Korean J Urol.  2006 Oct;47(10):1041-1045. 10.4111/kju.2006.47.10.1041.

Urinary Survivin Test Compared to the Nuclear Matrix Protein (NMP)-22 Test and Urine Cytology for the Diagnosis of Bladder Cancer

• Chang SH
• Kim YH
• Kim ME

• KMID: 2139802
• DOI: http://doi.org/10.4111/kju.2006.47.10.1041

Abstract

PURPOSE: The aim of this study was to compare the sensitivity and specificity of the urinary survivin test for the diagnosis of bladder cancer with the nuclear matrix protein (NMP)-22 test and the urine cytology, and we wanted to correlate survivin with the tumor stage and grade.
MATERIALS AND METHODS
Between October 2002 and March 2004, voided urine samples were obtained from 41 patients with bladder cancer and also from 36 controls who had no evidence of bladder cancer. The urinary survivin and NMP-22 levels were measured using a DuoSet IC ELISA kit and an automated chemiluminescent assay system. The results were compared with the cytologic results and the pathologic findings.
RESULTS
The comparative results showed the higher sensitivity for the urinary survivin test (78.0%) and the NMP-22 test (75.6%) than for the urine cytology (65.8%) for the detection of bladder cancer. The specificity of urinary survivin (86.1%) and urine cytology (97.2%) were higher than that for the NMP-22 test (66.6%). Measuring the urinary survivin level was a more accurate test than the urinary NMP-22 test and the urine cytology for the detection of lower grade and superficial bladder cancer.
CONCLUSIONS
The urinary survivin test was superior to urine cytology for sensitivity and specificity, and these two parameters of the urinary survivin test were higher than those of the NMP-22 test. Especially, the urinary survivin test is an accurate diagnostic test for superficial and lower grade bladder tumor. Our results suggested that the urinary survivin test appears to be a reliable diagnostic test to identify patients with bladder cancer.

Keyword

Bladder cancer; Survivin; Nuclear matrix protein 22; Urine; Cytology

MeSH Terms

Diagnosis*
Diagnostic Tests, Routine
Enzyme-Linked Immunosorbent Assay
Humans
Luminescent Measurements
Nuclear Matrix*
Sensitivity and Specificity
Urinary Bladder Neoplasms*
Urinary Bladder*

Reference

1. Kwon DH, Hong SJ. The clinical utility of BTA TRAK, BTA stat, NMP22 and urine cytology in the diagnosis of bladder cancer: a comparative study. Korean J Urol. 2003. 44:721–726.

2. Park JO, Moon DG, Cheon J, Kim JJ, Yoon DK. Urinary NMP (nuclear matrix protein) 22 in screening and post-treatment follow-up bladder cancer. Korean J Urol. 1999. 40:551–556.

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

4. Kim JM, Lee KW, Kim YH, Park SK, Lee YK, Kim ME. Expression of urinary survivin as a new tumor marker for the detection of bladder cancer. Korean J Urol. 2004. 45:1219–1223.

5. Fuessel S, Kueppers B, Ning S, Kotzsch M, Kraemer K, Schmidt U, et al. Systematic in vitro evaluation of survivin directed antisense oligodeoxynucleotides in bladder cancer cells. J Urol. 2004. 171:2471–2476.

6. Li F, Ambrosini G, Chu EY, Plescia J, Tognin S, Marchisio PC, et al. Control of apoptosis and mitotic spindle checkpoint by survivin. Nature. 1998. 396:580–584.

7. Velculescu VE, Madden SL, Zhang L, Lash AE, Yu J, Rago C, et al. Analysis of human transcriptomes. Nature Genet. 1999. 23:387–388.

8. Konno R, Yamakawa H, Utsunomiya H, Ito K, Sato S, Yajima A. Expression of survivin and Bcl-2 in the normal human endometrium. Mol Hum Reprod. 2000. 6:529–534.

9. Ambrosini G, Adida C, Altieri DC. A novel anti-apoptosis gene, survivin, expressed in cancer and lymphoma. Nat Med. 1997. 3:917–921.

10. Swana HA, Grossman D, Anthony JN, Weiss RM, Altieri DC. Tumor content of the antiapoptosis molecule survivin and recurrence of bladder cancer. N Engl J Med. 1999. 341:452–453.

11. Hausladen DA, Wheeler MA, Altieri DC, Colberg JW, Weiss RM. Effect of intravesical treatment of transitional cell carcinoma with bacillus Calmette-Guerin and mitomycin C on urinary survivin levels and outcome. J Urol. 2003. 170:230–234.

12. Ku JH, Kwak C, Lee HS, Park HK, Lee ES, Lee SE. Expression of survivin, a novel inhibitor of apoptosis, in superficial transitional cell carcinoma of the bladder. J Urol. 2004. 171:631–635.

13. Garcia I, Martinou I, Tsujimoto Y, Martinou JC. Prevention of programmed cell death of sympathetic neurons by the bcl-2 proto-oncogene. Science. 1992. 258:302–304.

14. Tamm I, Wang Y, Sausville E, Scudiero DA, Vigna N, Oltersdorf T, et al. IAP-family protein survivin inhibits caspase activity and apoptosis induced by Fas (CD95), Bax, caspases, and anticancer drugs. Cancer Res. 1998. 58:5315–5320.

15. Smith SD, Wheeler MA, Plescia J, Colberg JW, Weiss RM, Altieri DC. Urine detection of survivin and diagnosis of bladder cancer. JAMA. 2001. 285:324–328.

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

17. Miller TE, Beausang LA, Winchell LF, Lidgard GP. Detection of nuclear matrix proteins in serum from cancer patients. Cancer Res. 1992. 52:422–427.

18. Keesee SK, Briggman JV, Thill G, Wu YJ. Utilization of nuclear matrix proteins for cancer diagnosis. Crit Rev Eukaryot Gene Expr. 1996. 6:189–214.