title: Clinical utility of urinary soluble Fas in screening for bladder cancer.
abstract: OBJECTIVE
  Early diagnosis of carcinoma of urinary bladder remains a challenge. Urine cytology, as an adjunct to cystoscopy, is less sensitive for low-grade tumors. Soluble Fas (sFas), a cell-surface receptor and member of the tumor necrosis factor superfamily, is frequently expressed in urinary bladder carcinoma. The objective of this study was to investigate the urinary sFas for diagnosis of transitional cell carcinoma (TCC) of urinary bladder.
  
  
  METHODS
  We examined urinary sFas concentration in 74 controls and 117 cases of TCC, both primary and recurrent disease, by using enzyme-linked immunosorbent assay and compared it with urinary cytology.
  
  
  RESULTS
  Urinary sFas concentration was found to be significantly higher in the patient as compared to control group (P < 0.05). An optimal cutoff value of 174.0 pg/mL was proposed. The urinary sFas level was found to have an approximate sensitivity and specificity of 88.03% and 89.19% (P < 0.001), whereas urine cytology had sensitivity of 66.67% and specificity of 95.95%. sFas had better sensitivity in higher grade and both primary and recurrent cases of urinary bladder cancer in comparison with cytology. Out of 15 node positive bladder cancer cases, 13 had high urinary sFas levels, whereas 12 were urinary cytology positive for malignancy.
  
  
  CONCLUSIONS
  Urinary sFas can be used as a non-invasive diagnostic biomarker for TCC of urinary bladder, both for primary and recurrent disease.
authors.affiliation: Department of Radiotherapy, King George's Medical University, Lucknow, Uttar Pradesh, India.
authors.forename: Anupam Kumar
authors.initials: AK
authors.lastname: Srivastava
authors.affiliation: Department of Radiotherapy, King George's Medical University, Lucknow, Uttar Pradesh, India.
authors.forename: Pankaj Kumar
authors.initials: PK
authors.lastname: Singh
authors.affiliation: Department of Urology, King George's Medical University, Lucknow, Uttar Pradesh, India.
authors.forename: Dhramveer
authors.initials: D
authors.lastname: Singh
authors.affiliation: Department of Urology, King George's Medical University, Lucknow, Uttar Pradesh, India.
authors.forename: Divakar
authors.initials: D
authors.lastname: Dalela
authors.affiliation: Genotoxicity Laboratory, Division of Toxicology, Central Drug Research Institute, Lucknow, Uttar Pradesh, India.
authors.forename: Srikanta Kumar
authors.initials: SK
authors.lastname: Rath
authors.affiliation: Department of Radiotherapy, King George's Medical University, Lucknow, Uttar Pradesh, India.
authors.forename: Madan Lal Brahma
authors.initials: ML
authors.lastname: Bhatt
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000652:urine*; D002295:Carcinoma, Transitional Cell / Q000175:diagnosis / Q000473:pathology / Q000652:urine*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D001749:Urinary Bladder Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000652:urine*; D019014:fas Receptor / Q000652:urine*
chemical_list: D014408:Biomarkers, Tumor; C491901:FAS protein, human; D019014:fas Receptor
keywords: non-invasive diagnosis; soluble Fas; urinary biomarker; urinary bladder cancer