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Lacoste-Collin L. [What contribution can make artificial intelligence to urinary cytology?]. Ann Pathol 2024; 44:195-203. [PMID: 38614871 DOI: 10.1016/j.annpat.2024.03.003] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 01/30/2024] [Accepted: 03/24/2024] [Indexed: 04/15/2024]
Abstract
Urinary cytology using the Paris system is still the method of choice for screening high-grade urothelial carcinomas. However, the use of the objective criteria described in this terminology shows a lack of inter- and intra-observer reproducibility. Moreover, if its sensitivity is excellent on instrumented urine, it remains insufficient on voided urine samples. Urinary cytology appears to be an excellent model for the application of artificial intelligence to improve performance, since the objective criteria of the Paris system are defined at cellular level, and the resulting diagnostic approach is presented in a highly "algorithmic" way. Nevertheless, there is no commercially available morphological diagnostic aid, and very few predictive devices are still undergoing clinical validation. The analysis of different systems using artificial intelligence in urinary cytology rises clear prospects for mutual contributions.
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Palermo M, D'Elia C, Trenti E, Comploj E, Mian C, Schwienbacher C, Heidegger I, Clauser S, Pycha A, Vjaters E. Prospective evaluation of the RT-PCR based urinary marker Bladder Epicheck® as a diagnostic tool in upper urinary tract tumor. Minerva Urol Nephrol 2024; 76:195-202. [PMID: 38498297 DOI: 10.23736/s2724-6051.23.05488-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/20/2024]
Abstract
BACKGROUND Upper-tract-urothelial-carcinoma (UTUC) represents 5-10% of all urothelial-neoplasms with increasing incidence in the last decades. Current standard tools for diagnosis of UTUC include cytology, computed tomography (CT) urography and ureterorenoscopy (URS). The aim of this study was to evaluate the impact of Bladder Epicheck® Test as diagnostic tool for UTUC diagnosis and recurrence. METHODS Overall, 136 urine samples, selective collected from upper-urinary-tract before URS for suspicion of UTUC were analyzed with cytology and Bladder Epicheck® Test. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of both markers were calculated and compared to URS and/or histology as reference. RESULTS UTUC was detected in 40 cases (33.3%), among them 30 were classified as low-grade (LG) and 10 as high-grade (HG). Overall sensitivity of Bladder Epicheck® for UTUC detection was 65% compared to 42.5% for cytology, increasing to 100% for Bladder Epicheck® and 90% for cytology if considering only HG tumors. Overall specificity of Bladder Epicheck® was 81.2% and of cytology 93.7%. PPV and NPV were 63.4% and 82.2% for Bladder Epicheck® and 77.2% and 76.5% for cytology. Considering an EpiScore cut-off >75, instead of 60, specificity of Bladder Epicheck® improves to 89% and PPV to 74.2%. Limitations include the use of a marker validated only for bladder-cancer and the relatively small number of cases. CONCLUSIONS Due to its high sensitivity for HG tumors, the Bladder Epicheck® Test can be used in diagnosis and treatment decision-making of UTUC. Furthermore, it could be very useful in follow-up of UTUC, after endoscopic treatment to postpone or avoid unnecessary endoscopic exploration. Even if further studies are needed to validate these findings, Bladder Epicheck® could be a promising clinical tool for detection of UTUC.
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Affiliation(s)
| | - Carolina D'Elia
- Department of Urology, Central Hospital of Bolzano, Bolzano, Italy
| | - Emanuela Trenti
- Department of Urology, Central Hospital of Bolzano, Bolzano, Italy -
| | - Evi Comploj
- Department of Urology, Central Hospital of Bolzano, Bolzano, Italy
| | - Christine Mian
- Department of Pathology, Central Hospital of Bolzano, Bolzano, Italy
| | | | - Isabel Heidegger
- Department of Urology, Medical University of Innsbruck, Innsbruck, Austria
| | - Silvia Clauser
- Department of Urology, Central Hospital of Bolzano, Bolzano, Italy
| | - Armin Pycha
- Department of Urology, Central Hospital of Bolzano, Bolzano, Italy
- Medical School, Sigmund Freud Private University, Vienna, Austria
| | - Egils Vjaters
- Department of Urology, Riga Stradins University Hospital, Riga, Latvia
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3
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Wu J, Lin Y, Yang K, Liu X, Wang H, Yu T, Tao R, Guo J, Chen L, Cheng H, Lou F, Cao S, Yu W, Hu H, Ye D. Clinical effectiveness of a multitarget urine DNA test for urothelial carcinoma detection: a double-blinded, multicenter, prospective trial. Mol Cancer 2024; 23:57. [PMID: 38504268 PMCID: PMC10949661 DOI: 10.1186/s12943-024-01974-4] [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: 10/26/2023] [Accepted: 02/28/2024] [Indexed: 03/21/2024] Open
Abstract
Urine-based testing is promising for noninvasive diagnosis of urothelial carcinoma (UC) but has suboptimal sensitivity for early-stage tumors. Herein, we developed a multitarget urine tumor DNA test, UI-Seek, for UC detection and evaluated its clinical feasibility. The prediction model was developed in a retrospective cohort (n = 382), integrating assays for FGFR3 and TERT mutations and aberrant ONECUT2 and VIM methylation to generate a UC-score. The test performance was validated in a double-blinded, multicenter, prospective trial (n = 947; ChiCTR2300076543) and demonstrated a sensitivity of 91.37% and a specificity of 95.09%. The sensitivity reached 75.81% for low-grade Ta tumors and exceeded 93% in high-grade Ta and higher stages (T1 to T4). Simultaneous identification of both bladder and upper urinary tract tumors was enabled with sensitivities exceeding 90%. No significant confounding effects were observed regarding benign urological diseases or non-UC malignancies. The test showed improved sensitivities over urine cytology, the NMP22 test, and UroVysion FISH alongside comparable specificities. The single-target accuracy was greater than 98% as confirmed by Sanger sequencing. Post-surgery UC-score decreased in 97.7% of subjects. Overall, UI-Seek demonstrated robust performance and considerable potential for the early detection of UC.
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Affiliation(s)
- Junlong Wu
- Department of Urology, Fudan University Shanghai Cancer Center, Shanghai, 200032, People's Republic of China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Yuda Lin
- Department of Urology, Tianjin Institute of Urology, The Second Hospital of Tianjin Medical University, 23 Pingjiang Road, Hexi District, Tianjin, 300211, People's Republic of China
- Tianjin Key Laboratory of Urology, Tianjin Institute of Urology, The Second Hospital of Tianjin Medical University, Tianjin, China
| | - Kaiwei Yang
- Department of Urology, Peking University First Hospital, No. 8 Xishiku Dajie, Xicheng District, Beijing, 100034, People's Republic of China
| | - Xiao Liu
- Acornmed Biotechnology Co., Ltd, Beijing, 100176, People's Republic of China
| | - Huina Wang
- Acornmed Biotechnology Co., Ltd, Beijing, 100176, People's Republic of China
| | - Tingting Yu
- Acornmed Biotechnology Co., Ltd, Beijing, 100176, People's Republic of China
| | - Ran Tao
- Acornmed Biotechnology Co., Ltd, Beijing, 100176, People's Republic of China
| | - Jing Guo
- Acornmed Biotechnology Co., Ltd, Beijing, 100176, People's Republic of China
| | - Libin Chen
- Acornmed Biotechnology Co., Ltd, Beijing, 100176, People's Republic of China
| | - Huanqing Cheng
- Acornmed Biotechnology Co., Ltd, Beijing, 100176, People's Republic of China
| | - Feng Lou
- Acornmed Biotechnology Co., Ltd, Beijing, 100176, People's Republic of China.
| | - Shanbo Cao
- Acornmed Biotechnology Co., Ltd, Beijing, 100176, People's Republic of China.
| | - Wei Yu
- Department of Urology, Peking University First Hospital, No. 8 Xishiku Dajie, Xicheng District, Beijing, 100034, People's Republic of China.
| | - Hailong Hu
- Department of Urology, Tianjin Institute of Urology, The Second Hospital of Tianjin Medical University, 23 Pingjiang Road, Hexi District, Tianjin, 300211, People's Republic of China.
- Tianjin Key Laboratory of Urology, Tianjin Institute of Urology, The Second Hospital of Tianjin Medical University, Tianjin, China.
| | - Dingwei Ye
- Department of Urology, Fudan University Shanghai Cancer Center, Shanghai, 200032, People's Republic of China.
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.
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4
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Lotan Y, Raman JD, Konety B, Daneshmand S, Schroeck F, Shariat SF, Black P, de Lange M, Asroff S, Goldfischer E, Efros M, Chong KT, Huang E, Chua HL, Wu QH, Yeow S, Lau W, Yong J, Eng M. Urinary Analysis of FGFR3 and TERT Gene Mutations Enhances Performance of Cxbladder Tests and Improves Patient Risk Stratification. J Urol 2023; 209:762-772. [PMID: 36583640 DOI: 10.1097/ju.0000000000003126] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
PURPOSE Cxbladder tests are urinary biomarker tests for detection of urothelial carcinoma. We developed enhanced Cxbladder tests that incorporate DNA analysis of 6 single nucleotide polymorphisms for the FGFR3 and TERT genes, in addition to the current 5 mRNA biomarkers and clinical risk factors. MATERIALS AND METHODS Two multicenter, prospective studies were undertaken in: (1) U.S. patients with gross hematuria aged ≥18 years and (2) Singaporean patients with gross hematuria or microhematuria aged >21 years. All patients provided a midstream urine sample and underwent cystoscopy. Samples were retrospectively analyzed using enhanced Cxbladder-Triage (risk stratifies patients), enhanced Cxbladder-Detect (risk stratifies patients and detects positive patients), and the combination enhanced Cxbladder-Triage × Cxbladder-Detect. RESULTS In the pooled cohort (N=804; gross hematuria: n=484, microhematuria: n=320), enhanced Cxbladder-Detect had a sensitivity of 97% (95% CI 89%-100%), specificity of 90% (95% CI 88%-92%), and negative predictive value of 99.7% (95% CI 99%-100%) for detection of urothelial carcinoma. Overall, 83% of patients were enhanced Cxbladder-Detect-negative (ie, needed no further work-up). Of 133 enhanced Cxbladder-Detect-positive patients, 59 had a confirmed tumor, of which 19 were low-grade noninvasive papillary carcinoma or papillary urothelial neoplasm of low malignant potential. In total, 40 tumors were high-grade Ta, T1-T4, Tis, including concomitant carcinoma in situ. Of the 74 patients with normal cystoscopy, 41 were positive by single nucleotide polymorphism analysis. Enhanced Cxbladder-Triage and enhanced Cxbladder-Detect had significantly better specificity than the first-generation Cxbladder tests (P < .001). CONCLUSIONS This study in ethnically diverse patients with hematuria showed the analytical validity of the enhanced Cxbladder tests.
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Affiliation(s)
- Yair Lotan
- University of Texas Southwestern, Dallas, Texas
| | - Jay D Raman
- Penn State Health Milton S. Hershey Medical Center, Hershey, Pennsylvania
| | | | - Siamak Daneshmand
- Department of Urology, USC/Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, California
| | - Florian Schroeck
- White River Junction Veteran Affairs Medical Center, White River Junction, Vermont
| | - Shahrokh F Shariat
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
- Department of Urology, Weill Cornell Medical College, New York, New York
- Department of Urology, University of Texas Southwestern, Dallas, Texas
- Department of Urology, Second Faculty of Medicine, Charles University, Prague, Czech Republic
- Hourani Center for Applied Scientific Research, Al-Ahliyya Amman University, Amman, Jordan
| | - Peter Black
- Department of Urologic Sciences, University of British Columbia, Vancouver, British Columbia, Canada
| | | | - Scott Asroff
- New Jersey Urology, Mount Laurel Township, New Jersey
| | | | | | - Kian Tai Chong
- Surgi-TEN Specialists, Farrer Park Hospital, Singapore
- PanAsia Surgery, Mount Elizabeth Novena Specialist Centre, Singapore
| | - Eugene Huang
- Department of Urogynaecology, KK Women's and Children's Hospital, Singapore
| | - Hong Liang Chua
- Department of Urogynaecology, KK Women's and Children's Hospital, Singapore
| | - Qing Hui Wu
- Department of Urology, National University Hospital, Singapore
| | - Siying Yeow
- Department of Urology, Khoo Teck Puat Hospital, Singapore
| | - Weida Lau
- Department of Urology, Khoo Teck Puat Hospital, Singapore
| | - Jin Yong
- Department of Urology, Singapore General Hospital, Singapore
| | - Molly Eng
- Department of Urology, Khoo Teck Puat Hospital, Singapore
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Zvereva M, Hosen MI, Forey N, Sheikh M, Kannengiesser C, Ba I, Manel A, Vian E, Le Calvez-Kelm F. Simplex Droplet Digital PCR Assays for the Detection of TERT Promoter Mutations in Urine Samples for the Non-invasive Diagnosis of Urothelial Cancer. Methods Mol Biol 2023; 2684:213-228. [PMID: 37410237 DOI: 10.1007/978-1-0716-3291-8_13] [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] [Indexed: 07/07/2023]
Abstract
Somatic mutations in the telomerase reverse transcriptase (TERT) promoter region are highly frequent in urothelial cancer (UC), and their detection in urine (cell-free DNA from the urine supernatant or DNA from exfoliated cells in the urine pellet) has demonstrated promising evidence as putative non-invasive biomarkers for UC detection and monitoring. However, detecting these tumour-derived mutations in urine requires highly sensitive methods, capable of measuring low-allelic fraction mutations. We developed sensitive droplet digital PCR (ddPCR) assays for detecting urinary TERT promoter mutations (uTERTpm), targeting the two most common mutations (C228T and C250T), as well as the rare A161C, C228A, and CC242-243TT mutations. Here, we described the step-by-step protocol uTERTpm mutation screening using simplex ddPCR assays and give some recommendations for isolation of DNA from urine samples. We also provide limits of detection for the two most frequent mutations and discuss advantages of the method for clinical implementation of the assays for the detection and monitoring of UC.
