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Diagnostic and Prognostic Performance of Secreted Protein Acidic and Rich in Cysteine (SPARC) Assay for Detecting Primary and Recurrent Urinary Bladder Cancer
Author(s) -
Critselis Elena,
Rava Marta,
Marquez Mirari,
Lygirou Vasiliki,
Chatzicharalambous Despoina,
Liapi Panagiota,
Lichtinghagen Ralph,
Brand Korbinian,
Cecchini Lluís,
Vlahou Antonia,
Malats Nuria,
Zoidakis Jerome
Publication year - 2019
Publication title -
proteomics – clinical applications
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.948
H-Index - 54
eISSN - 1862-8354
pISSN - 1862-8346
DOI - 10.1002/prca.201800148
Subject(s) - medicine , bladder cancer , urinary system , cohort , cancer , oncology , urology , tumor progression , disease , cohort study , gastroenterology
Purpose To evaluate the diagnostic and prognostic performance of Secreted Protein Acidic and Rich in Cysteine (SPARC) in detecting urinary bladder cancer (UBC). Methods The Integrated Study on Bladder Cancer ( n = 571; mean age:69.4 ± 12.2 years) evaluates cross‐sectionally SPARC diagnostic performance in primary ( n = 264) and recurrent ( n = 307) UBC. SPARC prognostic performance is evaluated in a nested cohort ( n = 250) prospectively followed for 80 months to detect tumor relapse, recurrence and/or progression. Baseline urine samples are analyzed blindly using a commercially available SPARC ELISA assay, characterized for its analytical performance according to clinical test regulatory requirements (R&D Manufactures Inc.). Results While higher mean SPARC levels are detected in primary ( p = 0.008) and recurrent ( p < 0.0001) UBC, the assay has limited diagnostic performance (AUC:0.593; 95% CI:0.524‐0.663). SPARC positive patients undergoing disease monitoring are more likely to develop tumor relapse (age and gender Adj. HR:1.52; 95% CI:1.04‐2.22) and progression (Adj. HR:1.83; 95% CI:1.02–3.27). However, prognostic performance is affected by hematuria. Conclusions SPARC diagnostic performance for detecting UBC appears insufficient for clinical implementation. In patients undergoing disease monitoring, SPARC is a promising prognostic marker for tumor relapse and/or progression, but is affected by hematuria.