Medical Oncology

, Volume 28, Issue 2, pp 513–518 | Cite as

The clinical relevance of urine-based markers for diagnosis of bladder cancer

  • Sanaa Eissa
  • Menha Swellam
  • Amr Amin
  • Mohamed E. Balbaa
  • Galila Ahmed Yacout
  • Tarek Mostafa El-Zayat
Original Paper


The aim of the present study was to evaluate the diagnostic relevance of urinary fibronectin (FN), telomerase (RTA), and cytokeratin 20 (CK20) mRNA in comparison with voided urine cytology (VUC). The study included 132 patients with bladder cancer, 60 patients with benign bladder lesions, and 48 healthy individuals. All were subjected to urine cytology, estimation of fibronectin by ELISA, RTA by TRAP, and CK20 mRNA by conventional RT–PCR in urothelial cells from voided urine. The best cutoff point for FN was determined by receiver operating characteristic curve (41.7 ng/mg protein) revealed the highest sensitivity for malignant (80%) followed by the benign (70%) than the healthy individuals (4.1%) at P < 0.001. Also, RTA and VUC showed significant difference among the three investigated groups (P < 0.001). The overall sensitivity (89.3%) and specificity (98.4%) were the highest for CK20 mRNA. Combined sensitivity of VUC with FN, RTA, and CK20 mRNA together (98.4%) was higher than either the combined sensitivity of VUC with any of them or than that of the biomarker alone. Accordingly, when the diagnostic efficacy was considered, CK20 mRNA had the highest sensitivity and specificity compared to all investigated markers.


Fibronectin Relative telomerase activity Cytokeratin 20 mRNA Voided urine cytology Bladder cancer 



This work was supported by the Egyptian Academy of Research and Technology, the Technical development and Scientific Sector. The Science and Technology Center, Project 21/2. The authors acknowledge Dr. Kahled Kamel, Assistant Professor of Cytopathology at Early Cancer Detection Unit, Faculty of Medicine, Ain Shams University, Cairo, Egypt for his help in the cytological and pathological examinations of all investigated urine samples.


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Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  • Sanaa Eissa
    • 1
  • Menha Swellam
    • 2
  • Amr Amin
    • 1
  • Mohamed E. Balbaa
    • 3
  • Galila Ahmed Yacout
    • 3
  • Tarek Mostafa El-Zayat
    • 4
  1. 1.Oncology Diagnostic Unit, Medical Biochemistry Department, Faculty of MedicineAin Shams UniversityCairoEgypt
  2. 2.Genetic Engineering and Biotechnology Division, Biochemistry DepartmentNational Research CenterGizaEgypt
  3. 3.Biochemistry Department, Faculty of ScienceAlexandria UniversityAlexandriaEgypt
  4. 4.Urology Department, Faculty of MedicineAin Shams UniversityCairoEgypt

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