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Affiliation(s)
- Maria Zvereva
- Department of Chemistry, Lomonosov Moscow State University, Moscow, Russia
- Genomic Epidemiology Branch, International Agency for Research on Cancer (IARC), Lyon, France
| | - Md Ismail Hosen
- Genomic Epidemiology Branch, International Agency for Research on Cancer (IARC), Lyon, France
- Department of Biochemistry and Molecular Biology, Faculty of Biological Sciences, University of Dhaka, Dhaka, Bangladesh
| | - Nathalie Forey
- Genomic Epidemiology Branch, International Agency for Research on Cancer (IARC), Lyon, France
| | - Mahdi Sheikh
- Genomic Epidemiology Branch, International Agency for Research on Cancer (IARC), Lyon, France
| | | | - Ibrahima Ba
- Department of Genetics, Bichat Claude Bernard Hospital, Paris, France
| | - Arnaud Manel
- Department of Urology, Le Creusot Hospital, Le Creusot, France
| | - Emmanuel Vian
- Department of Urology Infirmerie Protestante de Lyon, Caluire et Cuire, France
| | - Florence Le Calvez-Kelm
- Genomic Epidemiology Branch, International Agency for Research on Cancer (IARC), Lyon, France.
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Lett L, George M, Slater R, De Lacy Costello B, Ratcliffe N, García-Fiñana M, Lazarowicz H, Probert C. Investigation of urinary volatile organic compounds as novel diagnostic and surveillance biomarkers of bladder cancer. Br J Cancer 2022; 127:329-336. [PMID: 35352020 PMCID: PMC9296481 DOI: 10.1038/s41416-022-01785-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 02/21/2022] [Accepted: 03/08/2022] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND The diagnosis and surveillance of urothelial bladder cancer (UBC) require cystoscopy. There is a need for biomarkers to reduce the frequency of cystoscopy in surveillance; urinary volatile organic compound (VOC) analysis could fulfil this role. This cross-sectional study compared the VOC profiles of patients with and without UBC, to investigate metabolomic signatures as biomarkers. METHODS Urine samples were collected from haematuria clinic patients undergoing diagnostic cystoscopy and UBC patients undergoing surveillance. Urinary headspace sampling utilised solid-phase microextraction and VOC analysis applied gas chromatography-mass spectrometry; the output underwent metabolomic analysis. RESULTS The median participant age was 70 years, 66.2% were male. Of the haematuria patients, 21 had a new UBC diagnosis, 125 had no cancer. In the surveillance group, 75 had recurrent UBC, 84 were recurrence-free. A distinctive VOC profile was observed in UBC patients compared with controls. Ten VOCs had statistically significant abundances useful to classify patients (false discovery rate range 1.9 × 10-7-2.8 × 10-2). Two prediction models were evaluated using internal validation. An eight-VOC diagnostic biomarker panel achieved AUROC 0.77 (sensitivity 0.71, specificity 0.72). A six-VOC surveillance biomarker panel obtained AUROC 0.80 (sensitivity 0.71 and specificity 0.80). CONCLUSIONS Urinary VOC analysis could aid the diagnosis and surveillance of UBC.
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Affiliation(s)
- Lauren Lett
- Department of Molecular and Clinical Cancer Medicine, Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, L69 3GE, UK
| | - Michael George
- Department of Molecular and Clinical Cancer Medicine, Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, L69 3GE, UK
- School of Medicine, Cedar House, University of Liverpool, Liverpool, L69 3GE, UK
| | - Rachael Slater
- Department of Molecular and Clinical Cancer Medicine, Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, L69 3GE, UK
| | - Ben De Lacy Costello
- Centre of Research in Biosciences, University of the West of England, Frenchay Campus, Bristol, BS16 1QY, UK
| | - Norman Ratcliffe
- Centre of Research in Biosciences, University of the West of England, Frenchay Campus, Bristol, BS16 1QY, UK
| | - Marta García-Fiñana
- Department of Health Data Science, University of Liverpool, Liverpool, L69 3GE, UK
| | - Henry Lazarowicz
- Department of Urology, Royal Liverpool University Hospital, Liverpool University Hospitals NHS Trust, Liverpool, L7 8XP, UK
| | - Chris Probert
- Department of Molecular and Clinical Cancer Medicine, Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, L69 3GE, UK.
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Karanović S, Ardin M, Tang Z, Tomić K, Villar S, Renard C, Venturini E, Lorch AH, Lee DS, Stipančić Ž, Slade N, Vuković Brinar I, Dittrich D, Karlović K, Borovečki F, Dickman KG, Olivier M, Grollman AP, Jelaković B, Zavadil J. Molecular profiles and urinary biomarkers of upper tract urothelial carcinomas associated with aristolochic acid exposure. Int J Cancer 2022; 150:374-386. [PMID: 34569060 PMCID: PMC8627473 DOI: 10.1002/ijc.33827] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 07/25/2021] [Accepted: 08/31/2021] [Indexed: 12/23/2022]
Abstract
Recurrent upper tract urothelial carcinomas (UTUCs) arise in the context of nephropathy linked to exposure to the herbal carcinogen aristolochic acid (AA). Here we delineated the molecular programs underlying UTUC tumorigenesis in patients from endemic aristolochic acid nephropathy (AAN) regions in Southern Europe. We applied an integrative multiomics analysis of UTUCs, corresponding unaffected tissues and of patient urines. Quantitative microRNA (miRNA) and messenger ribonucleic acid (mRNA) expression profiling, immunohistochemical analysis by tissue microarrays and exome and transcriptome sequencing were performed in UTUC and nontumor tissues. Urinary miRNAs of cases undergoing surgery were profiled before and after tumor resection. Ribonucleic acid (RNA) and protein levels were analyzed using appropriate statistical tests and trend assessment. Dedicated bioinformatic tools were used for analysis of pathways, mutational signatures and result visualization. The results delineate UTUC-specific miRNA:mRNA networks comprising 89 miRNAs associated with 1,862 target mRNAs, involving deregulation of cell cycle, deoxyribonucleic acid (DNA) damage response, DNA repair, bladder cancer, oncogenes, tumor suppressors, chromatin structure regulators and developmental signaling pathways. Key UTUC-specific transcripts were confirmed at the protein level. Exome and transcriptome sequencing of UTUCs revealed AA-specific mutational signature SBS22, with 68% to 76% AA-specific, deleterious mutations propagated at the transcript level, a possible basis for neoantigen formation and immunotherapy targeting. We next identified a signature of UTUC-specific miRNAs consistently more abundant in the patients' urine prior to tumor resection, thereby defining biomarkers of tumor presence. The complex gene regulation programs of AAN-associated UTUC tumors involve regulatory miRNAs prospectively applicable to noninvasive urine-based screening of AAN patients for cancer presence and recurrence.
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Affiliation(s)
- Sandra Karanović
- Department of Nephrology, Arterial Hypertension, Dialysis and Transplantation, University Hospital Center ZagrebSchool of Medicine, University of ZagrebZagrebCroatia
| | - Maude Ardin
- Epigenomics and Mechanisms BranchInternational Agency for Research on Cancer, WHOLyonFrance
| | - Zuojian Tang
- Institute for Systems GeneticsNew York University Langone Medical CenterNew YorkNew YorkUSA
- Present address:
Boehringer Ingelheim Pharmaceuticals, Inc.RidgefieldCTUSA
| | - Karla Tomić
- Department of PathologyGeneral Hospital Dr. Josip BenčevićSlavonski BrodCroatia
- Present address:
Department of PathologyÅlesund Hospital, Møre and Romsdal Health TrustÅlesundNorway
| | - Stephanie Villar
- Epigenomics and Mechanisms BranchInternational Agency for Research on Cancer, WHOLyonFrance
| | - Claire Renard
- Epigenomics and Mechanisms BranchInternational Agency for Research on Cancer, WHOLyonFrance
| | - Elisa Venturini
- Office for Collaborative ScienceNew York University Langone Medical CenterNew YorkNew YorkUSA
- Present address:
Natera, Inc.San CarlosCAUSA
| | - Adam H. Lorch
- Biochemistry and Molecular GeneticsNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA
| | - Daniel S. Lee
- Office for Collaborative ScienceNew York University Langone Medical CenterNew YorkNew YorkUSA
| | - Želimir Stipančić
- Department for Dialysis OdžakCounty Hospital OrašjeOdžakBosnia and Herzegovina
| | - Neda Slade
- Division of Molecular MedicineInstitute Ruđer BoškovićZagrebCroatia
| | - Ivana Vuković Brinar
- Department of Nephrology, Arterial Hypertension, Dialysis and Transplantation, University Hospital Center ZagrebSchool of Medicine, University of ZagrebZagrebCroatia
| | - Damir Dittrich
- Department of UrologyGeneral Hospital Dr. Josip BenčevićSlavonski BrodCroatia
| | - Krešimir Karlović
- Department of UrologyGeneral Hospital Dr. Josip BenčevićSlavonski BrodCroatia
| | - Fran Borovečki
- Department for Functional Genomics, Center for Translational and Clinical ResearchUniversity Hospital Center Zagreb, School of Medicine, University of ZagrebZagrebCroatia
| | - Kathleen G. Dickman
- Department of MedicineStony Brook UniversityStony BrookNew YorkUSA
- Department of Medicine/NephrologyStony Brook UniversityStony BrookNew YorkUSA
| | - Magali Olivier
- Epigenomics and Mechanisms BranchInternational Agency for Research on Cancer, WHOLyonFrance
| | | | - Bojan Jelaković
- Department of Nephrology, Arterial Hypertension, Dialysis and Transplantation, University Hospital Center ZagrebSchool of Medicine, University of ZagrebZagrebCroatia
| | - Jiri Zavadil
- Epigenomics and Mechanisms BranchInternational Agency for Research on Cancer, WHOLyonFrance
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Moon C, Gordon M, Moon D, Reynolds T. Microsatellite Instability Analysis (MSA) for Bladder Cancer: Past History and Future Directions. Int J Mol Sci 2021; 22:ijms222312864. [PMID: 34884669 PMCID: PMC8657622 DOI: 10.3390/ijms222312864] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Revised: 11/11/2021] [Accepted: 11/19/2021] [Indexed: 12/18/2022] Open
Abstract
Microsatellite instability (MSI), the spontaneous loss or gain of nucleotides from repetitive DNA tracts, is a diagnostic phenotype for gastrointestinal, endometrial, colorectal, and bladder cancers; yet a landscape of instability events across a wider variety of cancer types is beginning to be discovered. The epigenetic inactivation of the MLH1 gene is often associated with sporadic MSI cancers. Recent next-generation sequencing (NGS)-based analyses have comprehensively characterized MSI-positive (MSI+) cancers, and several approaches to the detection of the MSI phenotype of tumors using NGS have been developed. Bladder cancer (here we refer to transitional carcinoma of the bladder) is a major cause of morbidity and mortality in the Western world. Cystoscopy, a gold standard for the detection of bladder cancer, is invasive and sometimes carries unwanted complications, while its cost is relatively high. Urine cytology is of limited value due to its low sensitivity, particularly to low-grade tumors. Therefore, over the last two decades, several new "molecular assays" for the diagnosis of urothelial cancer have been developed. Here, we provide an update on the development of a microsatellite instability assay (MSA) and the development of MSA associated with bladder cancers, focusing on findings obtained from urine analysis from bladder cancer patients as compared with individuals without bladder cancer. In our review, based on over 18 publications with approximately 900 sample cohorts, we provide the sensitivity (87% to 90%) and specificity (94% to 98%) of MSA. We also provide a comparative analysis between MSA and other assays, as well as discussing the details of four different FDA-approved assays. We conclude that MSA is a potentially powerful test for bladder cancer detection and may improve the quality of life of bladder cancer patients.
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Affiliation(s)
- Chulso Moon
- Department of Otolaryngology-Head and Neck Surgery, The Johns Hopkins Medical Institution, Cancer Research Building II, 5M3, 1550 Orleans Street, Baltimore, MD 21205, USA
- HJM Cancer Research Foundation Corporation, 10606 Candlewick Road, Lutherville, MD 21093, USA; (M.G.); (D.M.)
- BCD Innovations USA, 10606 Candlewick Road, Lutherville, MD 21093, USA
- Correspondence: ; Tel.: +1-(443)-370-5056
| | - Maxie Gordon
- HJM Cancer Research Foundation Corporation, 10606 Candlewick Road, Lutherville, MD 21093, USA; (M.G.); (D.M.)
- BCD Innovations USA, 10606 Candlewick Road, Lutherville, MD 21093, USA
| | - David Moon
- HJM Cancer Research Foundation Corporation, 10606 Candlewick Road, Lutherville, MD 21093, USA; (M.G.); (D.M.)
| | - Thomas Reynolds
- NEXT Bio-Research Services, LLC, 11601 Ironbridge Road, Suite 101, Chester, VA 23831, USA;
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9
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Abstract
OBJECTIVES The microscopic features of urine cytology specimens are subjective and may not reliably distinguish between benign urothelial cells and low-grade urothelial carcinoma (UC). Prior studies demonstrated that keratin 17 (K17) detection in biopsies is highly sensitive for UC. The current study aimed to define K17 diagnostic test performance for initial screening and detect recurrent UC in urine specimens. METHODS K17 was detected by immunocytochemistry (ICC) in consecutively collected urine specimens (2018-2019). A qualitative score for the K17 test was determined in 81 samples (discovery cohort) and validated in 98 samples (validation cohort). K17 sensitivity and specificity were analyzed in both cohorts across all grades of UC. RESULTS Based on the discovery cohort, the presence of 5 or more K17 immunoreactive urothelial cells (area under the curve = 0.90; P < .001) was the optimal threshold to define a K17-positive test. The sensitivity of the K17 ICC test for biopsy-confirmed UC was 35 of 36 (97%) and 18 of 21 (86%) in the discovery and validation cohorts, respectively. K17 was positive in 16 of 19 (84%) specimens with biopsy-confirmed low-grade UC and in 34 of 34 (100%) of specimens with high-grade UC. CONCLUSIONS K17 ICC is a highly sensitive diagnostic test for initial screening and detection of recurrence across all grades of UC.
