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Individual risk assessment in bladder cancer patients based on a multi-marker panel

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Abstract

Purpose

To investigate whether a combined application of urine cytology (CYT) and molecular markers for bladder cancer (BC) can predict tumor aggressiveness.

Methods

The study comprised 2,113 patients who underwent urethrocystoscopy and transurethral resection of the bladder. CYT, fluorescence in situ hybridization (FISH), immunocytology (uCyt+) and nuclear matrix protein 22 test (NMP22-ELISA) were performed. Results of the individual tests and of a multi-marker panel were correlated with pT-stages and tumor grades.

Results

Five hundred and two of 2,113 (23.8 %) patients had BC. False-negative test rates of CYT (p < 0.001), FISH (p = 0.01) and NMP22-ELISA (p = 0.05) were lower in patients with muscle-invasive BC compared with patients with non-muscle-invasive BC. Furthermore, false-negative rates of CYT (p < 0.001), FISH (p = 0.0002) and NMP22-ELISA (p < 0.001) were lower in patients with G3/CIS compared with patients with G1–G2 BC. In patients with evidence of tumor in urethrocystoscopy, the presence of simultaneously positive CYT and NMP22 was associated with a 20-fold risk for G3/CIS (p < 0.0001).

Conclusions

This is the first study investigating the combined use of four urine markers in addition to cystoscopy to predict tumor aggressiveness. Our results indicate that combined application of urine markers as an adjunct to cystoscopy may facilitate identification of patients harboring high-grade tumors.

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Authors and Affiliations

  1. Department of Urology, University Hospital Tuebingen, Tuebingen, Germany

    Tilman Todenhöfer, Jörg Hennenlotter, Stefan Aufderklamm, Ursula Kühs, Georgios Gakis, Miriam Germann, Arnulf Stenzl & Christian Schwentner

  2. Department of Urology, Eberhard-Karls University, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany

    Christian Schwentner

Authors
  1. Tilman Todenhöfer
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  2. Jörg Hennenlotter
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  3. Stefan Aufderklamm
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  4. Ursula Kühs
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  5. Georgios Gakis
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  6. Miriam Germann
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  7. Arnulf Stenzl
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  8. Christian Schwentner
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Corresponding author

Correspondence to Christian Schwentner.

Additional information

Tilman Todenhöfer and Stefan Aufderklamm contributed equally to this manuscript.

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Todenhöfer, T., Hennenlotter, J., Aufderklamm, S. et al. Individual risk assessment in bladder cancer patients based on a multi-marker panel. J Cancer Res Clin Oncol 139, 49–56 (2013). https://doi.org/10.1007/s00432-012-1297-9

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  • DOI: https://doi.org/10.1007/s00432-012-1297-9

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