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Diagnostic value of urinary survivin as a biomarker for bladder cancer: a systematic review and meta-analysis of published studies

World Journal of Urology volume 36, pages 1373–1381 (2018)Cite this article

Abstract

Objective

This study is a meta-analysis and aims to determine the value of urinary survivin for detecting bladder cancer (BC) on the basis of preceding statistical performance and to compare their diagnostic value.

Materials and methods

Considering that the urinary survivin data were from both RNA and protein levels, the key words “bladder cancer” AND “survivin” and “bladder cancer” AND “survivin RNA” were used; and PubMed, Web of Science, and Cochrane Library were systematically searched to identify relevant articles. The methodological quality of each study was assessed by QUADAS-2. Data were analyzed by STATA 12.0 and Meta-disc v.1.4 software package. A random-effects model was used and subgroup analysis was carried out to identify possible sources of heterogeneity.

Results

Nine articles for survivin protein test with 789 patients and 684 controls, and 12 articles for survivin RNA test with 880 patients and 922 controls were identified. The results showed that the pooled sensitivity was 0.79 (95% CI 0.73, 0.84), specificity was 0.87 (95% CI 0.79, 0.92) of the survivin protein test for bladder cancer, and the sensitivity and specificity was 0.84 (95% CI 0.79, 0.88) and 0.94 (95% CI 0.89, 0.97) of the survivin RNA test. The AUC of the two approaches was 0.89 (95% CI 0.86, 0.91) and 0.94 (95% CI 0.92, 0.96), respectively.

Conclusions

The survivin protein and survivin RNA both had great potential as biomarkers for BC detection, and survivin RNA showed higher accuracy than survivin protein on BC diagnosis.

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References

  1. Malats N, Real FX (2015) Epidemiology of bladder cancer. Hematol Oncol Clin North Am 29: 177-189, vii

  2. Lokeshwar VB, Habuchi T, Grossman HB, Murphy WM, Hautmann SH et al (2005) Bladder tumor markers beyond cytology: international Consensus Panel on bladder tumor markers. Urology 66:35–63

    Article  PubMed  Google Scholar 

  3. Eissa S, Kassim SK, Labib RA, El-Khouly IM, Ghaffer TM et al (2005) Detection of bladder carcinoma by combined testing of urine for hyaluronidase and cytokeratin 20 RNAs. Cancer 103:1356–1362

    Article  PubMed  CAS  Google Scholar 

  4. D’Costa JJ, Goldsmith JC, Wilson JS, Bryan RT, Ward DG (2016) A systematic review of the diagnostic and prognostic value of urinary protein biomarkers in urothelial bladder cancer. Bladder Cancer 2:301–317

    Article  PubMed  PubMed Central  Google Scholar 

  5. Sullivan PS, Chan JB, Levin MR, Rao J (2010) Urine cytology and adjunct markers for detection and surveillance of bladder cancer. Am J Transl Res 2:412–440

    PubMed  PubMed Central  Google Scholar 

  6. Dong ZL, Lu ZP, Wang HZ, Zhang LY, Wang ZP et al (2011) Detection of nuclear matrix protein 22 and survivin baseline level in patients after radical cystectomy. Urol Int 87:445–449

    Article  PubMed  CAS  Google Scholar 

  7. Schultz IJ, Kiemeney LA, Witjes JA, Schalken JA, Willems JL et al (2003) Survivin mRNA expression is elevated in malignant urothelial cell carcinomas and predicts time to recurrence. Anticancer Res 23:3327–3331

    PubMed  CAS  Google Scholar 

  8. Altieri DC (2004) Molecular circuits of apoptosis regulation and cell division control: the survivin paradigm. J Cell Biochem 92:656–663

    Article  PubMed  CAS  Google Scholar 

  9. Li F, Ling X (2006) Survivin study: an update of “what is the next wave”? J Cell Physiol 208:476–486

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  10. Chang Y, Xu J, Zhang Q (2017) Microplate magnetic chemiluminescence immunoassay for detecting urinary survivin in bladder cancer. Oncol Lett 14:4043–4052

