title: Urine cell-free DNA integrity as a marker for early bladder cancer diagnosis: preliminary data.
abstract: OBJECTIVE
  Urine cell-free (UCF) DNA has recently been proposed as a potential marker for early bladder cancer diagnosis. It is known that normal apoptotic cells produce highly fragmented DNA while cancer cells release longer DNA. Therefore, we verified the potential role of UCF DNA integrity in early bladder cancer diagnosis.
  
  
  METHODS
  UCF DNA was isolated from 51 bladder cancer patients, 46 symptomatic patients, and 32 healthy volunteers. To verify UCF DNA integrity, sequences longer than 250 bp, c-Myc, BCAS1, and HER2, were quantified by real time PCR.
  
  
  RESULTS
  At the best cutoff value of 0.1 ng/μl, UCF DNA integrity analysis showed a sensitivity of 0.73 (95% CI 0.61-0.85), and a specificity of 0.84 (95% CI 0.71-0.97) in healthy individuals and 0.83 (95% CI 0.72-0.94) in symptomatic patients. Receiver operating characteristic (ROC) curve analysis revealed an area under the curve of 0.834 (95% CI 0.739-0.930) for healthy individuals and 0.796 (95% CI 0.707-0.885) for symptomatic patients.
  
  
  CONCLUSIONS
  These preliminary data suggest that UCF DNA integrity is a potentially good marker for early noninvasive diagnosis of bladder cancer. Its diagnostic performance does not seem to vary significantly, even in an "at risk" population of symptomatic individuals.
authors.affiliation: Biosciences Laboratory, IRCCS Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST), Meldola, Italy. Electronic address: v.casadio@irst.emr.it.
authors.forename: Valentina
authors.initials: V
authors.lastname: Casadio
authors.forename: Daniele
authors.initials: D
authors.lastname: Calistri
authors.forename: Michela
authors.initials: M
authors.lastname: Tebaldi
authors.forename: Sara
authors.initials: S
authors.lastname: Bravaccini
authors.forename: Roberta
authors.initials: R
authors.lastname: Gunelli
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Martorana
authors.forename: Alessandro
authors.initials: A
authors.lastname: Bertaccini
authors.forename: Luigi
authors.initials: L
authors.lastname: Serra
authors.forename: Emanuela
authors.initials: E
authors.lastname: Scarpi
authors.forename: Dino
authors.initials: D
authors.lastname: Amadori
authors.forename: Rosella
authors.initials: R
authors.lastname: Silvestrini
authors.forename: Wainer
authors.initials: W
authors.lastname: Zoli
mesh_terms: D000368:Aged; D014408:Biomarkers, Tumor / Q000235:genetics / Q000652:urine*; D004247:DNA / Q000235:genetics / Q000652:urine*; D055088:Early Detection of Cancer; D005260:Female; D006801:Humans; D008297:Male; D009363:Neoplasm Proteins / Q000235:genetics; D016271:Proto-Oncogene Proteins c-myc / Q000235:genetics; D012372:ROC Curve; D060888:Real-Time Polymerase Chain Reaction; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000235:genetics; D012016:Reference Values; D013053:Spectrophotometry; D001749:Urinary Bladder Neoplasms / Q000175:diagnosis* / Q000235:genetics / Q000652:urine*
chemical_list: D014408:Biomarkers, Tumor; D004247:DNA; D009363:Neoplasm Proteins; D016271:Proto-Oncogene Proteins c-myc; D018719:Erb-b2 Receptor Tyrosine Kinases; C113699:BCAS1 protein, human; C489427:MYC protein, human
keywords: Bladder cancer; Early diagnosis; Urine cell-free DNA integrity