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Affiliation(s)
- Sruthi Babu
- Department of Pathology, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY, USA
- Program of Public Health and Department of Preventative Medicine, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY, USA
| | | | - Maoxin Wu
- Department of Pathology, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY, USA
| | - Ina Chan
- Department of Pathology, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY, USA
| | - Luisa F Escobar-Hoyos
- Department of Pathology, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY, USA
- Department of Therapeutic Radiology, Yale University, New Haven, CT, USA
- Molecular Biophysics and Biochemistry, Yale University, New Haven, CT, USA
- Department of Biology, Genetic Toxicology and Cytogenetics Research Group, School of Natural Sciences and Education, Universidad Del Cauca, Popayán, Colombia
| | - Kenneth R Shroyer
- Department of Pathology, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY, USA
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10
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Davidson PJ, McGeoch G, Shand B. Assessment of a clinical pathway for investigation of haematuria that reduces the need for cystoscopy. N Z Med J 2020; 133:71-82. [PMID: 33332329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
AIM To evaluate prospectively a clinical pathway for investigation of haematuria that involves an initial screening using a urinary biomarker of bladder cancer (Cxbladder Triage™ (CxbT)) in combination with either a renal ultrasound or a computed tomography imaging. Only test-positive patients are referred for specialist assessment and flexible cystoscopy. METHODS The clinical outcomes of 884 patients with haematuria who presented to their general practitioner were reviewed. Outcome measurements included the findings of laboratory tests, imaging, cystoscopies, specialist assessment and histology. RESULTS Forty-eight transitional cell carcinomas (TCC) and three small cell carcinomas were diagnosed in the study cohort. The clinical pathway missed a solitary, small, low-risk TCC. When combined, imaging and CxbT had a sensitivity of 98.1% and a negative predictive value of 99.9% to detect a bladder cancer. Follow-up for a median of 21 months showed no further new cases of bladder cancer had occurred in the patient cohort. Review of all new bladder cancers diagnosed in the 15 months following the study showed that none had been missed by haematuria assessment using the clinical pathway. CONCLUSIONS The combination of CxbT and imaging reliably identifies patients with haematuria who can be managed safely in primary care without the need for a secondary care referral and a flexible cystoscopy.
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Affiliation(s)
- Peter J Davidson
- Urologist, Department of Urology, Christchurch Hospital, Christchurch
| | - Graham McGeoch
- Clinical Leader, Canterbury Initiative, Canterbury District Health Board, Christchurch
| | - Brett Shand
- Clinical Writer and Analyst, Canterbury Initiative, Canterbury District Health Board, Christchurch
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11
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Courtade-Saïdi M, Cochand-Priollet B, Vielh P, Piaton E. [A new terminology for urinary cytopathology: The Paris System for Reporting Urinary Cytology (2015)]. Ann Pathol 2019; 39:344-351. [PMID: 31255415 DOI: 10.1016/j.annpat.2019.04.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2017] [Revised: 04/11/2019] [Accepted: 04/19/2019] [Indexed: 01/10/2023]
Abstract
As for the Bethesda system for cervical and thyroid cytopathology, a terminology for reporting urinary cytology has been published in 2015. The new "Paris System" provides a consensus terminology for urinary cytology which underlines the criteria for the recognition of high-grade urothelial carcinoma (HGUC) and of those excluding HGUC, or suspicious for HGUC. It also focuses on new rules to recognize and report the subgroup of "atypical urothelial cells". Here we describe and illustrate the various categories as in the reference book. We analyse the main diagnostic criteria, including microscopic features as well as the risk of malignancy associated to every diagnostic category.
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Affiliation(s)
- Monique Courtade-Saïdi
- Département d'anatomie et cytologie pathologiques, institut universitaire du cancer Toulouse oncopôle, 1, avenue Irène Joliot-Curie, 31059 Toulouse cedex, France.
| | - Béatrix Cochand-Priollet
- Département de pathologie, université Paris Descartes, hôpital Cochin, 27, rue du Faubourg Saint-Jacques, 75679 Paris cedex 14, France
| | - Philippe Vielh
- Laboratoire national de santé, Grand Duché de Luxembourg, 1, rue Louis-Rech, 3555 Dudelange, Luxembourg
| | - Eric Piaton
- Centre de pathologie est, hôpital femme-mère-enfant, hospices civils de Lyon, 59, boulevard Pinel, 69677 Bron cedex, France
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12
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Tan WS, Sarpong R, Khetrapal P, Rodney S, Mostafid H, Cresswell J, Watson D, Rane A, Hicks J, Hellawell G, Davies M, Srirangam SJ, Dawson L, Payne D, Williams N, Brew‐Graves C, Feber A, Kelly JD. Does urinary cytology have a role in haematuria investigations? BJU Int 2019; 123:74-81. [PMID: 30003675 PMCID: PMC6334509 DOI: 10.1111/bju.14459] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To determine the diagnostic accuracy of urinary cytology to diagnose bladder cancer and upper tract urothelial cancer (UTUC) as well as the outcome of patients with a positive urine cytology and normal haematuria investigations in patients in a multicentre prospective observational study of patients investigated for haematuria. PATIENT AND METHODS The DETECT I study (clinicaltrials.gov NCT02676180) recruited patients presenting with haematuria following referral to secondary case at 40 hospitals. All patients had a cystoscopy and upper tract imaging (renal bladder ultrasound [RBUS] and/ or CT urogram [CTU]). Patients, where urine cytology were performed, were sub-analysed. The reference standard for the diagnosis of bladder cancer and UTUC was histological confirmation of cancer. A positive urine cytology was defined as a urine cytology suspicious for neoplastic cells or atypical cells. RESULTS Of the 3 556 patients recruited, urine cytology was performed in 567 (15.9%) patients from nine hospitals. Median time between positive urine cytology and endoscopic tumour resection was 27 (IQR: 21.3-33.8) days. Bladder cancer was diagnosed in 39 (6.9%) patients and UTUC in 8 (1.4%) patients. The accuracy of urinary cytology for the diagnosis of bladder cancer and UTUC was: sensitivity 43.5%, specificity 95.7%, positive predictive value (PPV) 47.6% and negative predictive value (NPV) 94.9%. A total of 21 bladder cancers and 5 UTUC were missed. Bladder cancers missed according to grade and stage were as follows: 4 (19%) were ≥ pT2, 2 (9.5%) were G3 pT1, 10 (47.6%) were G3/2 pTa and 5 (23.8%) were G1 pTa. High-risk cancer was confirmed in 8 (38%) patients. There was a marginal improvement in sensitivity (57.7%) for high-risk cancers. When urine cytology was combined with imaging, the diagnostic performance improved with CTU (sensitivity 90.2%, specificity 94.9%) superior to RBUS (sensitivity 66.7%, specificity 96.7%). False positive cytology results were confirmed in 22 patients, of which 12 (54.5%) had further invasive tests and 5 (22.7%) had a repeat cytology. No cancer was identified in these patients during follow-up. CONCLUSIONS Urine cytology will miss a significant number of muscle-invasive bladder cancer and high-risk disease. Our results suggest that urine cytology should not be routinely performed as part of haematuria investigations. The role of urine cytology in select cases should be considered in the context of the impact of a false positive result leading to further potentially invasive tests conducted under general anaesthesia.
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Affiliation(s)
- Wei Shen Tan
- Division of Surgery and Interventional ScienceUniversity College LondonLondonUK
- Department of UrologyUniversity College London HospitalLondonUK
| | - Rachael Sarpong
- Surgical and Interventional Trials UnitUniversity College LondonLondonUK
| | - Pramit Khetrapal
- Division of Surgery and Interventional ScienceUniversity College LondonLondonUK
- Department of UrologyUniversity College London HospitalLondonUK
| | - Simon Rodney
- Division of Surgery and Interventional ScienceUniversity College LondonLondonUK
- UCL Cancer InstituteLondonUK
| | - Hugh Mostafid
- Department of UrologyRoyal Surrey County HospitalGuildfordUK
| | - Joanne Cresswell
- Department of UrologyJames Cook University HospitalMiddlesbroughUK
| | - Dawn Watson
- Department of UrologyJames Cook University HospitalMiddlesbroughUK
| | - Abhay Rane
- Department of UrologyEast Surrey HospitalRedhillUK
| | - James Hicks
- Department of UrologyWorthing HospitalWorthingUK
| | | | - Melissa Davies
- Department of UrologySalisbury District HospitalSalisburyUK
| | | | | | - David Payne
- Department of UrologyKettering General HospitalKetteringUK
| | - Norman Williams
- Surgical and Interventional Trials UnitUniversity College LondonLondonUK
| | - Chris Brew‐Graves
- Surgical and Interventional Trials UnitUniversity College LondonLondonUK
| | - Andrew Feber
- Division of Surgery and Interventional ScienceUniversity College LondonLondonUK
- UCL Cancer InstituteLondonUK
| | - John D. Kelly
- Division of Surgery and Interventional ScienceUniversity College LondonLondonUK
- Department of UrologyUniversity College London HospitalLondonUK
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13
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Abstract
Cytologic evaluation of the urinary tract can be diagnostically rewarding in cases of renomegaly or when discrete kidney or bladder masses are identified. Cytology can often help to distinguish between cystic, inflammatory, and neoplastic disorders. Various types of cystic and benign urinary tract lesions, diseases associated with urinary tract inflammation, and the cytologic differences between primary and metastatic neoplasms of the kidney and bladder are described. Basic sampling techniques for urinary tract cytology are also discussed.
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Affiliation(s)
- Kathryn L Wycislo
- Department of Pathology and Population Medicine, Midwestern University College of Veterinary Medicine, 5715 West Utopia Road, Glendale, AZ 85308, USA.
| | - Tara L Piech
- Department of Pathology and Population Medicine, Midwestern University College of Veterinary Medicine, 5715 West Utopia Road, Glendale, AZ 85308, USA
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Freund JE, Liem EIML, Savci-Heijink CD, de Reijke TM. Fluorescence in situ hybridization in 1 mL of selective urine for the detection of upper tract urothelial carcinoma: a feasibility study. Med Oncol 2018; 36:10. [PMID: 30499061 PMCID: PMC6267383 DOI: 10.1007/s12032-018-1237-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Accepted: 11/26/2018] [Indexed: 12/26/2022]
Abstract
Kidney-sparing surgery of upper tract urothelial carcinoma (UTUC) requires a stringent follow-up with frequent ureteroscopies. Triage testing could reduce the number of follow-up ureteroscopies and hence minimize the invasiveness of follow-up. The use of urine-based markers for triage seems appealing but should be feasible with selective urine from outpatient cystoscopy to maximize the reduction of invasiveness. In this study, the feasibility of UroVysion® fluorescence in situ hybridization (FISH) for the detection of UTUC in 1 mL of selective urine is investigated. Ten consecutive patients with biopsy-proven UTUC and five patients with negative diagnostic ureteroscopy findings were included in this case-control study. During ureteroscopy, 1 mL of selective urine was collected passively with a ureteral splint for Urovysion® FISH. The FISH rater was blinded to any clinical information. The results of FISH were compared to the findings of concomitantly collected selective urine cytology and the patients' UTUC status. FISH was feasible in all samples with a sensitivity of 90% and a specificity of 80% for UTUC. In comparison, selective cytology resulted in a diagnostic yield of 87% with a sensitivity of 80% and a specificity of 67%. In conclusion, UTUC detection is feasible with FISH in 1 mL of passively collected selective urine. Thus from a technical point of view, FISH could be used as an outpatient triage test to decide if follow-up ureteroscopy is necessary after kidney-sparing surgery of UTUC. Evaluation of the diagnostic accuracy of FISH for the suggested pathway deserves further attention.
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Affiliation(s)
- J. E. Freund
- Department of Urology, Amsterdam University Medical Centers, University of Amsterdam, Meibergdreef 9 G4-223, 1105AZ Amsterdam, The Netherlands
| | - E. I. M. L. Liem
- Department of Urology, Amsterdam University Medical Centers, University of Amsterdam, Meibergdreef 9 G4-223, 1105AZ Amsterdam, The Netherlands
| | - C. D. Savci-Heijink
- Department of Pathology, Amsterdam University Medical Centers, University of Amsterdam, Meibergdreef 9, 1105AZ Amsterdam, The Netherlands
| | - T. M. de Reijke
- Department of Urology, Amsterdam University Medical Centers, University of Amsterdam, Meibergdreef 9 G4-223, 1105AZ Amsterdam, The Netherlands
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15
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Abstract
The utility of urine cytology has shifted from the identification of red blood cells, crystals, or parasites to its currently used role of detection of cancer cells exfoliated in urine samples. A variety of ancillary tests have been developed to complement the diagnostic ability of urine cytology. Furthermore, urine testing will continue to evolve as the pathogenesis of genitourinary tract diseases in depth is understood. This article focuses on the diagnostic advances in urine cytology from the cytomorphological perspective, past and current reporting schemes, and the application of ancillary testing in urine samples.
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Affiliation(s)
- Juan Xing
- University of Pittsburgh Medical Center, UPMC Shadyside Hospital, 5150 Centre Avenue, POB2, Suite 201.2, Pittsburgh, PA 15232, USA
| | - Jordan P Reynolds
- Cleveland Clinic Foundation, Pathology and Laboratory Medicine Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, USA.
