 |
|
Measuring certain enzyme activity in urine shows promise for detection of bladder cancer
October 26, 2005Measurement of an enzyme level (telomerase activity) in urine appears useful for detection of bladder cancer in men, according to a study in the October 26 issue of JAMA.
The incidence of human bladder cancer has greatly increased over the last few decades, with more than 60,000 new cases diagnosed each year in the United States alone, and now represents the 4th most common malignancy in men and the 10th most common in women, according to background information in the article. At present, about 20 percent of patients die each year, but when the disease is diagnosed and treated in the early stage, the chances of survival are good, indicating the importance of a timely and accurate diagnosis.
Established approaches for detecting bladder cancer are either invasive and costly or have limited sensitivity, highlighting the need for the development of a noninvasive, reliable, and simple test to increase the rate of detection of bladder cancer. Among the markers investigated for this purpose has been telomerase (a certain enzyme) activity in urine.
Maria Aurora Sanchini, M.Sc., of Morgagni-Pierantoni Hospital, Forlì, Italy, and colleagues conducted a study to define the diagnostic accuracy of different telomerase activity cutoff values in terms of sensitivity and specificity. The study included 218 men (84 healthy individuals and 134 patients at first diagnosis of histologically confirmed bladder cancer), recruited between March 2003 and November 2004 in Italy. Urine telomerase activity was determined using a highly sensitive telomeric repeat amplification protocol (TRAP) assay. Urine samples were processed for cytological (cell) diagnosis and TRAP assay. The diagnosis of bladder cancer was based on bioptic and cystoscopic examinations (direct visual examination of the urinary tract). The performance of the TRAP assay to detect urine telomerase activity was compared to urine cytology as an aid to early cancer detection.
Using a 50 arbitrary enzymatic unit (AEU) cutoff value, in the overall series, there was 90 percent sensitivity and 88 percent specificity. Specificity increased to 94 percent for individuals aged 75 years or younger. The same predictive capacity of telomerase activity levels was observed for patients with low-grade tumors or with negative cytology results. The sensitivity of urine telomerase activity in detecting bladder tumors was similar in the subgroups of patients with different tumor grades at all AEU cutoff values. In particular, at 50 AEUs the sensitivity was 93 percent, 87 percent, and 89 percent for grades 1, 2, and 3, respectively.
"The test we developed requires a small amount of urine; is noninvasive, inexpensive, and easy to perform; and permits a quantitative evaluation of telomerase activity in cellular extracts from urine. Furthermore, it is objective, reproducible, and specific and is not reliant on the expertise of the cytopathologist. Indeed, one important advantage of this test is its proven ability to also identify low-grade tumors, which often escape detection, thus largely contributing to false-negatives in cytologic examination," the researchers write.
"However, notwithstanding the validated optimal diagnostic accuracy of the test, it is not recommended for use in routine screening programs because of the low incidence of bladder cancer, and should be aimed at high-risk subgroups. Specifically, smokers have about a 3-fold increased risk of developing bladder cancer compared with nonsmokers," the authors add.
"In conclusion, we believe that our telomerase activity urine assay, with the reliability verified in pilot and confirmatory studies, represents a promising and potentially important contribution to the early diagnosis of bladder carcinoma, in particular for high-risk subgroups. Further prospective studies on larger patient populations are needed to assess the promising diagnostic role of urinary telomerase and to define the ability of this assay to detect low-grade tumors and disease recurrence before it becomes clinically evident, which is especially important in a tumor characterized by a high relapse rate."
JAMA and Archives Journals
Maria Aurora Sanchini, M.Sc., of Morgagni-Pierantoni Hospital, Forlì, Italy, and colleagues conducted a study to define the diagnostic accuracy of different telomerase activity cutoff values in terms of sensitivity and specificity. The study included 218 men (84 healthy individuals and 134 patients at first diagnosis of histologically confirmed bladder cancer), recruited between March 2003 and November 2004 in Italy. Urine telomerase activity was determined using a highly sensitive telomeric repeat amplification protocol (TRAP) assay. Urine samples were processed for cytological (cell) diagnosis and TRAP assay. The diagnosis of bladder cancer was based on bioptic and cystoscopic examinations (direct visual examination of the urinary tract). The performance of the TRAP assay to detect urine telomerase activity was compared to urine cytology as an aid to early cancer detection.
Using a 50 arbitrary enzymatic unit (AEU) cutoff value, in the overall series, there was 90 percent sensitivity and 88 percent specificity. Specificity increased to 94 percent for individuals aged 75 years or younger. The same predictive capacity of telomerase activity levels was observed for patients with low-grade tumors or with negative cytology results. The sensitivity of urine telomerase activity in detecting bladder tumors was similar in the subgroups of patients with different tumor grades at all AEU cutoff values. In particular, at 50 AEUs the sensitivity was 93 percent, 87 percent, and 89 percent for grades 1, 2, and 3, respectively.
