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Measurement of urinary protein can help detect recurrent bladder cancer
January 18, 2006Measurement of a certain protein in urine can increase the ability to detect bladder cancer recurrence, with test results available during the patient's visit, according to a study in the January 18 issue of JAMA.
Bladder cancer is the fifth most common malignancy in the United States, according to background information in the article. In 2005, there were an estimated 63,210 new cases and more than 13,000 deaths. There are 500,000 patients in the United States with a history of bladder cancer, making its prevalence higher than that of lung cancer. The probability of recurrence ranges from 50 percent to 90 percent, depending on stage, grade, and number of primary tumors. Consequently, rigorous surveillance is advocated. A combination of methods is used to monitor patients at risk of recurrent bladder cancer because no single procedure is 100 percent sensitive. Cystoscopy (visual examination of the bladder with a medical instrument) is a standard approach but can fail to detect some bladder cancers. Cytologic (cell) analysis of urine frequently is used as an adjunctive test, but can have poor sensitivity and variability in interpreting results.
H. Barton Grossman, M.D., of the M. D. Anderson Cancer Center, Houston, and colleagues investigated the clinical utility of a noninvasive urine test, which can be used in the physician's office, for the protein NMP22, as an aid in detecting recurrent cancer in patients with a history of bladder cancer. The researchers compared its usefulness with that of voided urine cytology, which must be analyzed in a clinical laboratory. The study, conducted from September 2001 to February 2002, included 23 academic, private practice, and hospital facilities in 9 U.S. states and enrolled 668 patients with a history of bladder cancer. Prior to undergoing cystoscopy, patients provided a urine sample for analysis of NMP22 protein and for cytology testing.
Bladder cancer was diagnosed in 103 patients. Cystoscopy alone identified 91.3 percent of the cancers. The combination of cystoscopy with the NMP22 assay detected 99.0 percent of the malignancies. The NMP22 assay detected 8 of 9 cancers that were not visualized during initial cystoscopy, including 7 that were high-grade. The sensitivity and specificity of the NMP22 test alone were 49.5 percent and 87.3 percent, respectively. Cytology based on voided urine detected only 3 of the malignancies missed during initial cystoscopy and did not significantly increase the sensitivity of cystoscopy (94.2 percent).
The authors conclude, "When combined with cystoscopy, the NMP22 test improves the detection of recurrence in patients with a history of bladder cancer."
JAMA and Archives Journals
Bladder cancer was diagnosed in 103 patients. Cystoscopy alone identified 91.3 percent of the cancers. The combination of cystoscopy with the NMP22 assay detected 99.0 percent of the malignancies. The NMP22 assay detected 8 of 9 cancers that were not visualized during initial cystoscopy, including 7 that were high-grade. The sensitivity and specificity of the NMP22 test alone were 49.5 percent and 87.3 percent, respectively. Cytology based on voided urine detected only 3 of the malignancies missed during initial cystoscopy and did not significantly increase the sensitivity of cystoscopy (94.2 percent).
The authors conclude, "When combined with cystoscopy, the NMP22 test improves the detection of recurrence in patients with a history of bladder cancer."
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.
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Fight Against Bladder Cancer T-shirt Large White by Shop Zeus |
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