title: Aurora A Kinase as a diagnostic urinary marker for urothelial bladder cancer.
abstract: OBJECTIVE
  To evaluate urinary Aurora A Kinase (AURKA) mRNA expression as a diagnostic biomarker for urothelial bladder cancer (UBC).
  
  
  METHODS
  One hundred and eighty-eight urine samples from patients with UBC (n = 122) and controls with hematuria (n = 66) were investigated. AURKA expression was quantified using real-time PCR and compared with voided urinary cytology. Associations with stage and grade were assessed. The area under curve was used to quantify the predictive accuracy (PA).
  
  
  RESULTS
  The sensitivity and the specificity of AURKA for UBC were 83.6 and 65.2 %, respectively (PA = 74.4 %). Among those with detectable AURKA, the quantity of expression was similar in cases and controls. Compared with Ta, tumors staged T1 and T2 showed a 9.31-fold and 4.78-fold increased AURKA expression (p = 0.034), respectively. Further, high-grade tumors showed 5.33-fold higher expression levels than low-grade tumors (p = 0.031). AURKA and urinary cytology showed similar overall PA for UBC detection (74.4 vs. 72.1 %, p = 0.588). For low-grade tumors, AURKA was more accurate (72.5 vs. 59.0 %, p = 0.004), while cytology was more accurate for high-grade lesions (76.8 vs. 89.1 %, p = 0.011).
  
  
  CONCLUSIONS
  In patients with hematuria, AURKA is associated with the presence and grade of UBC, suggesting a role as diagnostic and prognostic biomarker. As AURKA is more accurate in low-grade tumors but less accurate in high-grade tumors than urinary cytology, both could be complementary in detecting UBC.
authors.affiliation: Department of Urology, Vienna General Hospital, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.
authors.forename: Michela
authors.initials: M
authors.lastname: de Martino
authors.forename: Shahrokh F
authors.initials: SF
authors.lastname: Shariat
authors.forename: Sebastian L
authors.initials: SL
authors.lastname: Hofbauer
authors.forename: Ilaria
authors.initials: I
authors.lastname: Lucca
authors.forename: Christopher
authors.initials: C
authors.lastname: Taus
authors.forename: Helene G
authors.initials: HG
authors.lastname: Wiener
authors.forename: Andrea
authors.initials: A
authors.lastname: Haitel
authors.forename: Martin
authors.initials: M
authors.lastname: Susani
authors.forename: Tobias
authors.initials: T
authors.lastname: Klatte
mesh_terms: D000328:Adult; D000368:Aged; D064096:Aurora Kinase A / Q000235:genetics* / Q000652:urine*; D015415:Biomarkers / Q000652:urine; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D012333:RNA, Messenger / Q000652:urine; D012372:ROC Curve; D060888:Real-Time Polymerase Chain Reaction; D001749:Urinary Bladder Neoplasms / Q000175:diagnosis* / Q000235:genetics / Q000652:urine*; D019459:Urothelium
chemical_list: D015415:Biomarkers; D012333:RNA, Messenger; D064096:Aurora Kinase A