The Usefulness of the UBC(TM)(Urinary Bladder Cancer) Test for Screening of Transitional Cell Carcinoma of the Bladder in Patients with Hematuria

Choi, Dong Won; Jung, Se Il

Abstract

PURPOSE: A new quantitative tumor marker, based on the combined measurement of urinary fragments of cytokeratins 8 and 18, namely the urinary bladder cancer antigen(UBC(TM)) test, has been proposed for the detection of bladder transitional cell carcinoma(TCC). We evaluated the diagnostic efficacy of UBC(TM) test in comparison with that of urinary cytology to establish UBC(TM) test for the diagnosis of TCC.
MATERIALS AND METHODS
One-hundred ninety-six patients with hematuria were included in this study. Forty patients were diagnosed histologically as TCC by transurethral resection or radical cystectomy(group A), while the others had various benign urinary tract conditions(group B).
RESULTS
UBC(TM) levels were significantly different between groups A (1851.39+/-4627microgram/l) and B (19.28+/-107.03microgram/l) (p<0.001). Sensitivity for diagnosis of TCC was 89.7%(36/40) in UBC(TM) test and 45%(18/40) in cytology(p<0.05). Specificity for diagnosis of TCC was 84.6%(132/156) in UBC(TM) test and 100%(156/156) in cytology. UBC(TM) test was significantly more sensitive than cytology in stage Ta(85.7% vs. 0%, p<0.05), T1 tumors(89.4% vs. 31.5%, p<0.05), and in Grades 1(83.3% vs. 25%, p<0.05) and 2(90.4% vs. 52.3%, p<0.05) tumors. UBC(TM) test was more sensitive in higher Grade(83.3% in Grade 1, 90.4% in Grade 2 and 100% in Grade 3).
CONCLUSIONS
In comparison with urinary cytology, UBC(TM) test could be a valuable marker for diagnosis of TCC in patients with early stage and low grade TCC. Therefore, UBC(TM) test in association with cytology may be useful as a screening test for TCC of the bladder.