"The test we developed requires a small amount of urine; is noninvasive, inexpensive, and easy to perform; and permits a quantitative evaluation of telomerase activity in cellular extracts from urine. Furthermore, it is objective, reproducible, and specific and is not reliant on the expertise of the cytopathologist. Indeed, one important advantage of this test is its proven ability to also identify low-grade tumors, which often escape detection, thus largely contributing to false-negatives in cytologic examination," the researchers write.
"However, notwithstanding the validated optimal diagnostic accuracy of the test, it is not recommended for use in routine screening programs because of the low incidence of bladder cancer, and should be aimed at high-risk subgroups. Specifically, smokers have about a 3-fold increased risk of developing bladder cancer compared with nonsmokers," the authors add.
"In conclusion, we believe that our telomerase activity urine assay, with the reliability verified in pilot and confirmatory studies, represents a promising and potentially important contribution to the early diagnosis of bladder carcinoma, in particular for high-risk subgroups. Further prospective studies on larger patient populations are needed to assess the promising diagnostic role of urinary telomerase and to define the ability of this assay to detect low-grade tumors and disease recurrence before it becomes clinically evident, which is especially important in a tumor characterized by a high relapse rate."
JAMA and Archives Journals
Bladder Cancer Current Events and Bladder Cancer News RSSPrediction model superior to traditional criteria in bladder treatment decision
A statistical model can accurately predict which patients will have poor outcomes after bladder surgery and can determine the need for chemotherapy.
Hopkins scientists find cells responsible for bladder cancer's spread
Johns Hopkins scientists have tracked down a powerful set of cells in bladder tumors that seem to be primarily responsible for the cancer's growth and spread using a technique that takes advantage of similarities between tumor and organ growth.
Variation in prostate stem cell antigen gene raises bladder cancer risk
Researchers have pinpointed a specific gene variation that causes increased risk of urinary bladder cancer, according to a scientific team led by The University of Texas M. D. Anderson Cancer Center.
UT Southwestern researchers investigate high-risk populations for bladder-cancer screenings
A new study by UT Southwestern Medical Center researchers sheds light on the challenges involved in identifying which high-risk population would benefit most from bladder-cancer screening.
DKK-3 and WIF-1: Proteins related to liver cancer development?
Liver cancer is one of the most fatal human malignancies and the third most frequent cause of tumor-related death, about half a million people globally each year.
Certain ecologic factors associated with greater risk of bladder cancer
Persons drinking well water (as opposed to public supply) may be at an increased risk of bladder cancer, according to new research from the University of Alabama at Birmingham. Researchers will present data about the relationship between bladder cancer and certain ecologic factors including water source and UV radiation levels at the 104th Annual Scientific Meeting of the American Urological Association (AUA).
Mayo Clinic researcher says improved detection of bladder tumors reduces cancer recurrence
Making tumors inside the bladder fluoresce red under blue light allows physicians to more easily find and remove them, substantially reducing the rate at which these cancers come back, says a Mayo Clinic physician who is presenting results of a large, multicenter international clinical trial.
Genetic Variants Predict Recurrence of Bladder Cancer, Patient Survival
Scientists at The University of Texas M. D. Anderson Cancer Center have discovered genetic variations in the inflammation pathway that reduce the likelihood of recurrence and increase survival of patients with non-muscle invasive bladder cancer (NMIBC) who are treated with mainstream therapy.
More intense bladder cancer treatment does not improve survival, U-M study finds
Despite enduring more invasive tests and medical procedures, patients who were treated aggressively for early stage bladder cancer had no better survival than patients who were treated less aggressively.
New Discovery Raises Doubts About Use of Certain Targeted Therapies in Bladder Cancer
Researchers at the University of Virginia Health System have found that one of the genes commonly thought to promote the growth and spread of some types of cancers is in fact beneficial in bladder cancer - a major discovery that could significantly alter the way bladder cancers are treated in the future.