    Article  PubMed  PubMed Central  Google Scholar 

  11. Srivastava AK, Singh PK, Srivastava K, Singh D, Dalela D et al (2013) Diagnostic role of survivin in urinary bladder cancer. Asian Pacific J Cancer Prev Apjcp 14:81

    Article  Google Scholar 

  12. Shariat SF, Casella R, Khoddami SM, Hernandez G, Sulser T et al (2004) Urine detection of survivin is a sensitive marker for the noninvasive diagnosis of bladder cancer. J Urol 171:626–630

    Article  PubMed  CAS  Google Scholar 

  13. Zhao J, Wang ZQ, Wang XY, Yang XJ, He D (2010) Preliminary study of diagnostic utility of molecular beacons in bladder cancer. Urology 76:8–13

    Article  Google Scholar 

  14. Al-Maghrebi M, Kehinde EO, Kapila K, Anim JT (2012) Urinary survivin mRNA expression and urinary nuclear matrix protein 22 BladderChek(R) and urine cytology in the detection of transitional cell carcinoma of the bladder. Med Princ Pract 21:295–297

    Article  PubMed  Google Scholar 

  15. Hou JQ, He J, Wen D et al (2006) Survivin mRNA expression in urine as a biomarker for patients with transitional cell carcinoma of bladder. 中华医学杂志(英文版) 119:1118

    CAS  Google Scholar 

  16. Wang H, Xi X, Kong X, Huang G, Ge G (2004) The expression and significance of survivin mRNA in urinary bladder carcinomas. J Cancer Res Clin Oncol 130:487–490

    Article  PubMed  CAS  Google Scholar 

  17. Kenney DM, Geschwindt RD, Kary MR, Linic JM, Sardesai NY et al (2007) Detection of newly diagnosed bladder cancer, bladder cancer recurrence and bladder cancer in patients with hematuria using quantitative RT-PCR of urinary survivin. Tumor Biology 28:57–62

    Article  PubMed  CAS  Google Scholar 

  18. Sharaf S, Ketat A, Diab I, Dwidar F, Sameh W (2012) Evaluation of tissue and urinary survivin expression in non-muscle-invasive bladder cancer. Afr J Urol 18:143–148

    Article  Google Scholar 

  19. Leeflang MMG, Deeks JJ, Gatsonis C, Bossuyt PMM (2008) Systematic reviews of diagnostic test accuracy. Ann Intern Med 149:889

    Article  PubMed  PubMed Central  Google Scholar 

  20. Whiting PF, Rutjes AW, Westwood ME, Mallett S, Deeks JJ et al (2011) QUADAS-2: a revised tool for the quality assessment of diagnostic accuracy studies. Ann Intern Med 155:529–536

    Article  PubMed  Google Scholar 

  21. Glas AS, Lijmer JG, Prins MH, Bonsel GJ, Bossuyt PMM (2003) The diagnostic odds ratio: a single indicator of test performance. J Clin Epidemiol 56:1129–1135

    Article  PubMed  Google Scholar 

  22. Abd ElHakim TF, Elshafie MK, Abdou AG, Azmy RM, Elnaidany SS et al (2014) Value of urinary survivin as a diagnostic marker in bladder cancer. Anal Quant Cytopathol Histopathol 36:121–127

    Google Scholar 

  23. Eissa S, Badr S, Barakat M, Zaghloul AS, Mohanad M (2013) The diagnostic efficacy of urinary survivin and hyaluronidase mRNA as urine markers in patients with bladder cancer. Clin Lab 59:893–900

    PubMed  CAS  Google Scholar 

  24. Xuefeng Yaming, Wang Jianjun, Qingyun et al (2013) Sandwich ELISA for detecting urinary Survivin in bladder cancer. Chin J Cancer Res 25:375–381

    Google Scholar 

  25. Sun Y, He DL, Ma Q, Wan XY, Zhu GD et al (2006) Comparison of seven screening methods in the diagnosis of bladder cancer. Chin Med J 119:1763–1771

    PubMed  CAS  Google Scholar 

  26. Sang HC, Kim YH, Min EK (2006) Urinary survivin test compared to the nuclear matrix protein (NMP)-22 test and urine cytology for the diagnosis of bladder cancer. Korean J Urol 47:1041–1045