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Sutton AJ, Lamont JV, Evans RM, Williamson K, O’Rourke D, Duggan B, Sagoo GS, Reid CN, Ruddock MW. An early analysis of the cost-effectiveness of a diagnostic classifier for risk stratification of haematuria patients (DCRSHP) compared to flexible cystoscopy in the diagnosis of bladder cancer. PLoS One 2018; 13:e0202796. [PMID: 30138462 PMCID: PMC6107278 DOI: 10.1371/journal.pone.0202796] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Accepted: 08/09/2018] [Indexed: 12/20/2022] Open
Abstract
Background Urothelial bladder cancer (UBC) is the 5th most common cancer in Western societies. The most common symptom of UBC is haematuria. Cystoscopy the gold standard for UBC detection, allows direct observation of the bladder, but is expensive, invasive, and uncomfortable. This study examines whether an alternative new urine-based diagnostic test, the DCRSHP, is cost-effective as a triage diagnostic tool compared to flexible cystoscopy in the diagnosis of UBC in haematuria patients. Methods A model-based cost-utility analysis using cost per quality adjusted life year and life year gained, parameterised with secondary data sources. Results If the DCRSHP is targeted at haematuria patients at lower risk of having bladder cancer e.g. younger patients, non-smokers, then it can be priced as high as £620, and be both effective and cost-effective. Sensitivity analysis found that DCRSHP is approximately 80% likely to be cost-effective across all willingness to pay values (for a QALY) and prevalence estimates. Conclusion This analysis shows the potential for a non-invasive test to be added to the diagnostic pathway for haematuria patients suspected of having UBC. If the DCRSHP is applied targeting haematuria patients at low risk of UBC, then it has the potential to be both effective and cost-effective.
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Affiliation(s)
- Andrew J. Sutton
- Test Evaluation Group, Institute of Health Sciences, University of Leeds, NIHR Diagnostic Evidence Cooperative Leeds, Leeds, United Kingdom
- * E-mail:
| | - John V. Lamont
- Randox Laboratories Ltd, Molecular Biology, Crumlin, County Antrim, Northern Ireland
| | - R. Mark Evans
- Department of Urology, Belfast City Hospital, Belfast, Northern Ireland
| | - Kate Williamson
- Centre for Cancer Research and Cell Biology, Queen's University Belfast, Belfast, Northern Ireland
| | - Declan O’Rourke
- Department of Pathology, Belfast City Hospital, Belfast, Northern Ireland
| | - Brian Duggan
- Ulster Hospital Dundonald, South Eastern Trust, Belfast, Northern Ireland
| | - Gurdeep S. Sagoo
- Test Evaluation Group, Institute of Health Sciences, University of Leeds, NIHR Diagnostic Evidence Cooperative Leeds, Leeds, United Kingdom
| | - Cherith N. Reid
- Randox Laboratories Ltd, Molecular Biology, Crumlin, County Antrim, Northern Ireland
| | - Mark W. Ruddock
- Randox Laboratories Ltd, Molecular Biology, Crumlin, County Antrim, Northern Ireland
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17
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Abstract
Bladder cancer shows extreme variability in its behavior. Even the superficial forms, when surgically treated, are characterized by a high recurrence rate, and therefore regular and intensive post-treatment monitoring is an important aspect of the management of this tumor. The standard follow-up of patients with a bladder cancer history is based on cystoscopic examination of the internal bladder, which is an invasive procedure causing discomfort to the patient. In this context, the availability of a non-invasive laboratory test which measures circulating markers associated with bladder cancer could facilitate the monitoring of patients and could be of help in understanding the metastatic potential of bladder tumors, especially the superficial forms.
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Affiliation(s)
- C Botti
- Nuclear Medicine Department, Istituto Nazionale per lo Studio e la Cura dei Tumori, Milano
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18
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Pu X, Zhu L, Fu Y, Fan Z, Zheng J, Zhang B, Yang J, Guan W, Wu H, Ye Q, Huang Q. Companied P16 genetic and protein status together providing useful information on the clinical outcome of urinary bladder cancer. Medicine (Baltimore) 2018; 97:e0353. [PMID: 29642177 PMCID: PMC5908565 DOI: 10.1097/md.0000000000010353] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
SPEC P16/CEN3/7/17 Probe fluorescence-in-situ-hybridization (FISH) has become the most sensitive method in indentifying the urothelial tumors and loss of P16 has often been identified in low-grade urothelial lesions; however, little is known about the significations of other P16 genetic status (normal and amplification) in bladder cancer.We detected P16 gene status by FISH in 259 urine samples and divided these samples into 3 groups: 1, normal P16; 2, loss of P16; and 3, amplified P16. Meanwhile, p16 protein expression was measured by immunocytochemistry and we characterized the clinicopathologic features of cases with P16 gene status.Loss of P16 occurred in 26.2%, P16 amplification occurred in 41.3% and P16 gene normal occurred in 32.4% of all cases. P16 genetic status was significantly associated with tumor grade and primary tumor status (P = .008 and .017), but not with pathological tumor stage, overall survival, and p16 protein expression. However, P16 gene amplification accompanied protein high-expression has shorter overall survival compared with the overall patients (P = .023), and P16 gene loss accompanied loss of protein also had the tendency to predict bad prognosis (P = .067).Studies show that the genetic status of P16 has a close relation with the stages of bladder cancer. Loss of P16 is associated with low-grade urothelial malignancy while amplified P16 donotes high-grade. Neither P16 gene status nor p16 protein expression alone is an independent predictor of urothelial bladder carcinoma, but combine gene and protein status together providing useful information on the clinical outcome of these patients.
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Affiliation(s)
- Xiaohong Pu
- Department of Pathology, Nanjing University Medical School affiliated Drum Tower Hospital, Nanjing
| | - Liya Zhu
- Department of Blood Purification Center, Huan’an First People's Hospital, Nanjing Medical University, Jiangsu, China
| | - Yao Fu
- Department of Pathology, Nanjing University Medical School affiliated Drum Tower Hospital, Nanjing
| | - Zhiwen Fan
- Department of Pathology, Nanjing University Medical School affiliated Drum Tower Hospital, Nanjing
| | - Jinyu Zheng
- Department of Pathology, Nanjing University Medical School affiliated Drum Tower Hospital, Nanjing
| | - Biao Zhang
- Department of Pathology, Nanjing University Medical School affiliated Drum Tower Hospital, Nanjing
| | - Jun Yang
- Department of Pathology, Nanjing University Medical School affiliated Drum Tower Hospital, Nanjing
| | - Wenyan Guan
- Department of Pathology, Nanjing University Medical School affiliated Drum Tower Hospital, Nanjing
| | - Hongyan Wu
- Department of Pathology, Nanjing University Medical School affiliated Drum Tower Hospital, Nanjing
| | - Qing Ye
- Department of Pathology, Nanjing University Medical School affiliated Drum Tower Hospital, Nanjing
| | - Qing Huang
- Department of Pathology, Nanjing University Medical School affiliated Drum Tower Hospital, Nanjing
- Department of Pathology and Laboratory Medicine, Veterans Affairs Boston Healthcare System and Harvard Medical School, West Roxbury, MA
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Ammon A, Weber MH, Wallner I, Marschner N, Droese M, Gröne HJ, Hiddemann W. Immunocytochemical determination of the tumor-associated glycoproteins MCA, CA 125 and BW 495/36-P in urine of patients with epithelial tumors of the kidney and urinary bladder. Int J Biol Markers 2018; 10:17-23. [PMID: 7629422 DOI: 10.1177/172460089501000104] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Pre-operative and, in some cases, post-operative urine samples from 29 patients with renal cell or urinary bladder carcinoma were compared to samples from 24 healthy persons and 10 patients with nephrolithiasis and 9 patients with other benign disorders of the efferent urinary tract. The specimens were examined for the presence of MCA, CA 125 and BW 495/36-P expressing epithelial cells. The urine concentrations of the soluble antigens MCA and CA 125 were determined simultaneously in urine samples from 35 patients with renal cell or urinary bladder carcinoma, 10 patients with cystitis and 30 healthy individuals. MCA and BW 495/36-P expressing epithelial cells were significantly increased in all pre-operative urine samples of the tumor patients compared to the group of healthy persons. This increase was also seen with CA 125-positive cells in patients with bladder carcinoma, not however in patients with renal cell carcinoma. BW 495/36-P positive cells were also found in both groups of tumor patients in greater numbers than in the patients with nephrolithiasis or other benign urinary tract disorders. Based on a specificity of 97% when compared to the control urine samples, the cytological determination of the antigens MCA, CA 125 and BW 495/36-P in urinary tract cells of all tumor patients revealed a sensitivity of 48%, 33% and 79% as well as a positive predictive value of 92%, 89% and 95%, respectively. The sensitivity of CA 125 increased to 67% upon isolated analysis of patients with bladder carcinoma. The majority of labelled cells were not identifiable as tumor cells morphologically and appeared as normal transitional epithelial cells. The urinary concentration of soluble MCA was greatest in healthy patients whereas the concentration of CA 125 was increased in patients with bladder carcinoma. Our results indicate that especially the determination of BW 495/36-P expressing epithelial cells could be a helpful supplement to the cytological examination of urinary epithelium with regard to renal cell and bladder carcinoma. Determination of CA 125-positive cells appears to be of diagnostic relevance only in cases of suspected bladder carcinoma.
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Affiliation(s)
- A Ammon
- Department of Hematology and Oncology, Urbachtal-Klinik, Neukirchen, Germany
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Geva GA, Gielchinsky I, Aviv N, Max KEA, Gofrit ON, Gur-Wahnon D, Ben-Dov IZ. Urine cell-free microRNA as biomarkers for transitional cell carcinoma. BMC Res Notes 2017; 10:641. [PMID: 29187235 PMCID: PMC5708087 DOI: 10.1186/s13104-017-2950-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Accepted: 11/21/2017] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE MicroRNA (miRNA) are short nucleotide strands with a regulatory function in the cell. Several miRNAs have been shown to be useful as biomarkers for different neoplasms. The aim of this project was to assess whether levels of miRNA in cell free urine could be used as a biomarker in transitional cell carcinoma (TCC). RESULTS cDNA libraries were produced based on small RNAs in urine samples of fourteen TCC patients and twenty healthy volunteers. Resulting reads were deep sequenced on Illumina HiSeq sequencer with the intent of characterizing cell free urine miRNA profiles. A statistically significant difference was found for a single miRNA; miR-210 was > sixfold higher in the TCC group compared to the control group. Furthermore, we were able to produce a diagnostic score by summing of standardized levels of overexpressed miRNA. This score was considerably higher in TCC patients with a sensitivity of 0.93, specificity of 0.76 and negative predictive value > 0.97.
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Affiliation(s)
- Gil A. Geva
- Nephrology and Hypertension, Hadassah-Hebrew University Medical Center, POB 12000, 91120 Jerusalem, Israel
| | - Ilan Gielchinsky
- Department of Urology, Hadassah-Hebrew University Medical Center, POB 12000, 91120 Jerusalem, Israel
| | - Nina Aviv
- Nephrology and Hypertension, Hadassah-Hebrew University Medical Center, POB 12000, 91120 Jerusalem, Israel
| | - Klaas E. A. Max
- Laboratory of RNA Molecular Biology, The Rockefeller University, New York, NY 10065 USA
| | - Ofer N. Gofrit
- Department of Urology, Hadassah-Hebrew University Medical Center, POB 12000, 91120 Jerusalem, Israel
| | - Devorah Gur-Wahnon
- Nephrology and Hypertension, Hadassah-Hebrew University Medical Center, POB 12000, 91120 Jerusalem, Israel
| | - Iddo Z. Ben-Dov
- Nephrology and Hypertension, Hadassah-Hebrew University Medical Center, POB 12000, 91120 Jerusalem, Israel
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21
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Sabah-Ozcan S, Baser A, Olcucu T, Barıs IC, Elmas L, Tuncay L, Eskicorapci S, Turk NS, Caner V. Human TLR gene family members are differentially expressed in patients with urothelial carcinoma of the bladder. Urol Oncol 2017; 35:674.e11-674.e17. [PMID: 28843340 DOI: 10.1016/j.urolonc.2017.07.029] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Revised: 07/22/2017] [Accepted: 07/23/2017] [Indexed: 01/25/2023]
Abstract
PURPOSE Toll-like receptors (TLRs) have an important role in the activation of both innate and adaptive immunity in response to pathogens and endogenous danger signals from damaged or dying cells. The aim of this study was to determine the relationship between urothelial carcinoma (UC) and TLR expression. BASIC PROCEDURES Real-time polymerase chain reaction evaluation was made of the messenger RNA expression of TLRs 1-10 in 24 UC samples and 46 nontumoral bladder tissue samples. The levels of proinflammatory cytokines (IL-1β, IL-6, and IL-8) in the urine samples were also determined with enzyme-linked immunosorbent assay. MAIN FINDINGS TLR2-7 and TLR10 expressions were significantly higher in UC than in the control group (P<0.05 for all comparisons). No concordance was found between matched tumor tissue and urine samples in terms of TLR expression. IL-1β, IL-6, and IL-8 levels were significantly higher in urine specimens of patients with UC (P = 0.033, P = 0.001, and P = 0.008, respectively). PRINCIPAL CONCLUSIONS The results of this study demonstrated that the TLR gene expression profiles reflect the heterogeneity within UC. These results might also prompt further investigation to better understand the role of the TLR gene family expression in the tumor progression of UC.
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Affiliation(s)
- Seda Sabah-Ozcan
- Department of Medical Biology, School of Medicine, Bozok University, Yozgat, Turkey
| | - Aykut Baser
- Department of Urology, School of Medicine, Pamukkale University, Denizli, Turkey
| | - Taha Olcucu
- Department of Urology, School of Medicine, Pamukkale University, Denizli, Turkey
| | - Ikbal Cansu Barıs
- Department of Medical Biology, School of Medicine, Pamukkale University, Denizli, Turkey
| | - Levent Elmas
- Department of Medical Biology, School of Medicine, Pamukkale University, Denizli, Turkey
| | - Levent Tuncay
- Department of Urology, School of Medicine, Pamukkale University, Denizli, Turkey
| | | | - Nilay Sen Turk
- Department of Pathology, School of Medicine, Pamukkale University, Denizli, Turkey
| | - Vildan Caner
- Department of Medical Genetics, School of Medicine, Pamukkale University, Denizli, Turkey.
