Diagnostic value of fibronectin and mutant p53 in the urine of patients with bladder cancer: impact on clinicopathological features and disease recurrence

Med Oncol. 2010 Dec;27(4):1286-94. doi: 10.1007/s12032-009-9375-9. Epub 2009 Dec 11.

Abstract

Development of new methods for bladder cancer detection is required because cystoscopy is invasive, and voided urine cytology (VUC) has low sensitivity. The aim of this study was to evaluate the diagnostic performance of urinary fibronectin and mutant p53 in comparison with VUC in the detection of bladder cancer. This study included 100 patients diagnosed with bladder cancer, 93 patients with benign urological disorders and 47 healthy volunteers. The urine supernatant was used for determination of fibronectin by ELISA, while urine sediment was used for cytology and detection of mutant p53 by PCR-SSCP followed by DNA sequencing. The sensitivity and specificity were 59% and 91.4% for VUC, 82% and 84.3% for fibronectin, and 37% and 100% for mutant p53; combination of the three parameters increased sensitivity to 95% but specificity was only 78.6%. A significant association was observed between disease recurrence and mutant p53, stage and lymph node involvement. Our results indicate that fibronectin had the highest sensitivity compared to VUC and mutant p53 in bladder cancer detection; however, mutant p53 had superior specificity compared to VUC and fibronectin. Mutant p53 is associated with disease recurrence and hence it has a significant prognostic role in bladder cancer.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adenocarcinoma / diagnosis*
  • Adenocarcinoma / genetics
  • Adenocarcinoma / urine
  • Adult
  • Aged
  • Animals
  • Biomarkers, Tumor / genetics
  • Biomarkers, Tumor / urine
  • Carcinoma, Squamous Cell / diagnosis*
  • Carcinoma, Squamous Cell / genetics
  • Carcinoma, Squamous Cell / urine
  • Carcinoma, Transitional Cell / diagnosis*
  • Carcinoma, Transitional Cell / genetics
  • Carcinoma, Transitional Cell / urine
  • Case-Control Studies
  • Cystoscopy
  • Female
  • Fibronectins / urine*
  • Follow-Up Studies
  • Humans
  • Immunoenzyme Techniques
  • Lymphatic Metastasis
  • Male
  • Middle Aged
  • Mutation / genetics*
  • Neoplasm Recurrence, Local / diagnosis
  • Neoplasm Recurrence, Local / genetics
  • Neoplasm Recurrence, Local / urine
  • Neoplasm Staging
  • Polymerase Chain Reaction
  • Prognosis
  • ROC Curve
  • Schistosoma mansoni / pathogenicity
  • Schistosomiasis / diagnosis
  • Schistosomiasis / genetics
  • Schistosomiasis / urine
  • Sensitivity and Specificity
  • Survival Rate
  • Tumor Suppressor Protein p53 / genetics*
  • Urinary Bladder / metabolism
  • Urinary Bladder / pathology
  • Urinary Bladder Neoplasms / diagnosis*
  • Urinary Bladder Neoplasms / genetics
  • Urinary Bladder Neoplasms / urine

Substances

  • Biomarkers, Tumor
  • Fibronectins
  • TP53 protein, human
  • Tumor Suppressor Protein p53