More Bladder Cancer Current Events and Bladder Cancer News Articles
 |
Bladder Cancer: A Resource Guide for Patients and Their Families by Gary Dunetz (Author) If you, a loved one or friend has been diagnosed with bladder cancer, learning the basics is of utmost importance. It is essential to understand the nature of the disease, the work up and variety of treatments which are available. This book is comprehensive yet user friendly. It is written in a question and answer format in conversational tone. The physician author is a clinical urologist who has guided many individuals with bladder cancer through diagnosis and the various forms of treatment. This resource should enable those with bladder cancer and their family and friends to face this challenge with reason. After reading this book, you will be able to make an informed decision as you collaborate with your physician to regain your health. This book is written to allow the reader to have... |
 |
100 Questions & Answers About Bladder Cancer by Pamela Ellsworth (Author), Brett Carswell (Author) Approximately 62,000 people are diagnosed with bladder cancer each year, making bladder cancer the fourth most common type of cancer in men and the eighth most common type in women. Whether you're a newly diagnosed bladder cancer patient, a survivor, or a friend or relative of either, this book offers help. The only book to provide both the doctor's and patient's views, 100 Questions & Answers About Bladder Cancer gives you authoritative, practical answers to your questions about treatment options, post-treatment quality of life, coping strategies, sources of support, and much more. Written by two prominent urologists, with "insider" advice from actual patients, this book is an invaluable resource for anyone coping with the physical and emotional turmoil of this frightening disease. |
 |
Bladder Cancer (Cleveland Clinic Guide) by M D Raghavan (Author), Kathleen Tuthill (Author) Cancer that arises in the bladder is one of the most common malignancies in industrialized societies and yet is not well understood in the community at large. Bladder Cancer: A Cleveland Clinic Guide provides simple, non-medical explanations of this disease for people who have to deal with this illness, either as patients or as those who care for these patients. |
 |
The Guide to Living with Bladder Cancer by Dr. Mark P. Schoenberg MD FACS (Author) Johns Hopkins Univ., Baltimore, MD. Text for families and patients facing this disease. Discusses the structure and function of the urinary tract, an overview of bladder cancer and risk factors, symptoms, surgery, life after surgery, principles of chemotherapy, tests and diagnosis, and major surgical procedures. Hardcover, soft not available |
 |
Bladder Cancer Awareness Ribbon Mouse Pad by MyHeritageWear.com The Bladder Cancer Ribbon proudly displayed on a mouse pad. There is no better way to achieve awareness for the meaning of the Bladder Cancer Ribbon than to display it on your mouse pad for everyone to see. The mouse pad measures at 9.25 x 7.75, it is machine washable, and the colors will not fade or run. Start gaining awareness today by presenting your Bladder Cancer Ribbon mouse pad at work or at home. It is certain to keep your mouse rolling in style all while gaining support and awareness! |
 |
Fight Against Bladder Cancer T-shirt Large White by Shop Zeus |
 |
Fight Against Bladder Cancer Mug by Design a Product LLC Text on mug: Fight Against Bladder Cancer * Custom coffee mugs are dishwasher-safe and microwave-safe. Colors are permanently baked into the mug''s surface. * If you have new ideas or need help selecting text for your custom coffee mugs please contact us. * Size: 11 oz. capacity ceramic coffee mug. |
 |
Olympian Labs Prosplex For Men by Olympian Labs The prostate is a doughnut shaped gland located behind the pubic bone and below the bladder in males. It surrounds the neck of the bladder and the urethra, a small tubular structure that drains urine from the bladder to the penis. The prostate gland is a common site of Malfunction of mind or bodys in the male genitourinary system. As men age, their prostate gland often enlarges. This condition is referred to as Benign Prostate Hypertrophy or BPH. Over 50% of American men will develop an enlarged prostate in their lifetime. Dietary supplementation of nutrients essential for prostate health have been shown to be effective in the relief of BPH. |
 |
Treatment and Management of Bladder Cancer (with CD) by Seth P. Lerner (Editor), Mark Schoenberg (Editor), Cora Sternberg (Editor) Bladder cancer is an international public health problem affecting millions of people in both developed and underdeveloped nations. This major urologic malignancy was one of the first cancers to be linked to occupational and environmental exposure to carcinogens. Bladder cancer is the 5th most common cancer of American men and the 8th most common cancer of American women. Sixty thousand new cases of the disease are diagnosed each year in the US alone; disease prevalence is high in western nations due to the predominance of the chronic relapsing form of cancer that occurs in these countries (USA prevalence estimated to be 600,000; NCI-SEER database). This single fact makes bladder cancer one of the most expensive cancers to treat. Treatment and Management of Bladder Cancer, drawing on... |
 |
The Cleveland Clinic Guide to Bladder Cancer (Cleveland Clinic Guides) by Derek Raghavan (Author) Expert medical advice from the Chairman of the Cleveland Clinic Taussig Cancer Institute. Every year, 60,000 people are diagnosed with bladder cancer. If found early, bladder cancer is highly treatable,but it does have a high rate of recurrence. Staying informed is key for those facing a diagnosis as well as for those living with the disease. Dr. Derek Raghavan is one of the country’s leading experts in this field and, as the Chairman of the Cleveland Clinic Taussig Cancer Institute, he has access to the latest research and studies. In The Cleveland Clinic Guide to Bladder Cancer, he provides all of the essential information needed to understand and manage the challenges of bladder cancer. |
| © 2009 BrightSurf.com |