OBJECTIVE
To evaluate the clinical utility of novel gene urothelial carcinoma antigen 1 (UCA1) as a urinary tumor marker for the diagnosis of bladder urothelial carcinoma.
METHODS
A cohort of 180 cases of bladder cancer (including 94 cases in previous study), 144 cases of non-bladder-cancer individuals as control group (including 85 cases in previous study) from 2005 to 2009 were recruited. Reverse transcription PCR (RT-PCR) of urinary sediments was performed to detect the expression of UCA1. RNasin was added to the urinary sediments collected after 2007 from 86 cases of bladder cancer and 59 cases in control group to improve the quantity and quality of RNA isolation. The parameters of sensitivity, specificity, area under curve (AUC) of ROC and its 95%CI were calculated.χ(2) test was used to compare the sensitivity of UCA1 with NMP22 and cytology in 116 cases of bladder cancer with the parallel data of UCA1 and NMP22 and in 108 cases with the parallel data of UCA1 and cytology.
RESULTS
95.4% of RNA was isolated successfully from urinary sediments after the addition of RNasin UCA1 was highly specific (92.4%, 133/144) and quite sensitive (84.4%, 152/180) in the diagnosis of bladder cancer with a favorable AUC-ROC of 0.898 (95%CI: 0.851 - 0.945). It was especially valuable for superficial G(2)-G(3) patients (sensitivity: 86.4%, 92.3%) at a high risk for muscular invasion.
CONCLUSION
With a high level of sensitivity and specificity, UCA1 is a promising urinary marker for the diagnosis of bladder cancer.