Detection of bladder carcinoma by combined testing of urine for hyaluronidase and cytokeratin 20 RNAs

BACKGROUND A new, sensitive, noninvasive method for the detection of urothelial carcinomas of the urinary bladder would open new possibilities in both the diagnosis and followup of patients. METHODS This study included 228 patients diagnosed with bladder carcinoma, 68 patients with benign bladder le...

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Bibliographic Details
Published in:Cancer 2005-04, Vol.103 (7), p.1356-1362
Main Authors: Eissa, Sanaa, Kassim, Samar K., Labib, Randa Ali, El‐Khouly, Inas M., Ghaffer, Taghreed M., Sadek, Mohamed, Razek, Omar Abdel, El‐Ahmady, Omar
Format: Article
Language:English
Subjects:
Adult
Aged
bilharziasis
Biological and medical sciences
Biomarkers, Tumor - urine
bladder carcinoma
CK‐20
cytology
Female
HAase
Humans
Hyaluronoglucosaminidase - urine
Intermediate Filament Proteins - urine
Keratin-20
Male
Medical sciences
Middle Aged
Nephrology. Urinary tract diseases
Prospective Studies
Reverse Transcriptase Polymerase Chain Reaction
RNA - urine
Sensitivity and Specificity
Tumors
Tumors of the urinary system
Urinary Bladder Neoplasms - urine
urinary markers
Urinary tract. Prostate gland
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Summary:BACKGROUND A new, sensitive, noninvasive method for the detection of urothelial carcinomas of the urinary bladder would open new possibilities in both the diagnosis and followup of patients. METHODS This study included 228 patients diagnosed with bladder carcinoma, 68 patients with benign bladder lesions, and 44 healthy persons served as the control group. All were subjected to: serologic schistosomiasis antibody assay in serum, urine cytology, estimation of urine hyaluronic acid (HA) by enzyme‐linked immunosorbent assay, and detection of CK‐20 and hyaluronidase (HAase) by reverse transcription polymerase chain reaction (RT‐PCR) in urothelial cells from voided urine. RESULTS HA mean rank was higher in benign and malignant groups than in the healthy group (P < 0.0001) and was significantly related to tumor grade (P = 0.021). HA best‐cutoff, determined using receiver operating characteristic curve to discriminate between malignant and nonmalignant groups, was 58.5 units/mg protein at 85.8% sensitivity and 60.7% specificity. HAase RNA showed superior sensitivity (90.8%) over cytology (68.9%) and CK‐20 (78.1%) with specificity of 93.4%, 98.1% and 80.2%, respectively. The sensitivity reached 94.7% at a specificity of 91.5% when combined with CK‐20. All 4 of the investigated markers were related to grade at P
ISSN:0008-543X
1097-0142
DOI:10.1002/cncr.20902