title: Sensitivity and specificity of urinary hyaluronic acid and hyaluronidase in detection of bladder transitional cell carcinoma.
abstract: OBJECTIVE
  To the assess sensitivity and specificity of urinary levels of hyaluronic acid (HA) and hyaluronidase (HAase) as an individual or a combined test to diagnose bladder transitional cell carcinoma (TCC).
  
  
  METHODS
  One hundred and ninety-four urine specimens were collected from individuals between July 2007 and March 2008. The urinary level of hyaluronic acid (HA) was measured by Enzyme-linked immunosorbent assay. Thereafter, the urinary levels of HA and HAase were normalized to urinary creatinine level and expressed as ng/mg and μ/mg.
  
  
  RESULTS
  Eighty percent of patients with bladder cancer had urinary HA level < 500 ng/mg, and 90% of controls showed HA level < 500 ng/mg (P < .001). The mean urinary levels of HA in controls did not vary significantly (P < .05), whereas they significantly increased (2.5 to 6.5 folds) in all grades of TCC. More than 80% of patients with grades 2 and 3 TCC had urinary HAase level < 10 μ/mg and over 80% of controls showed HAase level < 10 μ/mg (P < .05). Hyaluronidase levels increased in patients with grades 2 and 3 bladder TCC.
  
  
  CONCLUSIONS
  Measurement of urinary levels of HA and HAase (with 89% sensitivity and 83% specificity) appears to be a highly accurate and non-invasive method for detecting bladder TCC and evaluating its grade.
authors.affiliation: Department of Uro-oncology, Imam Khomeini Hospital, Tehran University of Medical Sciences,Tehran,Iran.jamshidian@gmail.com.
authors.forename: Hassan
authors.initials: H
authors.lastname: Jamshidian
authors.affiliation: Department of Uro-oncology, Imam Khomeini Hospital, Tehran University of Medical Sciences,Tehran,Iran.
authors.forename: Mohsen
authors.initials: M
authors.lastname: Hashemi
authors.affiliation: Department of Uro-oncology, Imam Khomeini Hospital, Tehran University of Medical Sciences,Tehran,Iran.
authors.forename: Mohammad Reza
authors.initials: MR
authors.lastname: Nowroozi
authors.affiliation: Department of Uro-oncology, Imam Khomeini Hospital, Tehran University of Medical Sciences,Tehran,Iran.
authors.forename: Mohsen
authors.initials: M
authors.lastname: Ayati
authors.affiliation: Department of Uro-oncology, Imam Khomeini Hospital, Tehran University of Medical Sciences,Tehran,Iran.
authors.forename: Mahdieh
authors.initials: M
authors.lastname: Bonyadi
authors.affiliation: Department of Uro-oncology, Imam Khomeini Hospital, Tehran University of Medical Sciences,Tehran,Iran.
authors.forename: Vahid
authors.initials: V
authors.lastname: Najjaran Tousi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000652:urine*; D002295:Carcinoma, Transitional Cell / Q000175:diagnosis* / Q000652:urine*; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D006820:Hyaluronic Acid / Q000652:urine*; D006821:Hyaluronoglucosaminidase / Q000652:urine*; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity; D001749:Urinary Bladder Neoplasms / Q000175:diagnosis* / Q000652:urine*
chemical_list: D014408:Biomarkers, Tumor; D006820:Hyaluronic Acid; D006821:Hyaluronoglucosaminidase