Urinary cytokeratin 20 mRNA expression has the potential to predict recurrence in superficial transitional cell carcinoma of the bladder.
Higher levels of cytokeratin 20 (CK 20) mRNA are expressed in malignant urothelial tissue compared to normal tissue. We determined the CK 20 mRNA expression in urine from patients with transitional cell carcinoma (TCC) of the bladder and assessed the biological behavior of such tumors in a 5-year follow-up. Second voided urine was preoperatively collected from 56 patients with bladder carcinoma, from 20 patients with nonmalignant urological diseases and from 40 healthy volunteers. RNA extraction from exfoliated urothelial cells was followed by quantitative real-time RT-PCR with the Light Cycler. Patients in the superficial TCC group had a median expression of 8226AU (arbitrary units) with and 1523AU without tumor recurrence (P=0.023). No such correlation was detected in the group with muscle-invasive tumors. Kaplan-Meier analysis revealed a significant difference between recurrent and nonrecurrent disease (P=0.019) in superficial but not in muscle-invasive TCC (P=0.84). CK 20 mRNA expression in urine has the potential to identify patients at risk for recurrence of noninvasive papillary urothelial tumors. It helps to categorize patients prior to TUR-B, so that the cystoscopy interval during follow-up may be extended in those with low-risk superficial TCC.
Department of Urology, Universitätsmedizin Berlin, Charité-Campus Benjamin Franklin, Hindenburgdamm 30, 12200 Berlin, Germany. frank.christoph@charite.de
Frank
F
Christoph
Steffen
S
Weikert
Ingmar
I
Wolff
Martin
M
Schostak
Karim
K
Tabiti
Markus
M
Müller
Kurt
K
Miller
Mark
M
Schrader
D002295:Carcinoma, Transitional Cell / Q000235:genetics / Q000473:pathology* / Q000652:urine; D005260:Female; D005500:Follow-Up Studies; D015972:Gene Expression Regulation, Neoplastic; D006801:Humans; D053208:Kaplan-Meier Estimate; D053554:Keratin-20 / Q000235:genetics*; D008297:Male; D009364:Neoplasm Recurrence, Local; D011237:Predictive Value of Tests; D011379:Prognosis; D012333:RNA, Messenger / Q000235:genetics / Q000378:metabolism / Q000652:urine*; D020133:Reverse Transcriptase Polymerase Chain Reaction; D013997:Time Factors; D001749:Urinary Bladder Neoplasms / Q000235:genetics / Q000473:pathology* / Q000652:urine
D053554:Keratin-20; D012333:RNA, Messenger