title: Panel of Urinary Diagnostic Markers for Non-Invasive Detection of Primary and Recurrent Urothelial Urinary Bladder Carcinoma.
abstract: OBJECTIVE
  To determine the combination of urinary protein markers for noninvasive detection of primary and recurrent urothelial bladder carcinomas.
  
  
  METHODS
  Urinary concentrations of 27 biomarkers (NSE, ATT, AFABP, Resistin, Midkine, Clusterin, Uromodulin, ZAG2, HSP27, HSP 60, NCAM1/CD56, Angiogenin, Calreticulin, Chromogranin A, CEACAM1, CXCL1, IL13Ra2, Progranulin, VEGFA, CarbAnhydIX, Annexin-V, TIM4, Galectin1, Cystatin B, Synuclein G, ApoA1 and ApoA2) were assessed by enzyme-linked immunosorbent assay or by electrochemiluminiscence immunoassay.
  
  
  RESULTS
  During the primary diagnostics, a group of 70 patients with primary occurrence of bladder cancer and 49 healthy control subjects were compared. For this clinical situation, the most accurate combination proved to be the combination of cytology with markers Midkine and Synuclein G (sensitivity 91.8%, specificity 97.5%). During the monitoring of patients with non-muscle invasive bladder cancer (NMIBC), a group of 44 patients with cancer recurrence was compared with the group of 61 patients with a history of NMIBC without current disease. For this clinical situation, the most accurate combination proved to be the combination of cytology and erythrocytes count in urine sediment with markers Midkine, ZAG2, CEACAM1, and Synuclein G (sensitivity 92.68%, specificity 90.16%). A lower accuracy of the diagnostic panel and the necessity to use more markers in the case of recurrence was connected with a different structure of patients.
  
  
  CONCLUSIONS
  Multi-marker test can significantly improve the bladder cancer detection both during the primary diagnostics and monitoring of patients with NMIBC. This outcome should result in other, larger studies.
authors: Department of Urology, General University Hospital and The First Faculty of Medicine, Charles University in Prague, Prague, Czech Republic.
authors: Viktor
authors: V
authors: Soukup
authors: Marta
authors: M
authors: Kalousová
authors: Otakar
authors: O
authors: Capoun
authors: Roman
authors: R
authors: Sobotka
authors: Zuzana
authors: Z
authors: Breyl
authors: Michael
authors: M
authors: Pešl
authors: Tomas
authors: T
authors: Zima
authors: Tomáš
authors: T
authors: Hanuš
mesh_terms: D000368:Aged; D014408:Biomarkers, Tumor / Q000652:urine*; D002277:Carcinoma / Q000175:diagnosis / Q000652:urine*; D016022:Case-Control Studies; D004563:Electrochemistry; D004797:Enzyme-Linked Immunosorbent Assay; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D049449:Luminescence; D008297:Male; D008875:Middle Aged; D000078792:Midkine; D009363:Neoplasm Proteins / Q000378:metabolism; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000652:urine*; D009414:Nerve Growth Factors / Q000378:metabolism; D012372:ROC Curve; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D001749:Urinary Bladder Neoplasms / Q000175:diagnosis / Q000652:urine*; D014551:Urinary Tract / Q000473:pathology; D051845:gamma-Synuclein / Q000378:metabolism
chemical_list: D014408:Biomarkers, Tumor; C066254:MDK protein, human; D009363:Neoplasm Proteins; D009414:Nerve Growth Factors; C104249:SNCG protein, human; D051845:gamma-Synuclein; D000078792:Midkine