Premium
Microsatellite analysis—DNA test in urine competes with cystoscopy in follow‐up of superficial bladder carcinoma
Author(s) -
van Rhijn Bas W. G.,
Lurkin Irene,
Kirkels Wim J.,
van der Kwast Theodorus H.,
Zwarthoff Ellen C.
Publication year - 2001
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(20010815)92:4<768::aid-cncr1381>3.0.co;2-c
Subject(s) - cystoscopy , medicine , urine , bladder cancer , urine cytology , carcinoma , urology , cytology , urinary bladder , urinary system , cancer , pathology
BACKGROUND It has been shown that microsatellite analysis (MA) is able to detect bladder carcinoma in urine. Relatively small groups of patients often with high stage and grade disease were investigated. However, greater than 85% of cystoscopies are performed for follow‐up of superficial bladder carcinoma. The authors evaluated this DNA‐based method in a group of consecutive patients in follow‐up after transurethral resection of superficial disease. METHODS Matched blood and urine samples from 109 patients were obtained before cystoscopy and subjected to MA. The BTA stat test (Bard Diagnostic Sciences, Inc., Redmond, WA) and cytology were used for comparison. RESULTS Sixteen patients were excluded: the DNA was of insufficient quality for 7 patients and leukocyte abundance rendered the result of MA unreliable for 9 patients. For the remaining 93 patients, MA detected 18 of the 24 recurrent tumors. The six undetected tumors were small pTaG1 lesions for which immediate surgery was not necessary. Conversely, 5 of 9 patients with a positive MA and a negative cystoscopy had a tumor recurrence within 6 months after urine collection. In contrast, a recurrence occurred in only 7 of 60 patients who were negative in both MA and cystoscopy ( P = 0.006). The MA (74%) appeared more sensitive than the BTA stat test (56%) or urine cytology (22%). CONCLUSIONS Microsatellite analysis is a DNA test in urine that reliably signals the presence of recurrent bladder carcinoma, sometimes even before cystoscopic evidence of the disease. This noninvasive diagnostic tool has the potential to replace cystoscopy in many cases. The authors' results warrant the need for randomized trials. Cancer 2001;92:768–75. © 2001 American Cancer Society.