Clinical usefulness of the novel marker BLCA-4 for the detection of bladder cancer.
OBJECTIVE
Previous studies at our laboratory identified 6 bladder cancer specific nuclear matrix proteins termed BLCA-1 to 6. We recently developed an immunoassay that detects the bladder cancer specific nuclear matrix protein BLCA-4. We analyzed urine samples from patients with bladder cancer, those with spinal cord injury and normal volunteers to determine the BLCA-4 level in these 3 groups.


METHODS
Urine samples obtained from 51 normal controls, and 54 patients with bladder cancer and 202 with spinal cord injury were tested for BLCA-4. We evaluated the association of BLCA-4 level with tumor grade and stage, urine cytology and bladder cancer history in the nonspinal cord injured population. Similarly we compared parameters associated with BLCA-4, such as spinal cord injury duration, catheterization, history of urinary tract infection, smoking and urine culture, in spinal cord injured patients.


RESULTS
We established a normal cutoff point of 13 optical density units per microg. protein for the BLCA-4 assay. The BLCA-4 level was less than the cutoff in all 51 normal controls, while in 53 of the 55 urine samples (96.4%) of patients with bladder cancer and 38 of the 202 (19%) of spinal cord injured patients urinary BLCA-4 was greater than the cutoff. There was no correlation of any individual factors studied in these cases, including urinary tract infection and urinary BLCA-4.


CONCLUSIONS
Elevated urinary BLCA-4 levels may accurately identify bladder cancer and distinguish these patients from normal individuals. There is no correlation of urinary BLCA-4 with a history of urinary tract infection, smoking, catheterization or cystitis considered independently. Urinary BLCA-4 determination appears to have high potential as a test for screening and monitoring bladder cancer in the general population and in groups at high risk for the disease, such as those with spinal cord injury.
Konety
B R
BR
Department of Urology, Pathology and Pharmacology, University of Pittsburgh Medical Center, Rehabilitation Hospital, PA, USA.
Nguyen
T S
TS
Brenes
G
G
Sholder
A
A
Lewis
N
N
Bastacky
S
S
Potter
D M
DM
Getzenberg
R H
RH
D000328:Adult; D034961:Antigens, Nuclear; D014408:Biomarkers, Tumor / Q000652:urine*; D003556:Cystitis / Q000652:urine; D004268:DNA-Binding Proteins / Q000652:urine*; D006801:Humans; D008875:Middle Aged; D009363:Neoplasm Proteins / Q000652:urine*; D009367:Neoplasm Staging; D009687:Nuclear Proteins / Q000652:urine*; D011237:Predictive Value of Tests; D011507:Proteinuria / Q000652:urine; D012044:Regression Analysis; D012907:Smoking / Q000652:urine; D013119:Spinal Cord Injuries / Q000652:urine; D013997:Time Factors; D001749:Urinary Bladder Neoplasms / Q000473:pathology / Q000652:urine*; D014546:Urinary Catheterization; D014552:Urinary Tract Infections / Q000652:urine
D034961:Antigens, Nuclear; C413062:BLCA-4 protein, human; D014408:Biomarkers, Tumor; D004268:DNA-Binding Proteins; D009363:Neoplasm Proteins; D009687:Nuclear Proteins