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Scott SN, Ostrovnaya I, Lin CM, Bouvier N, Bochner B, Iyer G, Solit D, Berger MF, Lin O. Next-generation sequencing of urine specimens: A novel platform for genomic analysis in patients with non-muscle-invasive urothelial carcinoma treated with bacille Calmette-Guérin. Cancer 2017; 125:416-426. [PMID: 28339163 PMCID: PMC5477237 DOI: 10.1002/cncy.21847] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [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: 01/10/2017] [Revised: 01/25/2017] [Accepted: 01/27/2017] [Indexed: 12/30/2022]
Abstract
BACKGROUND Biopsies from patients with high-risk (HR) non-muscle-invasive urothelial carcinoma (NMIUC), especially flat urothelial carcinoma in situ, frequently contain scant diagnostic material or denuded mucosa only, and this precludes further extensive genomic analysis. This study evaluated the use of next-generation sequencing (NGS) analysis of urine cytology material from patients with HR NMIUC in an attempt to identify genetic alterations that might correlate with clinical features and responses to bacille Calmette-Guérin (BCG) treatment. METHODS Forty-one cytology slides from patients with HR NMIUC treated with intravesical BCG were selected for this study. Histological confirmation was available for all cases. The specimens were subjected to NGS analysis with a customized targeted exome capture assay composed of 341 genes. RESULTS In this cohort, genomic alterations were successfully identified in all cytology samples. Mutations were detected down to a 2% allele frequency and chromosomal rearrangements including copy number alterations and gene fusions were identified. The most frequently altered genes included telomerase reverse transcriptase (TERT), tumor protein 53 (TP53), Erb-B2 receptor tyrosine kinase 2 (ERBB2), and chromatin remodeling genes such as lysine demethylase 6A (KDM6A) and AT-rich interaction domain 1A (ARID1A). For patients with matched tumor tissue, cytology specimens revealed all mutations detected in tissue as well as additional mutations, and this suggested that urine might more effectively capture the full genetic heterogeneity of disease than an individual cystectomy. Alterations in multiple genes correlated with clinical and histopathological features, including responses to BCG treatment, flat architecture versus papillary architecture, and smoking history. CONCLUSIONS Urine specimens can replace tissue as a substrate for NGS analysis of HR NMIUC. Several genomic alterations identified in urine specimens might be associated with histological features and clinical characteristics. Cancer Cytopathol 2017;125:416-26. © 2017 American Cancer Society.
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Affiliation(s)
- Sasinya N. Scott
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Irina Ostrovnaya
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Caroline M. Lin
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Nancy Bouvier
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Bernard Bochner
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Gopakumar Iyer
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - David Solit
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Michael F. Berger
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Oscar Lin
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
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Gomella LG, Mann MJ, Cleary RC, Hubosky SG, Bagley DH, Thumar AB, McCue PA, Lallas CD, Trabulsi EJ. Fluorescence in situ hybridization (FISH) in the diagnosis of bladder and upper tract urothelial carcinoma: the largest single-institution experience to date. Can J Urol 2017; 24:8620-8626. [PMID: 28263126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
INTRODUCTION We evaluated the UroVysion (Abbott Molecular, IL, USA) fluorescence in situ hybridization (FISH) assay for the diagnosis of urothelial cancer in patients diagnosed with or suspected to have bladder, upper tract urothelial carcinoma (UTUC), and combined upper and lower tract urothelial carcinoma (BC). MATERIALS AND METHODS A single institution retrospective analysis comparing sensitivity, specificity, positive predictive value, and negative predictive values for FISH and urinary cytology. FISH within 6 months of endoscopic evaluation were obtained from outpatient voided urine samples. Our institutional pathology department confirmed pathologic disease from specimens obtained during endoscopic evaluations for lower tract disease. For upper tract disease, disease was confirmed by retrograde ureteroscopy, biopsies of visual lesions, and site-specific upper tract cytology. RESULTS A total of 415 patients submitted FISH specimens. Overall, FISH was more sensitive than cytology 54.9% in comparison with cytology 42.2% (p = 0.01), specificity favored cytology 92.9% compared to 73.5% with FISH (p < 0.01). For BC only patients, the same significant finding of increased sensitivity and decreased specificity was identified, but for UTUC alone and combined UTUC and BC, there was no significant difference. Cytology had improved positive predictive value (PPV) over FISH, 76.9% in comparison to 64.6% (p = 0.02). Negative predictive value (NPV) also favored cytology 74.2% versus 64.9% (p = 0.02). When analyzing individual cohorts, cytology had improved PPV for BC alone patients. UTUC showed no difference for PPV and NPV. For both UTUC and BC, NPV was slightly favored for FISH over cytology 93.2% versus 91.2% (p = 0.03). CONCLUSIONS Voided urine FISH testing does offer a higher detection of urothelial carcinoma for BC compared to voided cytology; however, specificity was worse. FISH does not appear to improve detection of urothelial carcinoma in patients with either UTUC only or both BC and UTUC.
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Affiliation(s)
- Leonard G Gomella
- Department of Urology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
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Pollard RE, Watson KD, Hu X, Ingham E, Ferrara KW. Feasibility of quantitative contrast ultrasound imaging of bladder tumors in dogs. Can Vet J 2017; 58:70-72. [PMID: 28042158 PMCID: PMC5157742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
The purpose of this pilot study was to assess the feasibility of Cadence contrast pulse sequencing ultrasound to predict clinical and angiogenic tumor response in dogs undergoing chemotherapy. Contrast ultrasound facilitated visualization of bladder tumors but failed to identify a straightforward relationship between ultrasound measures and clinical outcome.
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25
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Dusek P, Kotaska K, Vesely S, Prusa R, Babjuk M. Diagnostic Efficiency of Serum and Urine Procathepsin B and Cathepsin B in Patients with Carcinoma of the Urinary Bladder. Clin Lab 2016; 62:1709-1715. [PMID: 28164592 DOI: 10.7754/clin.lab.2016.160135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND The aim of the study was to evaluate the diagnostic efficiency of cathepsins B (cathepsin B and procathepsin B) in patients with transient cell carcinoma of the urinary bladder. METHODS Serum and urine concentrations of cathepsin B and procathepsin B were measured by two commercially available enzymatic immunoassays in a group of 125 patients with bladder cell carcinoma without metastases and in a group of 72 healthy individuals. Concentrations in urine were adjusted to creatinine. RESULTS Concentrations of both cathepsin B and procathepsin B in serum and urine were significantly elevated in patients with bladder cell carcinoma (p < 0.0001 for U-procathepsin B, U-procathepsin B/creatinine, and U-cathepsin B/creatinine, p = 0.0001 for U-cathepsin B, p = 0.0002 for S-procathepsin B and p = 0.02 for S-cathepsin B). Comparison of all diagnostic efficiencies of cathepsin B and procathepsin B in serum and in urine showed the best diagnostic accuracy for procathepsin B in urine (AUC = 0.81 vs. 0.50). The ratio of U-procathepsin B/creatinine was also more efficient than the ratio of U-cathepsin B/creatinine (AUC = 0.81 vs. AUC = 0.70). The diagnostic efficiencies of both parameters in serum were low (S-procathepsin B: AUC = 0.50, S-cathepsin B: AUC = 0.60). U-procathepsin B and U-procathepsin B/creatinine ratio show significantly better diagnostic efficiency in patients with invasive bladder tumors than other parameters (S-procathepsin B, S-cathepsin B, U-cathepsin B and U-Cathepsin B/creatinine; U-procathepsin B: AUC = 0.82, U-procathepsin B/creatinine: AUC = 0.86, S-procathepsin B and cathepsin B: AUC = 0.51 - 0.68). CONCLUSIONS Procathepsin B concentration in urine is a valuable diagnostic marker in patients with bladder cell carcinoma.
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Hassan M, Solanki S, Kassouf W, Kanber Y, Caglar D, Auger M, Brimo F. Impact of Implementing the Paris System for Reporting Urine Cytology in the Performance of Urine Cytology: A Correlative Study of 124 Cases. Am J Clin Pathol 2016; 146:384-90. [PMID: 27543983 DOI: 10.1093/ajcp/aqw127] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES We assessed the performance of urine cytology using the Paris System for Reporting Urine Cytology (PSRUC) in comparison to our current system. METHODS In total, 124 specimens with histologic correlation were reviewed and assigned to the PSRUC categories: benign, atypical urothelial cells (AUCs), suspicious for high-grade urothelial carcinoma (SHGUC), and high-grade urothelial carcinoma (HGUC). Original cytological diagnoses were recorded. RESULTS Fewer cases were given an AUC diagnosis using the PSRUC in comparison to the original diagnoses (26% vs 39%), while the association of AUCs with subsequent HGUC increased from 33% to 53% with the PSRUC. Using the PSRUC resulted in a higher number of low-grade carcinomas assigned to the benign (40%) rather than the AUC (22%) category. The performance of SHGUC/HGUC diagnoses was similar in both systems (predictive value = 94%). CONCLUSIONS The PSRUC seems to improve the performance of urine cytology by limiting the AUC category to cases that are more strongly associated with HGUC.
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Affiliation(s)
| | - Sharaddha Solanki
- Department of Urology, McGill University and McGill University Health Center, Montreal, Canada
| | - Wassim Kassouf
- Department of Urology, McGill University and McGill University Health Center, Montreal, Canada
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Zhou BF, Wei JH, Chen ZH, Dong P, Lai YR, Fang Y, Jiang HM, Lu J, Zhou FJ, Xie D, Luo JH, Chen W. Identification and validation of AIB1 and EIF5A2 for noninvasive detection of bladder cancer in urine samples. Oncotarget 2016; 7:41703-41714. [PMID: 27203388 PMCID: PMC5173089 DOI: 10.18632/oncotarget.9406] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2015] [Accepted: 03/28/2016] [Indexed: 11/25/2022] Open
Abstract
We previously demonstrated that amplified in breast cancer 1 (AIB1) and eukaryotic initiation factor 2 (EIF5A2) overexpression was an independent predictor of poor clinical outcomes for patients with bladder cancer (BCa). In this study, we evaluated the usefulness of AIB1 and EIF5A2 alone and in combination with nuclear matrix protein 22 (NMP22) as noninvasive diagnostic tests for BCa. Using urine samples from 135 patients (training set, controls [n = 50] and BCa [n = 85]), we detected the AIB1, EIF5A2, and NMP22 concentrations using enzyme-linked immunosorbent assay. We applied multivariate logistic regression analysis to build a model based on the three biomarkers for BCa diagnosis. The diagnostic accuracy of the three biomarkers and the model were assessed and compared by the area under the curve (AUC) of the receiver operating characteristic. We validated the diagnostic accuracy of these biomarkers and the model in an independent validation cohort of 210 patients. In the training set, urinary concentrations of AIB1, EIF5A2, and NMP22 were significantly elevated in BCa. The AUCs of AIB1, EIF5A2, NMP22, and the model were 0.846, 0.761, 0.794, and 0.919, respectively. The model had the highest diagnostic accuracy when compared with AIB1, EIF5A2, or NMP22 (p < 0.05 for all). The model had 92% sensitivity and 92% specificity. We obtained similar results in the independent validation cohort. AIB1 and EIF5A2 show promise for the noninvasive detection of BCa. The model based on AIB1, EIF5A2, and NMP22 outperformed each of the three individual biomarkers for detecting BCa.
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Affiliation(s)
- Bang-Fen Zhou
- Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
- Department of Urology, Hainan Provincal Nongken General Hospital, Haikou, Hainan, China
| | - Jin-Huan Wei
- Department of Urology, First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Zhen-Hua Chen
- Department of Urology, First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Pei Dong
- Department of Urology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Ying-Rong Lai
- Department of Pathology, First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Yong Fang
- Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Hui-Ming Jiang
- Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
- Department of Urology, Meizhou People's Hospital, Guangdong, China
| | - Jun Lu
- Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Fang-Jian Zhou
- Department of Urology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Dan Xie
- Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Jun-Hang Luo
- Department of Urology, First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Wei Chen
- Department of Urology, First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
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Arnold SA, Loomans HA, Ketova T, Andl CD, Clark PE, Zijlstra A. Urinary oncofetal ED-A fibronectin correlates with poor prognosis in patients with bladder cancer. Clin Exp Metastasis 2016; 33:29-44. [PMID: 26456754 PMCID: PMC4742427 DOI: 10.1007/s10585-015-9754-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [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: 03/24/2015] [Accepted: 10/01/2015] [Indexed: 01/18/2023]
Abstract
The extracellular matrix protein fibronectin (FN) contributes to the structural integrity of tissues as well as the adhesive and migratory functions of cells. While FN is abundantly expressed in adult tissues, the expression of several alternatively spliced FN isoforms is restricted to embryonic development, tissue remodeling and cancer. These FN isoforms, designated ED-A and ED-B, are frequently expressed by cancer cells, tumor-associated fibroblasts and newly forming blood vessels. Using a highly sensitive collagen-based indirect ELISA, we evaluated the correlation of urinary ED-A and ED-B at time of cystectomy with overall survival in patients with high-grade bladder cancer (BCa). Detectable levels of total FN as well as ED-A and ED-B were found in urine from 85, 73 and 51 % of BCa patients, respectively. The presence of urinary ED-A was a significant independent predictor of 2-year overall survival (OS) after adjusting for age, tumor stage, lymph node stage, and urinary creatinine by multivariable Logistic Regression (p = 0.029, OR = 4.26, 95 % CI 1.16-15.71) and improved accuracy by 3.6 %. Furthermore, detection of ED-A in the urine was a significant discriminator of survival specifically in BCa patients with negative lymph node status (Log-Rank, p = 0.006; HR = 5.78, 95 % CI 1.39-24.13). Lastly, multivariable Cox proportional hazards analysis revealed that urinary ED-A was an independent prognostic indicator of 5-year OS rate for patients with BCa (p = 0.04, HR = 2.20, 95 % CI 1.04-4.69). Together, these data suggest that cancer-derived, alternatively spliced FN isoforms can act as prognostic indicators and that additional studies are warranted to assess the clinical utility of ED-A in BCa.
