Efficacy of BTA stat, cytology, and survivin in bladder cancer surveillance over 5 years in patients with spinal cord injury.
OBJECTIVE
To evaluate three urine markers, BTA stat, cytology, and urinary survivin levels, in the spinal cord injury (SCI) population. The incidence of bladder cancer in patients with SCI is up to 20 times greater than in the general population. However, bladder cancer biomarkers have not been assessed in this population.


METHODS
Between April 1999 and April 2004, 457 patients with SCI enrolled at the HealthSouth Harmarville Rehabilitation Spinal Cord Clinic donated their urine to our SCI urine repository. BTA stat tests and the survivin assay were performed according to published standards. Cytology specimens were sent to our cytopathology laboratory for analysis.


RESULTS
A total of 1075 urine specimens from 457 patients were analyzed. Of the 1073 BTA stat tests, 119 showed positive reactions and 954 were negative. In the survivin assays, 47 samples had a score of 1, 38 a score of 2, and 9 a score of 3. No cytology specimens were noted to have malignant cells. During the past 5 years, 3 patients were diagnosed with bladder cancer by cystoscopy and treated for superficial disease. For these patients, none of these three tests (BTA stat, survivin assay, and cytology) was positive before the diagnosis of bladder cancer.


CONCLUSIONS
The BTA stat, survivin assay, and urine cytology were unable to predict bladder cancer cases in our cohort of patients with SCI. Cystoscopy, therefore, remains the gold standard for bladder cancer surveillance in patients with SCI.
Davies
Benjamin
B
Department of Urology, University of Pittsburgh School of Medicine, Cancer Institute, Pittsburgh, Pennsylvania 15232, USA. daviesb@upmc.edu
Chen
Joseph J
JJ
McMurry
Timothy
T
Landsittel
Douglas
D
Lewis
Nancy
N
Brenes
Gilbert
G
Getzenberg
Robert H
RH
D015415:Biomarkers / Q000652:urine; D003950:Diagnostic Techniques, Urological; D005500:Follow-Up Studies; D006801:Humans; D051034:Inhibitor of Apoptosis Proteins; D008869:Microtubule-Associated Proteins / Q000652:urine*; D008875:Middle Aged; D009363:Neoplasm Proteins / Q000652:urine*; D011159:Population Surveillance; D013119:Spinal Cord Injuries / Q000150:complications / Q000473:pathology* / Q000652:urine*; D000077022:Survivin; D013997:Time Factors; D001749:Urinary Bladder Neoplasms / Q000150:complications / Q000473:pathology* / Q000652:urine*
C107489:BIRC5 protein, human; D015415:Biomarkers; D051034:Inhibitor of Apoptosis Proteins; D008869:Microtubule-Associated Proteins; D009363:Neoplasm Proteins; D000077022:Survivin