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Articles |
1
Department of Urology, College of Physicians and Surgeons of Columbia University, New York, NY 10032.
2
Department of Urology, Heinrich-Heine-Universitaet,
40225 Dusseldorf, Germany.
a Address correspondence to this author at: Department of Urology, Columbia-Presbyterian Medical Center, Atchley Pavilion, 11th Floor, 161 Fort Washington Ave., New York, NY 10032. Fax 212-305-0106; e-mail iss1{at}columbia.edu
Background: Transitional cell carcinoma of the bladder (TCC) is the second most common malignancy of the urinary tract. More than 70% of treated tumors recur, and 30% of recurrent tumors progress. Currently, pathologic staging and grading are valuable prognostic factors for detecting and monitoring TCC. Urinalysis, cystoscopy, and cytology are either invasive or lack sensitivity and specificity. The availability of a noninvasive, reliable, and simple test would greatly improve the detection and monitoring of patients with TCC. Several biomarkers for bladder cancer have been proposed, but no single marker has emerged as the test of choice.
Approach: We undertook a comprehensive literature search using Medline to identify all publications from 1980 to 1999. Articles that discussed potential biomarkers for TCC were screened. Only compounds that demonstrated high sensitivity or specificity, significant correlation with TCC diagnosis and staging, and extensive investigation were included in this review.
Content: Potential biomarkers of disease progression and prognosis include nuclear matrix protein, fibrin/fibrinogen product, bladder tumor antigen, blood group-related antigens, tumor-associated antigens, proliferating antigens, oncogenes, growth factors, cell adhesion molecules, and cell cycle regulatory proteins. The properties of the biomarkers and the methods for detecting or quantifying them are presented. Their sensitivities and specificities for detecting and monitoring disease were 54–100% and 61–97%, respectively, compared with 20–40% and 90% for urinalysis and cytology.
Summary: Although urine cytology and cystoscopy are still the standard of practice, many candidate biomarkers for TCC are emerging and being adopted into clinical practice. Further research and better understanding of the biology of bladder cancer, improved diagnostic techniques, and standardized interpretation are essential steps to develop reliable biomarkers. It is possible that using the current biomarkers as an adjuvant modality will improve our ability to diagnose and monitor bladder cancer.
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 K. Stoeber, R. Swinn, A. T. Prevost, P. de Clive-Lowe, I. Halsall, S. M. Dilworth, J. Marr, W. H. Turner, N. Bullock, A. Doble, et al. Diagnosis of Genito-Urinary Tract Cancer by Detection of Minichromosome Maintenance 5 Protein in Urine Sediments J Natl Cancer Inst, July 17, 2002; 94(14): 1071 - 1079. [Abstract] [Full Text] [PDF]
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S. Gerhards, F. Koenig, D. Daniltchenko, S. Hauptmann, D. Schnorr, and S. A. Loening Correspondence re: C. F. M. Sier et al., Enhanced Urinary Gelatinase Activities (Matrix Metalloproteinases 2 and 9) Are Associated with Early-Stage Bladder Carcinoma: A Comparison with Clinically Used Tumor Markers. Clin. Cancer Res., 6: 2333-2340, 2000. Clin. Cancer Res., February 1, 2001; 7(2): 445 - 446. [Full Text]
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