoshie Kaneko
- Department of Anatomical Pathology, Hiroshima University Hospital, Hiroshima, Japan
| | - Kenichiro Ikeda
- Department of Urology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Masanori Hanamoto
- Department of Urology, Kure-Kyosai Hospital, Federation of National Public Service Personnel Mutual Aid Associations, Hiroshima, Japan
| | - Hiroyuki Nose
- Department of Urology, Kure-Kyosai Hospital, Federation of National Public Service Personnel Mutual Aid Associations, Hiroshima, Japan
| | - Koji Arihiro
- Department of Anatomical Pathology, Hiroshima University Hospital, Hiroshima, Japan
| | - Nobuyuki Hinata
- Department of Urology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Naohide Oue
- Department of Molecular Pathology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
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Bansal S, Pathuthara S, Joseph S, Dighe S, Menon S, Desai SB. Is Diagnosis of Low-Grade Urothelial Carcinoma Possible in Urine Cytology? J Cytol 2021; 38:64-68. [PMID: 34321771 PMCID: PMC8280861 DOI: 10.4103/joc.joc_193_18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Revised: 12/25/2019] [Accepted: 04/05/2021] [Indexed: 12/19/2022] Open
Abstract
Background: Urine cytology is a useful modality, primarily for the diagnosis and follow-up surveillance of high-grade urothelial carcinoma (HGUC). Its utility in diagnosing low-grade urothelial carcinoma (LGUC) remains controversial because of low reported sensitivity compared to cystoscopy. Aim: To study the cytomorphology of LGUC in voided urine samples and analyze its utility in diagnosis. Materials and Methods: This is a retrospective study of one year, including 48 voided urine samples in cases which were confirmed as LGUC on subsequent histology. Urine cytology smears of these cases, originally stained with Papanicolaou stain were reviewed, critically analyzed and the specific cytomorphologic and cystoscopic findings were documented. Results: On review 18 samples were re-categorized as LGUC which included 10 samples initially diagnosed as Negative for HGUC, 2 as Atypical Urothelial Cells – Not Otherwise Specified (AUC-NOS) and 6 as Suspicious for Carcinoma. In addition, another 3 samples with initial diagnosis of LGUC remained as LGUC on review. Thus, a total of 21 LGUC samples were identified after the review. 26 (54%) samples with a diagnosis of negative for HGUC remained negative even after review, as the tumor cells were not identified either due to sampling error or unrecognizable morphology. One (2%) samples of AUC-NOS remained the same on review due to very scant atypical cells. In 21 LGUC samples, cytology showed a dual population of benign differentiated urothelial cells and small urothelial cells with subtle nuclear atypia such as irregular and thickened nuclear membrane with increased nuclear cytoplasmic ratio. In 12 false negative LGUC samples, the diagnostic cells were camouflaged by their subtle nuclear atypia coupled with an overwhelming background of differentiated benign urothelial cells as both appeared almost similar in morphology. Papillary fragments were identified only in 2 samples. Conclusions: Diagnosis of LGUC on cytology is challenging and depends on the presence of diagnostic cells, pick up of diagnostic cells on screening and accurate interpretation. Special attention to papillary fragments and aforementioned nuclear atypia should be paid as tumor cells may resemble normal urothelial cells and can be easily missed.
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Affiliation(s)
- Saloni Bansal
- Department of Cytopathology, Tata Memorial Hospital, Tata Memorial Centre, Mumbai, Maharashtra, India
| | - Saleem Pathuthara
- Department of Cytopathology, Tata Memorial Hospital, Tata Memorial Centre, Mumbai, Maharashtra, India
| | - Santhosh Joseph
- Department of Cytopathology, Tata Memorial Hospital, Tata Memorial Centre, Mumbai, Maharashtra, India
| | - Swati Dighe
- Department of Cytopathology, Tata Memorial Hospital, Tata Memorial Centre, Mumbai, Maharashtra, India
| | - Santosh Menon
- Department of Pathology, Tata Memorial Centre, Mumbai, Maharashtra, India
| | - Sangeeta B Desai
- Department of Pathology, Tata Memorial Centre, Mumbai, Maharashtra, India
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Abstract
Cell-block preparations have become an essential part of integrated cytology diagnosis. They are essentially microbiopsies that are formalin fixed and embedded in paraffin. This has become more prevalent with greater sample procurement due to the advent of newer biopsy techniques and needles. Cell-blocks allow retrieval of small tissue fragments from cytology specimens that sometimes cannot be processed by alternate cytologic techniques. They represent concentrated, cell-enriched preparations that provide cytologists with the opportunity to evaluate cellular architecture, as well as to perform ancillary testing. A cell-block compatible sample may thus obviate the need for a more invasive procedure such as a tissue biopsy. Microscopic examination of cell-blocks is quick, avoids obscuring material, permits cells to be evaluated in one focal plane, and allows the histologic architecture such as glandular differentiation, papillary formations, and sometimes invasion to be easily identified. This new era of “cytohistology” accordingly requires practicing cytologists to become more familiar with histopathology. This review article discusses the benefit of various architectural patterns identifiable in cell-blocks employed as an adjunct to Pap tests, exfoliative fluid specimens, and fine-needle aspirations.
