Urinary calreticulin in the diagnosis of bladder urothelial carcinoma.
OBJECTIVE
To evaluate the potential suitability of calreticulin (CRT) as a urinary marker for bladder cancer.


METHODS
Urine specimens were collected from patients with histologically confirmed bladder urothelial carcinoma (Group 1; n = 109), urological patients without urothelial carcinoma (Group 2; n = 60), and non-urological patients (Group 3; n = 40). We developed an enzyme-linked immunosorbent assay (ELISA) procedure using commercially available anti-CRT mono/polyclonal antibodies, and then measured the concentration of urinary CRT.


RESULTS
Urinary CRT concentration of group 1 was significantly higher than group 2 and 3 (Mann-Whitney U-test, P < 0.001). Groups 2 and 3 were joined together and considered as a non-bladder cancer group (n = 100), and a cutoff value (2.85 ng/mL) was determined using receiver operating characteristic (ROC) analysis. The sensitivity, specificity, and the area under the curve were 67.9%, 80.0%, and 0.742, respectively. The overall sensitivity of voided urine cytology (VUC) was 39.0% (n = 105), and the sensitivity of urinary CRT was significantly superior to VUC (McNemar test, P < 0.001). Higher sensitivity was observed especially in Ta, G1-2, and <or=3 cm tumors.


CONCLUSIONS
Urinary CRT may be useful for diagnosis of bladder urothelial cancer. However, given that its specificity is relatively low, further evaluation in larger series is needed to define its clinical usefulness.
Kageyama
Susumu
S
Department of Urology, Shiga University of Medical Science, Otsu, Shiga. kageyama@belle.shiga-med.ac.jp
Isono
Takahiro
T
Matsuda
Shinjiro
S
Ushio
Yoshihiro
Y
Satomura
Shinji
S
Terai
Akito
A
Arai
Yoichi
Y
Kawakita
Mutsushi
M
Okada
Yusaku
Y
Yoshiki
Tatsuhiro
T
D000368:Aged; D000369:Aged, 80 and over; D019540:Area Under Curve; D015415:Biomarkers / Q000652:urine*; D037282:Calreticulin / Q000652:urine*; D003950:Diagnostic Techniques, Urological; D004797:Enzyme-Linked Immunosorbent Assay / Q000379:methods* / Q000592:standards; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012372:ROC Curve; D012680:Sensitivity and Specificity; D001749:Urinary Bladder Neoplasms / Q000175:diagnosis* / Q000652:urine*; D019459:Urothelium
D015415:Biomarkers; D037282:Calreticulin