    Article  Google Scholar 

  27. Smith SD, Wheeler MA, Plescia J, Colberg JW, Weiss RM et al (2001) Urine detection of survivin and diagnosis of bladder cancer. JAMA J Am Med Assoc 285:324–328

    Article  CAS  Google Scholar 

  28. Schmidt J, Propping C, Siow WY, Lohse-Fischer A, Toma M et al (2016) Diagnostic and prognostic value of bladder cancer-related transcript markers in urine. J Cancer Res Clin Oncol 185:e211

    Google Scholar 

  29. Eissa S, Badr S, Elhamid SA, Helmy AS, Nour M et al (2013) The value of combined use of survivin mRNA and matrix metalloproteinase 2 and 9 for bladder cancer detection in voided urine. Dis Markers 34:57–62

    Article  PubMed  CAS  Google Scholar 

  30. Shabayek MI, Ismail MF, El-Allawy RM, Hamdy MA (2010) Diagnostic evaluation of apoptosis inhibitory gene and tissue inhibitor matrix metalloproteinase-2 in patients with bladder cancer. Iubmb Life 62:394–399

    PubMed  Google Scholar 

  31. Eissa S, Swellam M, Shehata H, Elkhouly IM, Elzayat T et al (2010) Expression of HYAL1 and survivin RNA as diagnostic molecular markers for bladder cancer. J Urol 183:493–498

    Article  PubMed  CAS  Google Scholar 

  32. Pu XY, Wang ZP, Chen YR, Wang XH, Wu YL et al (2008) The value of combined use of survivin, cytokeratin 20 and mucin 7 mRNA for bladder cancer detection in voided urine. J Cancer Res Clin Oncol 134:659

    Article  PubMed  CAS  Google Scholar 

  33. Weikert S, Christoph F, Schrader M, Krause H, Miller K et al (2005) Quantitative analysis of survivin mRNA expression in urine and tumor tissue of bladder cancer patients and its potential relevance for disease detection and prognosis. Int J Cancer 116:100–104

    Article  PubMed  CAS  Google Scholar 

  34. Moussa O, Abol-Enein H, Bissada NK, Keane T, Ghoneim MA et al (2006) Evaluation of survivin reverse transcriptase-polymerase chain reaction for noninvasive detection of bladder cancer. J Urol 175:2312–2316

    Article  PubMed  CAS  Google Scholar 

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Acknowledgements

This study was supported by Technology Project of the Department of Health of Jilin Province (Grant No. 2016J044).

Funding

This study was supported by Technology Project of the Department of Health of Jilin Province (Grant No. 2016J044).

Author information

Affiliations

  1. Epidemiology and Statistics, School of Public Health, Jilin University, Changchun, 130021, China

    Zhenzhen Liang, Yinghui Yu, Rui Wang & Xin Liu

  2. Department Radiology, The 2nd Hospital Affiliated to Jilin University, Changchun, China

    Rui Xin

  3. School of Mathematics and Statistics, Northeast Normal University, Changchun, Jilin, China

    Chunpeng Wang

Authors
  1. Zhenzhen Liang
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  2. Rui Xin
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  3. Yinghui Yu
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  4. Rui Wang
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  5. Chunpeng Wang
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  6. Xin Liu
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Contributions

Protocol/project development XL. Data collection or management XL, ZZL, QZ. Data analysis ZZL, RX. Investigation CPW, QZ. Methodology XL. Project administration ZZL. Software FS. Supervision RX. Validation XL. Visualization ZZL, QZ. Writing—original draft ZZL, FS, QZ. Writing—review and editing XL, CPW.

Corresponding author

Correspondence to Xin Liu.

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None declared.

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Liang, Z., Xin, R., Yu, Y. et al. Diagnostic value of urinary survivin as a biomarker for bladder cancer: a systematic review and meta-analysis of published studies. World J Urol 36, 1373–1381 (2018). https://doi.org/10.1007/s00345-018-2285-8

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  • DOI: https://doi.org/10.1007/s00345-018-2285-8

Keywords

  • Bladder cancer
  • Survivin
  • Diagnosis
  • Meta-analysis