title: Contribution of the prostate limits the usefulness of survivin for the detection of bladder cancer.
abstract: OBJECTIVE
  We determined if urinary survivin is influenced by the prostate and analyzed survivin levels in a healthy control population.
  
  
  METHODS
  This was a blinded, retrospective analysis of frozen urine samples. Three groups were designated. Group 1 patients were diagnosed with prostate cancer and samples were collected immediately prior to radical retropubic prostatectomy. Group 2 patients had already undergone radical retropubic prostatectomy at least 3 months prior to providing a urine sample. Group 3 comprised healthy controls. Groups 1 and 2 patients were recruited at an institutional practice. Group 3 patients were recruited from the local community.
  
  
  RESULTS
  The frequency of high survivin scores was much lower in patients who did not have a prostate (p < 0.0002). The survivin score was 2 in 35% and 44% of the patients in groups 1 and 3, respectively, while only 9% of those in group 2 had a survivin score of 2 (p < 0.0002). Of healthy controls 50% had a false-positive survivin score. Urinary survivin predicted prostate cancer poorly with 52% sensitivity and 50% specificity, and it did not predict any biological features of prostate cancer.
  
  
  CONCLUSIONS
  Urinary survivin markedly decreases after prostatectomy. There is a 50% false-positive rate when using urinary survivin in controls. These 2 features make urinary survivin a poor bladder cancer biomarker.
authors.affiliation: Department of Urology, University of Pittsburgh, Pittsburgh, Pennsylvania 15232, USA. daviesb@upmc.edu
authors.forename: Benjamin
authors.initials: B
authors.lastname: Davies
authors.forename: Joseph
authors.initials: J
authors.lastname: Chen
authors.forename: Francesmary
authors.initials: F
authors.lastname: Modugno
authors.forename: Joel
authors.initials: J
authors.lastname: Weissfeld
authors.forename: Doug
authors.initials: D
authors.lastname: Landsittel
authors.forename: Rajiv
authors.initials: R
authors.lastname: Dhir
authors.forename: Joel
authors.initials: J
authors.lastname: Nelson
authors.forename: Robert H
authors.initials: RH
authors.lastname: Getzenberg
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D014408:Biomarkers, Tumor / Q000652:urine*; D016022:Case-Control Studies; D015653:Cystectomy / Q000379:methods; D005189:False Positive Reactions; D006801:Humans; D051034:Inhibitor of Apoptosis Proteins; D008297:Male; D008869:Microtubule-Associated Proteins / Q000378:metabolism / Q000652:urine*; D008875:Middle Aged; D009363:Neoplasm Proteins / Q000378:metabolism / Q000652:urine*; D009367:Neoplasm Staging; D011379:Prognosis; D011468:Prostatectomy / Q000379:methods; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000601:surgery / Q000652:urine; D012016:Reference Values; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D018709:Statistics, Nonparametric; D000077022:Survivin; D016482:Urinalysis; D001749:Urinary Bladder Neoplasms / Q000175:diagnosis* / Q000601:surgery / Q000652:urine
chemical_list: C107489:BIRC5 protein, human; D014408:Biomarkers, Tumor; D051034:Inhibitor of Apoptosis Proteins; D008869:Microtubule-Associated Proteins; D009363:Neoplasm Proteins; D000077022:Survivin