World journal of urology · 2010
Clinical experience with survivin as a biomarker for urothelial bladder cancer.
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Horstmann Marcus, Bontrup Heike, Hennenlotter Jörg, Taeger Dirk, Weber Anne, Pesch Beate, Feil Gerhard, Patschan Oliver, Johnen Georg, Stenzl Arnulf, Brüning Thomas
Аннотация
OBJECTIVES: This study was carried out as a prospective pilot study to evaluate the potential of survivin mRNA measurement in patients suspicious for urothelial bladder cancer (BC). Data were also analyzed for possible influences of secondary urological findings on survivin measurements.
METHODS: Survivin was measured by an mRNA assay in voided urine samples of 50 patients with suspicion of new or recurrent BC prior to transurethral resection. Sample evaluation was possible in 49 cases. Histopathology revealed no malignancy in 17 (35%) and BC in 32 (65%) patients. Survivin mRNA was quantitated by real-time PCR from frozen cell pellets of centrifuged urine samples. A ROC analysis of the survivin data was performed.
RESULTS: ROC analysis identified the best cut-off level at 10,000 mRNA copies, resulting in a sensitivity of 53% and a specificity of 88%. Seven of the 20 pTa tumors (35%), all four pT1 (100%) and all four muscle-invasive tumors (100%) were detected. Of four patients with carcinoma in situ (Cis), 50% could be identified. Only two patients (4%) were assessed as false positive. Histologically confirmed cystitis and concomitant urological findings (inflammatory cells in urine, microhematuria and others) had no detectable influence on survivin measurements.
CONCLUSION: In present group of patients, survivin was a reliable biomarker for high-grade urothelial BC (sensitivity 83%), but not for low grade (sensitivity 35%) urothelial BC with a high specificity (88%). No confounders influencing the results of survivin measurements could be identified.
METHODS: Survivin was measured by an mRNA assay in voided urine samples of 50 patients with suspicion of new or recurrent BC prior to transurethral resection. Sample evaluation was possible in 49 cases. Histopathology revealed no malignancy in 17 (35%) and BC in 32 (65%) patients. Survivin mRNA was quantitated by real-time PCR from frozen cell pellets of centrifuged urine samples. A ROC analysis of the survivin data was performed.
RESULTS: ROC analysis identified the best cut-off level at 10,000 mRNA copies, resulting in a sensitivity of 53% and a specificity of 88%. Seven of the 20 pTa tumors (35%), all four pT1 (100%) and all four muscle-invasive tumors (100%) were detected. Of four patients with carcinoma in situ (Cis), 50% could be identified. Only two patients (4%) were assessed as false positive. Histologically confirmed cystitis and concomitant urological findings (inflammatory cells in urine, microhematuria and others) had no detectable influence on survivin measurements.
CONCLUSION: In present group of patients, survivin was a reliable biomarker for high-grade urothelial BC (sensitivity 83%), but not for low grade (sensitivity 35%) urothelial BC with a high specificity (88%). No confounders influencing the results of survivin measurements could be identified.
Предметные рубрики MeSH
Age FactorsAgedAged, 80 and overBiomarkers, TumorCarcinoma in SituCarcinoma, Transitional CellFalse Positive ReactionsFemaleHumansInhibitor of Apoptosis ProteinsMaleMicrotubule-Associated ProteinsMiddle AgedNeoplasm Recurrence, LocalNeoplasm StagingPilot ProjectsPrognosisProspective StudiesRNA, MessengerROC CurveRisk AssessmentSensitivity and SpecificitySex FactorsSurvival AnalysisSurvivinUltrasonographyUrinary Bladder Neoplasms