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Affiliation(s)
- Swati Satturwar
- Department of Pathology, University of Pittsburgh Medical Center, Pennsylvania, United States
| | - Liron Pantanowitz
- Department of Pathology, University of Michigan, Michigan, United States
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Kapoor K, Datta C, Pal DK. Is liquid-based cytology an alternative to conventional cytology for detection of malignant cells in urine of bladder cancer? Eastern Indian prospective observational study. Turk J Urol 2019; 45:351-356. [PMID: 31509507 DOI: 10.5152/tud.2019.19040] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Accepted: 07/23/2019] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Conventional cytology (CC) is a widely employed biomarker for the detection of bladder cancer, but due to its decreased sensitivity, liquid-based cytology (LBC) has been studied. Despite its improved cell-free background, decreased cell degeneration, and an automated slide preparation technique, it shows a variable rate of malignant cells detection. Thus, we did this study to compare the positivity of LBC with CC in eastern Indian population. MATERIAL AND METHODS A total of 150 patients who underwent a transurethral resection of bladder tumor (June 2017 to December 2018) were enrolled. Pre-operative CC and LBC were processed from freshly voided urine samples. The malignant cells detection rate and influential factors were noted and compared. RESULTS The detection of malignant cells by LBC was higher compared to CC (37.3% vs. 25.3%; p<0.0001). Among 59 high-grade tumors, 59% and 86% slides were positive for CC and LBC, respectively (p<0.0001). Even in the background of hematuria, LBC showed a better detection (43.33% by LBC vs. 23.66% by CC; p<0.0001). CONCLUSION The present study concludes that LBC offers a better detection of malignant cells in the urine of patients with bladder tumor as compared to CC. The detection of malignant cells by LBC is even better in the background of hematuria.
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Affiliation(s)
- Kunal Kapoor
- Department of Urology, Institute of Post Graduate Medical Education & Research (IPGMER&R), Kolkata, India
| | - Chhanda Datta
- Department of Pathology, Institute of Post Graduate Medical Education & Research (IPGMER&R), Kolkata, India
| | - Dilip Kumar Pal
- Department of Urology, Institute of Post Graduate Medical Education & Research (IPGMER&R), Kolkata, India
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Liang Q, Zhang G, Li W, Wang J, Sheng S. Comparison of the diagnostic performance of fluorescence in situ hybridization (FISH), nuclear matrix protein 22 (NMP22), and their combination model in bladder carcinoma detection: a systematic review and meta-analysis. Onco Targets Ther 2018; 12:349-358. [PMID: 30643432 PMCID: PMC6317485 DOI: 10.2147/ott.s186065] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background Emerging studies reported that combination of fluorescence in situ hybridization (FISH) and nuclear matrix protein 22 (NMP22) could increase the sensitivity and specificity of bladder carcinoma (BC) management. Nevertheless, the reports remain inconsistent. This meta-analysis was undertaken to evaluate the diagnostic performance of FISH, NMP22, and their combination model in BC. Materials and methods A systematic literature search was carried out in PubMed, Embase, Cochrane Library, Web of Science, Chinese National Knowledge Infrastructure, and Wanfang database dated up to October 2018. Suitable studies were identified and raw data were extracted. Meta-analysis was conducted to calculate the global sensitivities, specificities, likelihood ratio, diagnostic odds ratio (DOR), and the areas under the summary receiver operating characteristic (SROC) curves for FISH, NMP22, and their combination model, separately. All the meta-analysis estimates were derived using STATA (version 12.0) and MetaDisc (version 1.4) software packages. Results Seven eligible studies were included for analysis. The global sensitivities with 95% CI for FISH, NMP22, and their combination model were 0.79 (95% CI: 0.75–0.83), 0.76 (95% CI: 0.71–0.81), and 0.82 (95% CI: 0.75–0.88); specificities were 0.85 (95% CI: 0.76–0.91), 0.70 (95% CI: 0.55–0.81), and 0.90 (95% CI: 0.70–0.97); DORs were 22.215 (95% CI: 10.695–46.144), 7.365 (95% CI: 3.986–13.610), and 41.940 (95% CI: 13.546–129.853); and the areas under the SROC curves were 0.86 (95% CI: 0.82–0.88), 0.79 (95% CI: 0.76–0.83), and 0.90 (95% CI: 0.87–0.92). Conclusion Our systematic review implied that the diagnostic performance of combination model of FISH plus NMP22 may outperform FISH or NMP22 alone in BC detection.
