A side by side comparison of cytology and biomarkers for bladder cancer detection.

Abstract

PURPOSE:

The identification of accurate bladder tumor markers/tests could improve diagnosis, recurrence monitoring and treatment in patients with bladder cancer. In this study we compared the efficacy of the hyaluronic acid (HA)-hyaluronidase (HAase), BTA-Stat (Bard/Bion Diagnostics, Redmond, Washington), Hemastix (Bayer Corp., Elkhart, Indiana) (hematuria detection) and UBC-Rapid (IDL Biotech, Borlänger, Sweden) tests, and cytology to detect bladder cancer. The HA-HAase test measures urinary HA and HAase levels, BTA-Stat detects complement factor-H and H related protein in urine, the Hemastix hemoglobin dipstick detects hematuria and UBC-Rapid detects cytokeratin 8 and 18 fragments in urine.

MATERIALS AND METHODS:

A total of 138 urine specimens from 115 patients were collected at University Hospital Hamburg-Eppendorf, including 59 with active bladder cancer and 79 with a history of bladder cancer (73) or with benign genitourinary conditions (6). Specimens were assayed by the HA-HAase test, BTA-Stat, Hemastix (hemoglobin dipstick) and UBC-Rapid. Cystoscopy and histological findings were used to make the clinical diagnosis. Cytology results were available on 92 patients.

RESULTS:

In a side by side comparison the HA-HAase test, cytology, BTA-Stat, Hemastix and UBC-Rapid had 88.1%, 70.6%, 52.5%, 50.8% and 35.6% sensitivity, and 81%, 81%, 76.7%, 78.2% and 75% specificity, respectively. The accuracy, and negative and positive predictive values of the HA-HAase test were the highest (84.1%, 90.1% and 77.6%), followed by cytology (77.2%, 82.5% and 68.6%), Hemastix (66.4%, 67.8% and 63.8%), BTA-Stat (66.2%, 67.8% and 63.3%) and UBC-Rapid (57.8%, 60% and 52.5%), respectively.

CONCLUSIONS:

: The HA-HAase test is superior to cytology, BTA-Stat, Hemastix and UBC-Rapid for detecting bladder cancer recurrence. A side-by-side comparison of tumor markers should help identify a marker for monitoring bladder cancer recurrence.

• Authors: Grethchen L Schroeder, Maria-Fernanda Lorenzo-Gomez, Stefan H Hautmann, Martin G Friedrich, Sinan Ekici, Hartwig Huland, Vinata Lokeshwar
• Journal: The Journal of urology (J Urol) Vol. 172 Issue 3 Pg. 1123-6 (Sep 2004) ISSN: 0022-5347 [Print] United States
• PMID: 15311054 (Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't, Research Support, U.S. Gov't, P.H.S.)

Chemical References

• Biomarkers
• Reagent Kits, Diagnostic

Topics

• Adult
• Aged
• Aged, 80 and over
• Biomarkers (analysis)
• Cytodiagnosis
• Female
• Humans
• Male
• Middle Aged
• Predictive Value of Tests
• Reagent Kits, Diagnostic
• Sensitivity and Specificity
• Urinary Bladder Neoplasms (diagnosis)