Detection of Newly Diagnosed Bladder Cancer, Bladder Cancer Recurrence and Bladder Cancer in Patients with Hematuria Using Quantitative RT-PCR of Urinary Survivin

Abstract

Background/Aims: Survivin mRNA in urine was measured to detect newly diagnosed bladder cancer, bladder cancer recurrence and bladder cancer in patients with hematuria. Methods: We have investigated urinary survivin mRNA of 118 voided urine specimens, including 24 patients with bladder cancer, 50 with bladder cancer history, 68 not known to harbor bladder cancer, and 55 with hematuria using quantitative reverse transcriptase polymerase chain reaction. β-Actin mRNA expression was also examined and used as an endogenous control to ensure validity of the assay for each sample. Results: The survivin expression in urological patient urine had sensitivities and specificities for all patients of 79 and 93%, for detection of newly diagnosed bladder cancer 83 and 95%, for bladder cancer recurrence 82 and 90%, and for bladder cancer in patients with hematuria 80 and 90%. Conclusion: Our results indicate that quantitative reverse transcriptase polymerase chain reaction of urinary survivin is a sensitive, noninvasive and highly specific assay to detect both newly diagnosed bladder cancer and bladder cancer recurrence. Furthermore, this assay may be useful in stratifying the hematuria population in urological practice.

Survivin Expression as a Predictive Marker for Local Control in Patients With High-Risk T1 Bladder Cancer Treated With Transurethral Resection and Radiochemotherapy

“…Several studies on survivin expression in urinary samples confirmed the potential value of this protein as sensitive marker for early, noninvasive detection of bladder carcinoma (24)(25)(26)(27)(28). In addition, some groups reported a significant association of survivin expression with higher tumor grade and stage, in urinary samples or tissue specimens (24,(29)(30)(31).…”

Survivin: Key Regulator of Mitosis and Apoptosis and Novel Target for Cancer Therapeutics

“…In the same study, survivin expression correlated with disease recurrence and disease-specific mortality, suggesting that survivin expression may represent a diagnosis marker of occult malignancy. Indeed, the detection of urinary survivin by immunochemistry or reverse transcription-PCR seems to be a promising assay to detect both newly diagnosed and recurrent bladder cancer (62,63). Finally, survivin overexpression may be a predictive factor to determine response to chemotherapy and radiotherapy in patients with bladder cancer (64), breast cancer (65), multiple myeloma (66), and lymphoma (67 -69).…”

National Academy of Clinical Biochemistry Laboratory Medicine Practice Guidelines for Use of Tumor Markers in Liver, Bladder, Cervical, and Gastric Cancers

“…Survivin expression can be detected in all bladder cancer tissues, but not in normal urothelium specimens (292,293 ). The expression patterns of survivin in patients with bladder cancer can be examined in urine, as can the diagnostic potential of RT-PCR detection of survivin mRNA (294,295 ). Smith et al have developed a polyclonal semiquantitative immunoassay to assess the role of survivin as a urine marker for bladder cancer (291 ).…”