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Affiliation(s)
- Shanna A Arnold
- Department of Veterans Affairs, Nashville, TN, 37212, USA
- Department of Pathology, Microbiology, and Immunology, Vanderbilt University, Nashville, TN, 37232, USA
| | - Holli A Loomans
- Department of Cancer Biology, Vanderbilt University, Nashville, TN, 37232, USA
| | - Tatiana Ketova
- Department of Pathology, Microbiology, and Immunology, Vanderbilt University, Nashville, TN, 37232, USA
| | - Claudia D Andl
- Department of Cancer Biology, Vanderbilt University, Nashville, TN, 37232, USA
- Department of Surgery, Vanderbilt University, Nashville, TN, 37232, USA
- Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, 1161 21st Ave S., C-2102B Medical Center North, Nashville, TN, 37232, USA
- Epithelial Biology Center, Vanderbilt University, Nashville, TN, 37232, USA
| | - Peter E Clark
- Department of Surgery, Vanderbilt University, Nashville, TN, 37232, USA
- Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, 1161 21st Ave S., C-2102B Medical Center North, Nashville, TN, 37232, USA
| | - Andries Zijlstra
- Department of Pathology, Microbiology, and Immunology, Vanderbilt University, Nashville, TN, 37232, USA.
- Department of Cancer Biology, Vanderbilt University, Nashville, TN, 37232, USA.
- Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, 1161 21st Ave S., C-2102B Medical Center North, Nashville, TN, 37232, USA.
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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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Rybotycka Z, Długosz A. [Diagnostic significance of protein NMP22 in bladder cancer]. Pol Merkur Lekarski 2015; 38:309-314. [PMID: 26098648] [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] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Bladder cancer is a malignancy that affects mainly the elderly and males. Up to 90% of these cancers originate from urothelial epithelial cells and therefore they are called Transitional (Urothelial) Cell Carcinoma (TCC). Another types are: Squamous Cell Carcionoma (SCC), which involves about 5% of cases and Adenocarcinoma (less than 2%). The factors that may lead to the development of bladder cancer include: genetic disorders, molecular changes, environmental exposures, industrial carcinogens, chemical contaminants and chronic cystitis. This article depicts the current state of diagnostics of bladder cancer, with particular focus on urine-based tests. Although many markers with different structure are under research, only the following have gained FDA approval for bladder cancer screening: BTAstat, BTA TRAK, UroVysion and NMP22 BladderChek. For follow-up NMP22 ELISA and Immunocyt (uCyt+) are approved. This work is mainly focused on mainly on evaluating the diagnostic value of nuclear matrix protein NMP22 for bladder cancer in terms of the outlined researches among people susceptible to environmental toxins. A review of the current literature depicts that no research on correlation between NMP22 and genetic susceptibility has been conducted so far. There is some evidence that NMP22 protein is particularly important in high-risk groups, e.g. among tobacco smokers. The work also describes the methods of detecting NMP22 protein and factors that may influence the results. The review of current literature showed that NMP22 cannot replace invasive cystoscopy neither in screening for bladder cancer nor in follow-up. The NMP22 test could be useful for determining the frequency of cystoscopy and for early detection of high-grade tumors. Research focused on improving the specificity of this marker seems to be crucial, e.g. through the correlation between NMP22 and other parameters (e.g. other laboratory tests), which is confirmed by preliminary data about combining various markers.
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MESH Headings
- Adenocarcinoma/diagnosis
- Adenocarcinoma/genetics
- Adenocarcinoma/urine
- Aged
- Biomarkers, Tumor/urine
- Carcinoma, Squamous Cell/diagnosis
- Carcinoma, Squamous Cell/genetics
- Carcinoma, Squamous Cell/urine
- Carcinoma, Transitional Cell/diagnosis
- Carcinoma, Transitional Cell/genetics
- Carcinoma, Transitional Cell/urine
- Early Diagnosis
- Genetic Markers
- Humans
- Male
- Neoplasm Recurrence, Local/diagnosis
- Neoplasm Recurrence, Local/genetics
- Neoplasm Recurrence, Local/urine
- Nuclear Proteins/urine
- ROC Curve
- Urinary Bladder Neoplasms/diagnosis
- Urinary Bladder Neoplasms/genetics
- Urinary Bladder Neoplasms/urine
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Affiliation(s)
- Zuzanna Rybotycka
- Department of Toxicology, Faculty of Pharmacy and Division of Laboratory, Medical University of Wrocław, Poland
| | - Anna Długosz
- Department of Toxicology, Faculty of Pharmacy and Division of Laboratory, Medical University of Wrocław, Poland
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Zhang YR, Shi L, Wu H, Tang DD, Wang SM, Liu HM, Zhang LR, Song DK. Urinary modified nucleosides as novel biomarkers for diagnosis and prognostic monitoring of urothelial bladder cancer. Tumori 2015; 100:660-6. [PMID: 25688500 DOI: 10.1700/1778.19274] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
AIMS AND BACKGROUND To ascertain the value of the detection of urinary modified nucleosides in the early diagnosis and prognostic monitoring of urothelial bladder cancer. METHODS One hundred seventeen patients with urothelial bladder carcinoma and 66 healthy volunteers were included in the study. High-performance liquid chromatography/electrospray ionization quadrupole time-of-flight mass spectrometry (HPLC/ESI-Q-TOF-MS) was used to measure the levels of urinary modified nucleosides in the bladder cancer and control groups. Postoperative monitoring was done every 3 months in patients with noninvasive carcinoma; 85 patients attended the 1-year follow-up visit. RESULTS The levels of m1A, ac4C, O6-MeG and 1-MeI were significantly higher in cases than controls (P < 0.05). The highest sensitivity (92.45%) and specificity (87.50%) were obtained when 1-MeI detection was combined with m1A detection. The m1A and 1-MeI levels 3 months after operation in both patient groups were significantly lower than the preoperative levels (P < 0.01). The no-recurrence group subsequently maintained low levels, but in the recurrence group the levels rose again almost to preoperative values. At 6, 9 and 12 months after operation, the m1A and 1-MeI levels of the recurrence group were higher than those of the no-recurrence group and the control group (P < 0.01). CONCLUSIONS Urinary modified nucleosides might become novel tumor markers that will facilitate the clinical management and will be helpful in the diagnosis and follow-up of urothelial bladder cancer. m1A and 1-MeI appear to be most promising for clinical use and be worthy of further study in the near future.
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Jamshidian H, Hashemi M, Nowroozi MR, Ayati M, Bonyadi M, Najjaran Tousi V. Sensitivity and specificity of urinary hyaluronic acid and hyaluronidase in detection of bladder transitional cell carcinoma. Urol J 2014; 11:1232-1237. [PMID: 24595930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 03/03/2014] [Accepted: 03/03/2014] [Indexed: 06/03/2023]
Abstract
PURPOSE To the assess sensitivity and specificity of urinary levels of hyaluronic acid (HA) and hyaluronidase (HAase) as an individual or a combined test to diagnose bladder transitional cell carcinoma (TCC). MATERIALS AND METHODS One hundred and ninety-four urine specimens were collected from individuals between July 2007 and March 2008. The urinary level of hyaluronic acid (HA) was measured by Enzyme-linked immunosorbent assay. Thereafter, the urinary levels of HA and HAase were normalized to urinary creatinine level and expressed as ng/mg and μ/mg. RESULTS Eighty percent of patients with bladder cancer had urinary HA level < 500 ng/mg, and 90% of controls showed HA level < 500 ng/mg (P < .001). The mean urinary levels of HA in controls did not vary significantly (P < .05), whereas they significantly increased (2.5 to 6.5 folds) in all grades of TCC. More than 80% of patients with grades 2 and 3 TCC had urinary HAase level < 10 μ/mg and over 80% of controls showed HAase level < 10 μ/mg (P < .05). Hyaluronidase levels increased in patients with grades 2 and 3 bladder TCC. CONCLUSION Measurement of urinary levels of HA and HAase (with 89% sensitivity and 83% specificity) appears to be a highly accurate and non-invasive method for detecting bladder TCC and evaluating its grade.
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Affiliation(s)
- Hassan Jamshidian
- Department of Uro-oncology, Imam Khomeini Hospital, Tehran University of Medical Sciences,Tehran,
| | - Mohsen Hashemi
- Department of Uro-oncology, Imam Khomeini Hospital, Tehran University of Medical Sciences,Tehran,Iran
| | - Mohammad Reza Nowroozi
- Department of Uro-oncology, Imam Khomeini Hospital, Tehran University of Medical Sciences,Tehran,Iran
| | - Mohsen Ayati
- Department of Uro-oncology, Imam Khomeini Hospital, Tehran University of Medical Sciences,Tehran,Iran
| | - Mahdieh Bonyadi
- Department of Uro-oncology, Imam Khomeini Hospital, Tehran University of Medical Sciences,Tehran,Iran
| | - Vahid Najjaran Tousi
- Department of Uro-oncology, Imam Khomeini Hospital, Tehran University of Medical Sciences,Tehran,Iran
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Xylinas E, Kluth LA, Rieken M, Karakiewicz PI, Lotan Y, Shariat SF. Urine markers for detection and surveillance of bladder cancer. Urol Oncol 2013; 32:222-9. [PMID: 24054865 DOI: 10.1016/j.urolonc.2013.06.001] [Citation(s) in RCA: 76] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2013] [Revised: 06/04/2013] [Accepted: 06/06/2013] [Indexed: 11/16/2022]
Abstract
OBJECTIVES Bladder cancer detection and surveillance includes cystoscopy and cytology. Urinary cytology is limited by its low sensitivity for low-grade tumors. Urine markers have been extensively studied to help improve the diagnosis of bladder cancer with the goal of complementing or even replacing cystoscopy. However, to date, no marker has reached widespread use owing to insufficient evidence for clinical benefit. MATERIAL AND METHODS Pubmed/Medline search was conducted to identify original articles, review articles, and editorials regarding urine-based biomarkers for screening, early detection, and surveillance of urothelial carcinoma of the bladder. Searches were limited to the English language, with a time frame of 2000 to 2013. Keywords included urothelial carcinoma, bladder cancer, transitional cell carcinoma, biomarker, marker, urine, diagnosis, recurrence, and progression. RESULTS Although several urinary markers have shown higher sensitivity compared with cytology, it remains insufficient to replace cystoscopy. Moreover, most markers suffer from lower specificity than cytology. In this review, we aimed to summarize the current knowledge on commercially available and promising investigational urine markers for the detection and surveillance of bladder cancer. CONCLUSIONS Well-designed protocols and prospective, controlled trials are needed to provide the basis to determine whether integration of biomarkers into clinical decision making will be of value for bladder cancer detection and screening in the future.
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Affiliation(s)
- Evanguelos Xylinas
- Department of Urology, Weill Medical College of Cornell University, New York-Presbyterian Hospital, New York, NY
| | - Luis A Kluth
- Department of Urology, Weill Medical College of Cornell University, New York-Presbyterian Hospital, New York, NY
| | - Malte Rieken
- Department of Urology, Weill Medical College of Cornell University, New York-Presbyterian Hospital, New York, NY
| | | | - Yair Lotan
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX
| | - Shahrokh F Shariat
- Department of Urology, Weill Medical College of Cornell University, New York-Presbyterian Hospital, New York, NY; Division of Medical Oncology, Weill Medical College of Cornell University, New York-Presbyterian Hospital, New York, NY; Department of Urology, Medical University of Vienna, Vienna, Austria.
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Seifert G, Seifert M, Wittel UA. Searching for the common denominator of systemic inflammation and tumor invasion in the cases of bikunin and the inter-α-trypsin inhibitor heavy chains. J Surg Res 2013; 183:983. [PMID: 23726432 DOI: 10.1016/j.jss.2013.04.077] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2013] [Revised: 04/29/2013] [Accepted: 04/29/2013] [Indexed: 11/28/2022]
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Kehinde EO, Al-Maghrebi M, Anim JT, Kapila K, George SS, Al-Juwaiser A, Memon A. THE SIGNIFICANCE OF EPIDERMAL GROWTH FACTOR RECEPTOR AND SURVIVIN EXPRESSION IN BLADDER CANCER TISSUE AND URINE CYTOLOGY OF PATIENTS WITH TRANSITIONAL CELL CARCINOMA OF THE URINARY BLADDER. East Afr Med J 2013; 90:19-27. [PMID: 26862626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
OBJECTIVE To assess whether epidermal growth factor receptor (EGFR) and survivin immunostaining of tumour cells in urinary cytology and tissue of patients with bladder cancer has a prognostic significance. DESIGN Prospective study SETTING Department of Surgery (Division of Urology), Mubarak Al-Kabeer Teaching Hospital and Faculty of Medicine, Kuwait University, Kuwait SUBJECTS Urine cytology smears obtainedpriorto cystoscopy in patients with transitional cell carcinoma (TCC) of the bladder were immunostained for EGFR and survivin. Bladder cancer tissue resected at surgery was also immunostained for EGFR and survivin expression. Tissue expression of EGFR and survivin in TCC of the bladder was compared to their expression in urine cytology and relationship to tumour grade and stage. RESULTS 178 patients were studied (43 newly diagnosed bladder cancer, 58 with recurrent TCC and 77 in disease remission). Twenty five patients with normal urothelium served as controls. The mean sensitivity of urine cytology, tissue survivin immunohistochemistry (IHC) and tissue EGFR IHC was 30.5%, 62% and 59% respectively. The corresponding mean specificity was 95%, 79% and 38% respectively. For grades 1, 2 and 3 bladder tumors, tissue expression positivity for EGFR was 47.8%, 92.9%, 100% and for tissue survivin it was 27.8%, 18.2% and 33.3% respectively. For grades 1, 2 and 3 bladder tumors, urine expression positivity for EGFR was 35.7%, 40% and 67.7% and for urine survivin it was 8.3%, 42.9% and 33.3% respectively. CONCLUSION Positive EGFR immunostaining of urine cytology specimen or tumour tissue increases with histological grade of TCC of the bladder. Survivin expression is less consistent in both urine cytology specimen and tissue samples. EGFR immunostaining may provide a useful tool in the grading of bladder TCC and aid in the selection of patients that may benefit from administration of EGFR inhibitors.
