title: Non-invasive molecular detection of bladder cancer recurrence.
abstract: Transitional cell carcinoma (TCC) is the most common bladder tumor and approximately 90% of bladder TCC are superficial at initial diagnosis. High recurrence rate and possible progression to muscle invasive disease that is eventually indicated for radical cystectomy are established features of these tumors. Therefore, reliable predictors of tumor recurrence are of critical importance for management of superficial bladder TCC. Successful molecular diagnosis of bladder cancer by detecting genetic lesions: loss of heterozygosity (LOH) or microsatellite instability (MSI) in cells exfoliated in urine has been reported by several groups including ours. The aim of our study was to evaluate the predictive potential of microsatellite analysis of cells exfoliated in urine in the detection of superficial bladder TCC recurrence. We studied 47 Caucasian patients with confirmed superficial bladder TCC (37 pTa, 10 pT1) at initial diagnosis. Blood samples were obtained once from every patient whereas urine samples were collected before each cystoscopy (initial and follow-up). Matched DNAs from blood and urine were subjected to microsatellite analysis in a blinded fashion. The follow-up period ranged 12-48 months after tumor resection. Microsatellite analysis correctly identified 94% (44/47) of primary tumors and 92% (12/13) of tumor recurrences. Interestingly enough, 75% (9/12) of tumor recurrences were molecularly detected 1-9 months before cystoscopic evidence of recurrent disease. This study demonstrated clearly that not only urine microsatellite analysis reliably detected superficial bladder tumors, but also was a reliable test for detecting and predicting tumor recurrence in Caucasian patients. These results warrant multicenter randomized trials.
authors.affiliation: Unité d'Oncologie Moléculaire des Tumeurs Solides, Département de Biologie Hormonale, Centre Hospitalier Universitaire Saint Louis, Paris, France.
authors.forename: Najla
authors.initials: N
authors.lastname: Amira
authors.forename: Samia
authors.initials: S
authors.lastname: Mourah
authors.forename: François
authors.initials: F
authors.lastname: Rozet
authors.forename: Pierre
authors.initials: P
authors.lastname: Teillac
authors.forename: Jean
authors.initials: J
authors.lastname: Fiet
authors.forename: Philippe
authors.initials: P
authors.lastname: Aubin
authors.forename: Ariane
authors.initials: A
authors.lastname: Cortesse
authors.forename: François
authors.initials: F
authors.lastname: Desgrandchamps
authors.forename: Alain
authors.initials: A
authors.lastname: Le Duc
authors.forename: Olivier
authors.initials: O
authors.lastname: Cussenot
authors.forename: Hany
authors.initials: H
authors.lastname: Soliman
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002295:Carcinoma, Transitional Cell / Q000097:blood / Q000175:diagnosis / Q000652:urine*; D004273:DNA, Neoplasm / Q000032:analysis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D019656:Loss of Heterozygosity; D008297:Male; D018895:Microsatellite Repeats; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000097:blood / Q000175:diagnosis / Q000652:urine*; D001749:Urinary Bladder Neoplasms / Q000097:blood / Q000175:diagnosis / Q000235:genetics / Q000652:urine*; D014556:Urine / Q000166:cytology*
chemical_list: D004273:DNA, Neoplasm