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Affiliation(s)
- Qindong Liang
- Department of Clinical Laboratory, Affiliated Hospital & Clinical Medical College of Chengdu University, Chengdu, Sichuan, China,
| | - Guangjie Zhang
- Department of Clinical Laboratory, Chengdu Fifth People's Hospital, Chengdu, Sichuan, China
| | - Wuxian Li
- Department of Clinical Laboratory, Chongqing Health Center for Women and Children, Chongqing, China
| | - Jing Wang
- Department of Blood Transfusion, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Shangchun Sheng
- Department of Clinical Laboratory, Affiliated Hospital & Clinical Medical College of Chengdu University, Chengdu, Sichuan, China,
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Wang Z, Que H, Suo C, Han Z, Tao J, Huang Z, Ju X, Tan R, Gu M. Evaluation of the NMP22 BladderChek test for detecting bladder cancer: a systematic review and meta-analysis. Oncotarget 2017; 8:100648-56. [PMID: 29246009 DOI: 10.18632/oncotarget.22065] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Accepted: 09/03/2017] [Indexed: 12/11/2022] Open
Abstract
Background We examined the usefulness of the nuclear matrix protein 22 (NMP22) BladderChek test for detecting bladder cancer. Materials and Methods A literature search was performed using PubMed, Embase, the Cochrane Library, and Web of Science. The diagnostic accuracy of the NMP22 BladderChek test was evaluated via pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and area under curve (AUC). Inter-study heterogeneity was explored using meta-regression and subgroup analyses. Results We included 23 studies in the systematic review and 19 in the quantitative meta-analysis. Overall sensitivity and specificity were 56% (52-59%) and 88% (87-89%), respectively; pooled PLR and NLR were 4.36 (3.02-6.29) and 0.51 (0.40-0.66), respectively; DOR was 9.29 (5.55-15.55) with an AUC of 0.8295. The mean sensitivity for Ta, T1, ≥ T2, Tis, G1, G2, and G3 disease was 13.68%, 29.49%, 74.03%, 34.62%, 44.16%, 56.25%, and 67.34%, respectively. Conclusions The NMP22 BladderChek test shows good discrimination ability for detecting bladder cancer and a high-specificity algorithm that can be used for early detection to rule out patients with higher bladder cancer risk. It also has better potential for screening higher-grade and higher-stage tumors, and better diagnostic performance in Asians.