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Affiliation(s)
- E O Kehinde
- Department of Surgery (Division of Urology), Faculty of Medicine, Kuwait
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Alías-Melgar A, Neave-Sánchez E, Suárez-Cuenca JA, Morales-Covarrubias J. Association of urine oncofetal fibronectin levels with urology's most common disorders. Ann Clin Lab Sci 2013; 43:420-423. [PMID: 24247799] [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] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
UNLABELLED Urine oncofetal fibronectin (OnfFN) has proven useful in the assessment of malignant diseases such as transitional cell carcinoma (TCC) of the bladder. This study aimed to explore whether OnfFN may identify benign and common urinary diseases. METHODS The urine OnfFN concentrations from patients who had bladder TCC (8 patients), benign urinary diseases (10 benign prostatic enlargement [BPE] patients, 10 urolithiasis patients), or controls (10 healthy individuals) were determined by ELISA and compared. RESULTS The urine OnfFN concentration was significantly higher in patients with bladder TCC and lithiasis (mean ± SE 0.43 ± 0.18 and 0.45 ± 0.23 ug/mL) than in patients with BPE and in healthy individuals (0.15 ± 0.06 and 0.10 ± 0.02 ug/mL, p<0.05). The urine OnfFN level (cutoff value 0.038 μg/mL), was able to identify 75% of patients with bladder TCC, 60% of patients with BPE and 80% of patients with urolithiasis, achieving a sensitivity of 0.75 for the recognition of either cancer or a urinary disorder. The OnfFN level had a high sensitivity (0.9) for the identification of urolithiasis. CONCLUSION The urine OnfFN level proved helpful in the identification of bladder TCC patients. However, it had a better performance for the identification of urolithiasis, highlighting the potential usefulness of OnfFN as a biomarker for urothelial inflammation and repair.
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Affiliation(s)
- Alejandro Alías-Melgar
- MD; Departamento de Urología, Centro Médico Nacional "20 de Noviembre", I.S.S.S.T.E. Avenida Félix Cuevas, número 540, Colonia Del Valle, Delegación Benito Juárez, México, D.F., México. Código Postal 03229; phone: 00(+5255)55583132; fax: 00(+5255)51351347; e mail:
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Ganas V, Kalaitzis C, Sountoulides P, Giannakopoulos S, Touloupidis S. Predictive values of urinary bladder tumor markers survivin and soluble-Fas comparison with cystoscopy and bladder tumor antigen. MINERVA UROL NEFROL 2012; 64:279-285. [PMID: 23288215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
AIM The aim of the study was to evaluate the predictive values of two novel urinary markers for bladder cancer: survivin and soluble-Fas (s-Fas). METHODS The study included 84 individuals divided in two groups. The first group contained 47 patients, who underwent transurethral bladder tumor resection and the second, control, group 20 patients with non-malignant conditions, who underwent cystoscopy and 17 health volunteers. Fresh, second morning voided urine was collected for measurement of s-Fas, survivin, BTA and for cytology. Sensitivity, specificity, positive and negative predictive values and accuracy were calculated. RESULTS Bladder tumor patients had significantly higher survivin urine levels in comparison to the controls. Survivin correlated also with the tumor stage. Combination of survivin with BTA had a sensitivity of 86.4% but still lower than that of cystoscopy (97.8%). Only the specificity of the combination between survivin and BTA was higher than that of cystoscopy (86.4% and 75.6%, respectively). CONCLUSION Survivin was a better marker for tumor detection than s-Fas and was better enough to discriminate cancer stage. Combination of survivin and BTA had a specificity of 86.4% to exclude bladder malignancy and the combination of s-Fas with survivin and BTA had a sensitivity of 93.6% to detect bladder cancer.
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Affiliation(s)
- V Ganas
- Department of Urology, University of Thrace, Alexandroupolis, Greece
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van Kessel KEM, Kompier LC, de Bekker-Grob EW, Zuiverloon TCM, Vergouwe Y, Zwarthoff EC, Steyerberg EW. FGFR3 mutation analysis in voided urine samples to decrease cystoscopies and cost in nonmuscle invasive bladder cancer surveillance: a comparison of 3 strategies. J Urol 2012; 189:1676-81. [PMID: 23142690 DOI: 10.1016/j.juro.2012.11.005] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/01/2012] [Indexed: 11/18/2022]
Abstract
PURPOSE We determined whether FGFR3 mutation analysis of voided urine samples would be cost-effective to partly replace cystoscopy in the surveillance of patients treated for nonmuscle invasive urothelial carcinoma. MATERIALS AND METHODS In this decision analytical study we analyzed data on 70 Dutch patients with FGFR3 positive primary tumors and a median followup of 8.8 years. Surveillance strategies were compared in a Markov model. Modified surveillance consisted of FGFR3 mutation analysis of voided urine samples every 3 months, and cystoscopy at 3, 12 and 24 months. Standard surveillance was defined as cystoscopy every 3 months and minimal surveillance was defined as cystoscopy at 3, 12 and 24 months. Analysis was stratified for 3 risk profiles, including surveillance after 1) the primary tumor, 2) the first to third recurrence and 3) the fourth recurrence or more. Sensitivity analysis was performed to evaluate the impact of variations in cost, sensitivity and specificity. RESULTS The probability of no recurrence after 2 years of surveillance after a primary tumor was higher for modified surveillance than for standard and minimal surveillance, eg after primary tumors (95.7% vs 95.0% and 93.9%, respectively). The total cost of surveillance after the primary tumor was lower for minimal and modified surveillance (€2,254 and €2,558, respectively) than for standard surveillance (€5,861). Results were robust to changing inputs over plausible ranges and consistent for each of the 3 risk profiles. CONCLUSIONS Surveillance in which cystoscopy is partly replaced by FGFR3 mutation analysis of urine seems a safe, effective and cost-effective surveillance strategy. Further validation in larger cohorts is required.
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Affiliation(s)
- Kim E M van Kessel
- Department of Public Health, Erasmus Medical Center, Rotterdam, The Netherlands
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Feng CC, Wu Z, Jiang HW, Wen H, Guan M, Ding Q. [Urinary BLCA-4 level is useful to detect upper urinary tract urothelial cell carcinoma]. Actas Urol Esp 2012; 36:597-602. [PMID: 22998857 DOI: 10.1016/j.acuro.2012.03.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2012] [Accepted: 03/05/2012] [Indexed: 01/15/2023]
Abstract
OBJECTIVE Upper urinary tract urothelial cell carcinomas (UUT-UCCs) are rare but usually invasive at diagnosis. Early diagnosis of UUT-UCCs is thus warranted. UUT has the same embryological origin with bladder and BLCA-4 is a highly sensitive and specific marker for bladder cancer. We intend to investigate the viability of BLCA-4 in detecting UUT-UCCs. MATERIAL AND METHODS Urines from 30 UUT-UCC patients, 10 ureteral polyp patients, 20 infected patients with incarcerated ureteral stones, and 30 normal controls were included. BLCA-4 antibody was produced and applied in an indirect ELISA assay. RESULTS Urinary BLCA-4 is significantly higher in UUT-UCC group than «Polyp» group (P=0.0017), «Infection» group (P<0.0001), or « Normal» group (P<0.0001). The «Polyp» group is also higher than «Infection» group (P=0.015), or «Normal» group (P=0.0009). ROC curve revealed at cut-off of 5.5×10(-4)A, sensitivity was 93.3% and specificity was 100%. When grouped as ureteral mass vs normal, same cut-off value yielded 93.3% sensitivity and 83.3% specificity. At 2.4×10(-4)A, sensitivity was 56.7% and specificity was 97.2%. CONCLUSIONS Urinary BLCA-4 is also highly specific in UUT-UCCs detection. For incidentally identified ureteral mass, BLCA-4 can be considered an auxiliary indicator besides biopsy.
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Affiliation(s)
- C-C Feng
- Servicio de Urología, Hospital Huashan, Universidad Fudan, Shanghai, China.
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Hatzichristodoulou G, Kübler H, Schwaibold H, Wagenpfeil S, Eibauer C, Hofer C, Gschwend J, Treiber U. Nuclear matrix protein 22 for bladder cancer detection: comparative analysis of the BladderChek® and ELISA. Anticancer Res 2012; 32:5093-5097. [PMID: 23155286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
AIM To compare nuclear matrix protein 22 expression by BladderChek® and ELISA, as urine-based assays for bladder cancer (BC) detection. PATIENTS AND METHODS Urine samples of 100 BC patients and 100 controls were analyzed. Comparative statistical evaluations were based on sensitivity and specificity. RESULTS Seventy-one patients had primary and 29 recurrent BC. The sensitivity of BladderChek® was significantly higher compared to ELISA in the overall cancer cohort and in patients with primary BC (p<0.0001 and p=0.0001, respectively). Both tests demonstrated significant correlation of sensitivities and tumor stage/grade for the overall cancer cohort and for patients with primary BC. Both tests had specificity values of 100% in healthy individuals. Specificity was 93% for BladderChek® and 99% for ELISA in patients with benign diseases (p=0.048). CONCLUSION BladderChek® may be clinically more useful for BC detection. Due to high specificity, BladderChek® could be used for high-risk screening. However, due to its low sensitivity, BladderChek® cannot replace but only complement cystoscopy for BC detection.
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Affiliation(s)
- Georgios Hatzichristodoulou
- Technische Universität München, Klinikum rechts der Isar, Department of Urology, Ismaninger Str. 22, 81675 Munich, Germany.
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Sojitra P, Venkataraman G, Masoom S, Kapur U, Wojcik EM. Dysplastic squamous cells are frequently present in urine cytology specimens of patients with high-grade urothelial carcinoma. Acta Cytol 2012; 56:408-12. [PMID: 22846853 DOI: 10.1159/000337644] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2011] [Accepted: 02/28/2012] [Indexed: 11/19/2022]
Abstract
BACKGROUND In urothelial carcinoma (UCA), squamous differentiation (SqD) occurs mainly in high-grade UCA with invasion. Therefore, we sought to determine the frequency of dysplastic squamous cells (DSC) in urine specimens obtained from patients with high-grade UCA asking if DSC could serve as a surrogate marker for high-grade UCA. DESIGN We searched for cases with a histologic diagnosis of high-grade UCA and available concurrent cytology, yielding 93 surgical specimens (including 71 biopsies, 12 cystectomies, 5 nephrectomies, 4 ureterectomies, and 1 urethrectomy) from 68 patients with 98 urine cytology samples. Both cytology and histologic specimens were evaluated for the presence of any SqD on histology and the presence of DSC on cytology besides urothelial cells. RESULTS Forty-three of 68 patients (63%) had a cytologic diagnosis of 'positive/suspicious'. Twenty-one patients (30%) had surgical specimens that showed SqD. Seventeen patients had urine cytology specimens showing DSC (25%). Thirteen of these 17 patients showed DSC with concurrent malignant urothelial cells, while 4 patients displayed only isolated DSC. CONCLUSION SqD is common in patients with high-grade UCA. DSC were detected in a subset of specimens from patients with high-grade UCA. In some instances, isolated DSC on cytology may represent the only evidence of an unsampled high-grade malignancy.
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Affiliation(s)
- Payal Sojitra
- Department of Pathology, Loyola University Medical Center, Maywood, IL, USA
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Kelly JD, Dudderidge TJ, Wollenschlaeger A, Okoturo O, Burling K, Tulloch F, Halsall I, Prevost T, Prevost AT, Vasconcelos JC, Robson W, Leung HY, Vasdev N, Pickard RS, Williams GH, Stoeber K. Bladder cancer diagnosis and identification of clinically significant disease by combined urinary detection of Mcm5 and nuclear matrix protein 22. PLoS One 2012; 7:e40305. [PMID: 22792272 PMCID: PMC3392249 DOI: 10.1371/journal.pone.0040305] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2012] [Accepted: 06/04/2012] [Indexed: 01/15/2023] Open
Abstract
Background Urinary biomarkers for bladder cancer detection are constrained by inadequate sensitivity or specificity. Here we evaluate the diagnostic accuracy of Mcm5, a novel cell cycle biomarker of aberrant growth, alone and in combination with NMP22. Methods 1677 consecutive patients under investigation for urinary tract malignancy were recruited to a prospective blinded observational study. All patients underwent ultrasound, intravenous urography, cystoscopy, urine culture and cytologic analysis. An immunofluorometric assay was used to measure Mcm5 levels in urine cell sediments. NMP22 urinary levels were determined with the FDA-approved NMP22® Test Kit. Results Genito-urinary tract cancers were identified in 210/1564 (13%) patients with an Mcm5 result and in 195/1396 (14%) patients with an NMP22 result. At the assay cut-point where sensitivity and specificity were equal, the Mcm5 test detected primary and recurrent bladder cancers with 69% sensitivity (95% confidence interval = 62–75%) and 93% negative predictive value (95% CI = 92–95%). The area under the receiver operating characteristic curve for Mcm5 was 0.75 (95% CI = 0.71–0.79) and 0.72 (95% CI = 0.67–0.77) for NMP22. Importantly, Mcm5 combined with NMP22 identified 95% (79/83; 95% CI = 88–99%) of potentially life threatening diagnoses (i.e. grade 3 or carcinoma in situ or stage ≥pT1) with high specificity (72%, 95% CI = 69–74%). Conclusions The Mcm5 immunoassay is a non-invasive test for identifying patients with urothelial cancers with similar accuracy to the FDA-approved NMP22 ELISA Test Kit. The combination of Mcm5 plus NMP22 improves the detection of UCC and identifies 95% of clinically significant disease. Trials of a commercially developed Mcm5 assay suitable for an end-user laboratory alongside NMP22 are required to assess their potential clinical utility in improving diagnostic and surveillance care pathways.
