Clinical experience with survivin as a biomarker for urothelial bladder cancer
Clinical experience with survivin as a biomarker for urothelial bladder cancer
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DOI：
10.1007/s00345-010-0538-2
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发表时间：
2010-06-01
影响因子：
3.4
通讯作者：
Bruening, Thomas
中科院分区：
文献类型：
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作者：
Horstmann, Marcus;Bontrup, Heike;Bruening, Thomas
本研究是一项前瞻性的初步研究，以评估生存素mRNA测量的潜力，在患者怀疑为尿路上皮膀胱癌（BC）。我们还分析了继发性泌尿系统检查结果对Survivin测定的可能影响。在经尿道切除术前，对50例疑似新发或复发性BC的患者的排尿样本进行了Survivin mRNA测定。在49个案例中可以进行样本评价。组织学检查显示17例（35%）无恶性肿瘤，CT检查显示32例（65%）。通过实时PCR从离心的尿液样品的冷冻细胞团块定量Survivin mRNA。对生存素数据进行ROC分析，ROC分析确定了10，000 mRNA拷贝的最佳截断值，其敏感性为53%，特异性为88%。检测到20个pTa肿瘤中的7个（35%）、所有4个pT1（100%）和所有4个肌肉浸润性肿瘤（100%）。在4例原位癌（Cis）患者中，50%可被识别。只有两名患者（4%）被评估为假阳性。组织学证实的膀胱炎和伴随的泌尿系统检查结果（尿液中的炎性细胞，微量血尿等）对Survivin测量没有可检测的影响。在本组患者中，Survivin是高级别尿路上皮BC的可靠生物标志物（敏感性83%），但对于低级别尿路上皮BC（敏感性35%）则没有高特异性（88%）。未发现影响生存素测量结果的混杂因素。
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.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.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.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.