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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8
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Luo Y, She DL, Xiong H, Yang L, Fu SJ. Diagnostic Value of Liquid-Based Cytology in Urothelial Carcinoma Diagnosis: A Systematic Review and Meta-Analysis. PLoS One 2015; 10:e0134940. [PMID: 26241896 PMCID: PMC4524610 DOI: 10.1371/journal.pone.0134940] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2014] [Accepted: 07/15/2015] [Indexed: 01/22/2023] Open
Abstract
OBJECTIVE To evaluate the value of liquid-based cytology (LBC) in the diagnosis of urothelial carcinoma. METHOD Diagnostic studies were searched for the diagnostic value of LBC in urothelial carcinoma in PubMed, Embase, Cochrane Library, Web of Science, CBM and CNKI. The latest retrieval date was September 2014. The data were extracted and the quality of the included studies was independently assessed by 2 reviewers. Stata 13 software was used to perform the statistical analysis. The research was conducted in compliance with the PRISMA statement. RESULT Nineteen studies, which included 8293 patients, were evaluated. The results of the meta-analysis showed that the pooled sensitivity and specificity of LBC were 0.58 (0.51-0.65) and 0.96 (0.93-0.98), respectively. The diagnostic odds ratio (DOR) was 31 (18-56) and the area under the curve (AUC) of summary receiver operating characteristic (SROC) was 0.83 (0.80-0.86). The post-test probability was 80% when a positive diagnosis was made. Compared with high grade urothelial carcinoma (HGUC), the sensitivity of detecting low-grade urothelial carcinoma (LGUC) was significantly lower, risk ratio of sensitivity was 0.54 (0.43-0.66), P<0.001. However, no significant sensitivity improvement was observed with LBC when compared with traditional cytospin cytology, risk ratio was 1.03 (0.94-1.14), P = 0.524. CONCLUSION Despite LBC having a pooled 58% positive rate for urothelial carcinoma diagnosis in our meta-analysis, no significant improvement in sensitivity was observed based on the studies evaluated. Further research is needed to validate these findings.
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Affiliation(s)
- You Luo
- Gansu Nephro-Urological Clinical Center, Institute of Urology, Department of Urology, Key Laboratory of Urological Disease of Gansu Province, Lanzhou University Second Hospital, Lanzhou 730000, China
| | - Dong-Li She
- Gansu Nephro-Urological Clinical Center, Institute of Urology, Department of Urology, Key Laboratory of Urological Disease of Gansu Province, Lanzhou University Second Hospital, Lanzhou 730000, China
| | - Hu Xiong
- Gansu Nephro-Urological Clinical Center, Institute of Urology, Department of Urology, Key Laboratory of Urological Disease of Gansu Province, Lanzhou University Second Hospital, Lanzhou 730000, China
| | - Li Yang
- Gansu Nephro-Urological Clinical Center, Institute of Urology, Department of Urology, Key Laboratory of Urological Disease of Gansu Province, Lanzhou University Second Hospital, Lanzhou 730000, China
| | - Sheng-Jun Fu
- Gansu Nephro-Urological Clinical Center, Institute of Urology, Department of Urology, Key Laboratory of Urological Disease of Gansu Province, Lanzhou University Second Hospital, Lanzhou 730000, China
- * E-mail:
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Frantzi M, Zoidakis J, Papadopoulos T, Zürbig P, Katafigiotis I, Stravodimos K, Lazaris A, Giannopoulou I, Ploumidis A, Mischak H, Mullen W, Vlahou A. IMAC fractionation in combination with LC-MS reveals H2B and NIF-1 peptides as potential bladder cancer biomarkers. J Proteome Res 2013; 12:3969-79. [PMID: 23924207 DOI: 10.1021/pr400255h] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Improvement in bladder cancer (BC) management requires more effective diagnosis and prognosis of disease recurrence and progression. Urinary biomarkers attract special interest because of the noninvasive means of urine collection. Proteomic analysis of urine entails the adoption of a fractionation methodology to reduce sample complexity. In this study, we applied immobilized metal affinity chromatography in combination with high-resolution LC-MS/MS for the discovery of native urinary peptides potentially associated with BC aggressiveness. This approach was employed toward urine samples from patients with invasive BC, noninvasive BC, and benign urogenital diseases. A total of 1845 peptides were identified, corresponding to a total of 638 precursor proteins. Specific enrichment for proteins involved in nucleosome assembly and for zinc-finger transcription factors was observed. The differential expression of two candidate biomarkers, histone H2B and NIF-1 (zinc finger 335) in BC, was verified in independent sets of urine samples by ELISA and by immunohistochemical analysis of BC tissue. The results collectively support changes in the expression of both of these proteins with tumor progression, suggesting their potential role as markers for discriminating BC stages. In addition, the data indicate a possible involvement of NIF-1 in BC progression, likely as a suppressor and through interactions with Sox9 and HoxA1.
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Affiliation(s)
- Maria Frantzi
- Biomedical Research Foundation Academy of Athens, Athens, Greece
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