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Affiliation(s)
- John D. Kelly
- Department of Pathology and Cancer Institute, University College London, London, United Kingdom
| | - Tim J. Dudderidge
- Department of Pathology and Cancer Institute, University College London, London, United Kingdom
- The Royal Marsden National Health Service (NHS) Foundation Trust, London, United Kingdom
| | - Alex Wollenschlaeger
- Wolfson Institute for Biomedical Research, University College London, London, United Kingdom
- * E-mail: (AW)
| | - Odu Okoturo
- Department of Medicine, Imperial College London, London, United Kingdom
| | - Keith Burling
- Department of Clinical Biochemistry, Addenbrooke’s Hospital, University of Cambridge, Cambridge, United Kingdom
| | - Fiona Tulloch
- Department of Clinical Biochemistry, Addenbrooke’s Hospital, University of Cambridge, Cambridge, United Kingdom
| | - Ian Halsall
- Department of Clinical Biochemistry, Addenbrooke’s Hospital, University of Cambridge, Cambridge, United Kingdom
| | - Teresa Prevost
- Department of Public Health and Primary Care, Centre for Applied Medical Statistics, University of Cambridge, Institute of Public Health, Cambridge, United Kingdom
| | - Andrew Toby Prevost
- Department of Primary Care and Public Health Sciences, King’s College London, London, United Kingdom
| | - Joana C. Vasconcelos
- Department of Public Health and Primary Care, Centre for Applied Medical Statistics, University of Cambridge, Institute of Public Health, Cambridge, United Kingdom
| | - Wendy Robson
- Department of Urology, Freeman Hospital, Newcastle upon Tyne, United Kingdom
| | - Hing Y. Leung
- Beatson Institute for Cancer Research, University of Glasgow, Bearsden, Glasgow, United Kingdom
| | - Nikhil Vasdev
- Department of Urology, Freeman Hospital, Newcastle upon Tyne, United Kingdom
| | - Robert S. Pickard
- Department of Urology, Freeman Hospital, Newcastle upon Tyne, United Kingdom
| | - Gareth H. Williams
- Department of Pathology and Cancer Institute, University College London, London, United Kingdom
- Wolfson Institute for Biomedical Research, University College London, London, United Kingdom
- * E-mail: (AW)
| | - Kai Stoeber
- Department of Pathology and Cancer Institute, University College London, London, United Kingdom
- Wolfson Institute for Biomedical Research, University College London, London, United Kingdom
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Al-Maghrebi M, Kehinde EO, Kapila K, Anim JT. Urinary survivin mRNA expression and urinary nuclear matrix protein 22 BladderChek® and urine cytology in the detection of transitional cell carcinoma of the bladder. Med Princ Pract 2012; 21:295-7. [PMID: 22236881 DOI: 10.1159/000334811] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2011] [Accepted: 11/02/2011] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE To compare the diagnostic performance of urine cytology (UC), survivin mRNA expression, and the NMP22 BladderChek® (NMP22BC) test for the detection, grading and staging of transitional cell carcinoma (TCC) of the bladder. MATERIALS AND METHODS Voided urine samples collected from 25 healthy controls and 80 patients diagnosed with TCC of the bladder were subjected to UC, the NMP22BC test and reverse-transcription real-time PCR for survivin mRNA expression. RESULTS Survivin mRNA expression showed the highest sensitivity (87.5%) followed by the NMP22BC test (61.3%) while UC exhibited the lowest sensitivity (40%). All three urine markers had a similar specificity of 96% (95% CI 80.5-99.3%). Survivin mRNA expression was the only urine marker that showed a significant difference in relation to tumour histological grade (χ(2) 8.5, p = 0.015). None of the three urine markers was significantly related to tumour pathological stages. CONCLUSION The diagnostic sensitivity of urinary survivin mRNA expression was superior to that of UC and the NMP22BC test and correlates with tumour pathological grade but not stage.
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Affiliation(s)
- May Al-Maghrebi
- Department of Biochemistry, Faculty of Medicine, Kuwait University, Jabriya, Kuwait
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Hosseini J, Golshan AR, Mazloomfard MM, Mehrsai AR, Zargar MA, Ayati M, Shakeri S, Jasemi M, Kabiri M. Detection of recurrent bladder cancer: NMP22 test or urine cytology? Urol J 2012; 9:367-372. [PMID: 22395834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
PURPOSE To assess the accuracy of voided urine cytology versus urinary nuclear matrix protein 22 (NMP22) qualitative assay in the diagnosis of various grades and stages of recurrent bladder transitional cell carcinoma (TCC). MATERIALS AND METHODS From July 2007 to February 2009, all patients with history of superficial bladder TCC were included in this multi-center study. Each patient provided three serial voided urine samples for cytologic examination and one sample for the NMP22 qualitative assay prior to urethrocystoscopy. The sensitivity and specificity of urine cytology and the NMP22 test were determined. RESULTS The sensitivities of the NMP22 test and cytology for detection of recurrence were 78.8% and 44.2%, respectively (P = .001), while the specificities were 69.6% and 83.7%, respectively (P = .019). The NMP22 test showed significantly higher sensitivity than cytology in detecting recurrences in low-risk and intermediate-risk groups. CONCLUSION The NMP22 assay could be used for detection of superficial bladder cancer, especially in low- and intermediate-risk groups; however, the value of the test is limited by its low specificity.
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Affiliation(s)
- Jalil Hosseini
- Infertility and Reproductive Health Research Center, Reconstructive Urology, Shohada-e-Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Tyan YC, Yang MH, Chen SCJ, Jong SB, Chen WC, Yang YH, Chung TW, Liao PC. Urinary protein profiling by liquid chromatography/tandem mass spectrometry: ADAM28 is overexpressed in bladder transitional cell carcinoma. Rapid Commun Mass Spectrom 2011; 25:2851-2862. [PMID: 21913264 DOI: 10.1002/rcm.5169] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Bladder cancer is the most common urological cancer with higher incidence rate in the endemic areas of Blackfoot disease (BFD) in southern Taiwan. The aim of this study was to utilize the proteomic approach to establish urinary protein patterns of bladder cancer. The experimental results showed that most patients with bladder cancer had proteinuria or albuminuria. The urine arsenic concentrations of bladder cancer patients in BFD areas were significantly higher than those patients from non-BFD areas. In the proteomic analysis, the urinary proteome was identified by nano-high-performance liquid chromatography/electrospray ionization tandem mass spectrometry (nano-HPLC/ESI-MS/MS) followed by peptide fragmentation pattern analysis. We categorized 2782 unique proteins of which 89 proteins were identified with at least three unique matching peptide sequences. Among these 89 proteins, thirteen of them were not found in the control group and may represent proteins specific for bladder cancer. In this study, three proteins, SPINK5, ADAM28 and PTP1, were also confirmed by Western blotting and showed significant differential expression compared with the control group. ADAM28 may be used as a possible biomarker of bladder cancer.
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Affiliation(s)
- Yu-Chang Tyan
- Department of Medical Imaging and Radiological Sciences, Kaohsiung Medical University, Taiwan.
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Yang MH, Chu PY, Chen SCJ, Chung TW, Chen WC, Tan LB, Kan WC, Wang HY, Su SB, Tyan YC. Characterization of ADAM28 as a biomarker of bladder transitional cell carcinomas by urinary proteome analysis. Biochem Biophys Res Commun 2011; 411:714-20. [PMID: 21782798 DOI: 10.1016/j.bbrc.2011.07.010] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2011] [Accepted: 07/07/2011] [Indexed: 01/13/2023]
Abstract
Human urine contains a large number of proteins and peptides (the urinary proteome). Global analysis of the human urinary proteome is important for understanding urinary tract diseases. Bladder cancer is the most common urological cancer with higher incidence rates in endemic areas of Blackfoot disease (BFD) in southern Taiwan. The aim of this study was to use the proteomic approach to establish urinary protein biomarkers of bladder cancer. ADAM28, identified by proteomic approaches and confirmed by Western blotting, showed significant differences compared with normal individuals, so it may be a biomarker of bladder cancer.
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Affiliation(s)
- Ming-Hui Yang
- Department of Chemical and Material Engineering, National Yulin University of Science and Technology, Taiwan
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Gecks T, Junker K, Franz M, Richter P, Walther M, Voigt A, Neri D, Kosmehl H, Wunderlich H, Kiehntopf M, Berndt A. B domain containing Tenascin-C: a new urine marker for surveillance of patients with urothelial carcinoma of the urinary bladder? Clin Chim Acta 2011; 412:1931-6. [PMID: 21763295 DOI: 10.1016/j.cca.2011.06.038] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2011] [Revised: 06/26/2011] [Accepted: 06/26/2011] [Indexed: 11/18/2022]
Abstract
BACKGROUND ECM remodelling during tumorigenesis entails the re-occurrence of different Tn-C(L) splicing variants. In patients with urothelial carcinoma of the urinary bladder (UBC), B and C domain containing Tenascin-C (B(+) and C(+) Tn-C) urine levels were shown to be increased in case of muscle invasiveness. Thus, the present study was aimed at examining the ability of B(+) and C(+) Tn-C as potential urinary surveillance markers of UBC patients. METHODS Urine levels of B(+) and C(+) Tn-C were determined by ELISA in 35 UBC patients during a 2 year follow-up period after therapy and related to clinical diagnosis and histological stage in 4 defined groups representing typical courses of disease. RESULTS B(+) Tn-C levels showed significant differences between cases of tumour progression or regression. The urine levels of B(+) Tn-C could be used to discriminate between cases without tumour recurrence and such with tumour existence (cut-off value: 0.8 ng/ml) or between non-muscle invasive and muscle invasive tumour growth (cut-off value: 3.5 ng/ml). CONCLUSIONS Progression of UBC with time is accompanied by significant changes in urinary levels of B(+) Tn-C. Urinary B(+) Tn-C can therefore be suggested as a valuable urine surveillance marker in UBC follow-up care.
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Affiliation(s)
- T Gecks
- Institute of Pathology, University Hospital Jena, Germany
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Eissa S, Swellam M, Amin A, Balbaa ME, Yacout GA, El-Zayat TM. The clinical relevance of urine-based markers for diagnosis of bladder cancer. Med Oncol 2011; 28:513-8. [PMID: 21437743 DOI: 10.1007/s12032-010-9422-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2009] [Accepted: 01/06/2010] [Indexed: 02/07/2023]
Abstract
The aim of the present study was to evaluate the diagnostic relevance of urinary fibronectin (FN), telomerase (RTA), and cytokeratin 20 (CK20) mRNA in comparison with voided urine cytology (VUC). The study included 132 patients with bladder cancer, 60 patients with benign bladder lesions, and 48 healthy individuals. All were subjected to urine cytology, estimation of fibronectin by ELISA, RTA by TRAP, and CK20 mRNA by conventional RT-PCR in urothelial cells from voided urine. The best cutoff point for FN was determined by receiver operating characteristic curve (41.7 ng/mg protein) revealed the highest sensitivity for malignant (80%) followed by the benign (70%) than the healthy individuals (4.1%) at P < 0.001. Also, RTA and VUC showed significant difference among the three investigated groups (P < 0.001). The overall sensitivity (89.3%) and specificity (98.4%) were the highest for CK20 mRNA. Combined sensitivity of VUC with FN, RTA, and CK20 mRNA together (98.4%) was higher than either the combined sensitivity of VUC with any of them or than that of the biomarker alone. Accordingly, when the diagnostic efficacy was considered, CK20 mRNA had the highest sensitivity and specificity compared to all investigated markers.
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Affiliation(s)
- Sanaa Eissa
- Oncology Diagnostic Unit, Medical Biochemistry Department, Faculty of Medicine, Ain Shams University, Abbassia, Cairo, 11566, Egypt.
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Alguacil J, Kogevinas M, Silverman DT, Malats N, Real FX, García-Closas M, Tardón A, Rivas M, Torà M, García-Closas R, Serra C, Carrato A, Pfeiffer RM, Fortuny J, Samanic C, Rothman N. Urinary pH, cigarette smoking and bladder cancer risk. Carcinogenesis 2011; 32:843-7. [PMID: 21402590 DOI: 10.1093/carcin/bgr048] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Glucuronide conjugates of 4-aminobiphenyl and its N-hydroxy metabolite can be rapidly hydrolyzed in acidic urine to undergo further metabolic activation and form DNA adducts in the urothelium. We conducted a large multicenter case-control study in Spain to explore the etiology of bladder cancer and evaluated the association between urine pH and bladder cancer risk, alone and in combination with cigarette smoking. In total, 712 incident urothelial cell carcinoma cases and 611 hospital controls directly measured their urine pH with dipsticks twice a day (first void in the morning and early in the evening) during four consecutive days 2 weeks after hospital discharge. We found that a consistently acidic urine pH ≤6.0 was associated with an increased risk of bladder cancer [odds ratio (OR) = 1.5, 95% confidence interval (CI): 1.2-1.9] compared with all other subjects. Furthermore, risk estimates for smoking intensity and risk of bladder cancer among current smokers tended to be higher for those with a consistently acidic urine (OR = 8.8, 11.5 and 23.8) compared with those without (OR = 4.3, 7.7 and 5.8, respectively, for 1-19, 20-29 and 30+ cigarettes per day; P(interaction) for 30+ cigarettes per day = 0.024). These results suggest that urine pH, which is determined primarily by diet and body surface area, may be an important modifier of smoking and risk of bladder cancer.
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Affiliation(s)
- Juan Alguacil
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Department of Health and Human Services, Bethesda, MD 20892, USA.
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50
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Pal K, Roy S, Mondal SA, Chatterjee U, Tiwari P, Bera M. Urinary level of CA19-9 as a tumor marker in urothelial carcinoma of the bladder. Urol J 2011; 8:203-208. [PMID: 21910099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
PURPOSE To diagnose the urothelial carcinoma of the bladder by measuring CA19-9 level in the urine. MATERIALS AND METHODS This study was conducted on 47 patients with histopathologically confirmed urothelial cancer and 50 control subjects. The urinary level of CA19-9 was measured in both groups by enzyme-linked immunosorbent assay after concentration of urine with Bio-Gel dry beads. Urine cytology was also done in both controls and patients. RESULTS The mean urinary level of CA19-9 was 194.59 ± 110.56 u/mL in patients and 11.67 ± 8.42 u/mL in controls (P = .0001). The mean urinary level of CA19-9 in patients with low-grade and high-grade bladder cancer was 206.56 ± 114.56 u/mL and 174.80 ± 94.06 u/mL, respectively (P = .56). Urine cytology by Papanicolaou stain was mostly negative. CONCLUSION It can be concluded that CA19-9 may be a useful non-invasive test to diagnose the urothelial carcinoma of the bladder.
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Affiliation(s)
- Keya Pal
- Department of Biochemistry, IPGME & R, 244-AJC, Bose Road, Kolkata, 700020, West Bengal, India.
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