title: Urinary levels of soluble e-cadherin in the detection of transitional cell carcinoma of the urinary bladder.
abstract: OBJECTIVE
  To test the hypothesis that elevated urinary levels of soluble E-cadherin (sE-cadherin) would aid in the detection of transitional cell carcinoma (TCC) of the urinary bladder.
  
  
  METHODS
  We performed sE-cadherin staining of one murine (MBT2) and four human (RT4, 5637, T24, and TCCSUP) bladder cancer cell lines. sE-cadherin levels were also determined in voided urine of 188 consecutive subjects at risk for TCC recurrence, 31 patients with other uro-pathologic conditions, and 10 healthy subjects using a commercially-available ELISA kit. sE-cadherin was analyzed continuously and categorically on the basis of its median distribution.
  
  
  RESULTS
  Moderately and poorly differentiated bladder cancer cell lines had decreased cellular E-cadherin expression, whereas RT4, a well differentiated cell line, had preserved expression. All cell lines had measurable sE-cadherin levels in their conditioned media. The area under the ROC curve of sE-cadherin for the detection of TCC was 0.719 (95%CI, 0.637-0.801; p<0.001). Higher levels of sE-cadherin were associated with positive cytology results (p=0.012) and muscle invasive tumor stage (p=0.009). Urinary sE-cadherin was more sensitive, but less specific than urinary cytology for the detection of bladder TCC. In a multivariable logistic regression analysis, higher sE-cadherin and positive cytology were both associated with an increased risk of bladder TCC (p=0.048 and p<0.001, respectively). Combination of cytology and sE-cadherin allowed categorization of patients into three significantly different risk groups for bladder cancer. Adjustment of sE-cadherin for urinary creatinine levels did not affect any of the outcomes.
  
  
  CONCLUSIONS
  Urinary level of sE-cadherin may add information to cytology in the detection of bladder TCC.
authors.affiliation: Department of Urology, University of Texas Southwestern Medical School; 5323 Harry Hines Blvd, Dallas, Texas 75390-9110, USA. shahrokh.shariat@utsouthwestern.edu
authors.forename: Shahrokh F
authors.initials: SF
authors.lastname: Shariat
authors.forename: Kazumasa
authors.initials: K
authors.lastname: Matsumoto
authors.forename: Roberto
authors.initials: R
authors.lastname: Casella
authors.forename: Weiguo
authors.initials: W
authors.lastname: Jian
authors.forename: Seth P
authors.initials: SP
authors.lastname: Lerner
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D000911:Antibodies, Monoclonal; D014408:Biomarkers, Tumor / Q000096:biosynthesis / Q000652:urine*; D015820:Cadherins / Q000096:biosynthesis / Q000652:urine*; D002295:Carcinoma, Transitional Cell / Q000473:pathology / Q000652:urine*; D045744:Cell Line, Tumor / Q000378:metabolism; D003404:Creatinine / Q000652:urine; D017077:Culture Media, Conditioned / Q000737:chemistry; D003558:Cystoscopy; D005260:Female; D006801:Humans; D008297:Male; D051379:Mice; D008875:Middle Aged; D011237:Predictive Value of Tests; D012307:Risk Factors; D001749:Urinary Bladder Neoplasms / Q000473:pathology / Q000652:urine*
chemical_list: D000911:Antibodies, Monoclonal; D014408:Biomarkers, Tumor; D015820:Cadherins; D017077:Culture Media, Conditioned; D003404:Creatinine