Korean J Lab Med.  2007 Feb;27(1):50-55. 10.3343/kjlm.2007.27.1.50.

Comparison of the Urine ThinPrep Test and Melanoma Antigen Gene RT-PCR for the Detection of Bladder Cancer According to Three Urine Collection Methods

• Kim DY
• Cho HJ
• Oh HK
• Shin IH
• Jeon CH

• KMID: 1121660
• DOI: http://doi.org/10.3343/kjlm.2007.27.1.50

Abstract

BACKGROUND: For the detection of transitional cell carcinoma (TCC) of the bladder, we compared the sensitivities and specificities between the ThinPrep test and Melanoma Antigen Gene (MAGE) test with voided urine (V), drained urine (D), and irrigated urine (I). METHODS: We randomly selected 10 patients of a non-cancer group and 20 patients of a cancer group. V, D, and I were obtained preoperatively, and equally divided into two parts for the ThinPrep test and MAGE reverse transcriptase polymerase chain reaction (RT-PCR). The cystoscopic finding was used as the reference standard for detection of bladder cancer. The results of ThinPrep test and MAGE RT-PCR were compared according to cancer grade and stage. RESULTS: The overall sensitivities of ThinPrep test were 45%, 85% and 85% for V, D, and I, respec-tively, while those of MAGE test were 50%, 85%, and 65%. Detection rate from drainage urine was considerably higher than that of voided urine in both methods (P<0.05). The specificities were 100% for all types of urine specimens with ThinPrep test and 100%, 90%, and 90% for V, D, and I, respectively, using MAGE test, without any statistically significant differences. CONCLUSIONS: For the detection of bladder cancer, MAGE RT-PCR and ThinPrep test showed a comparable sensitivity and specificity, and drained urine revealed the best detection rate. MAGE RT-PCR might be utilized as another marker of bladder cancer using urine specimens.

Keyword

Bladder cancer; Cytology; Urine; MAGE

MeSH Terms

Adult
Aged
Aged, 80 and over
Antigens, Neoplasm/*genetics
Carcinoma, Transitional Cell/*diagnosis/pathology
Cytodiagnosis/*methods
Female
Humans
Male
Middle Aged
Neoplasm Proteins/*genetics
RNA, Neoplasm/urine
Reverse Transcriptase Polymerase Chain Reaction/*methods
Sensitivity and Specificity
Urinalysis
Urinary Bladder Neoplasms/*diagnosis/pathology
Urine/*cytology

Figure

• 

  Fig. 1. Results of MAGE RT-nested PCR from voided urine (A), drained urine (B) and irrigated urine (C) of bladder cancer. Patient no. 1–10; P, positive control; N, negative control; M, 490 bp of MAGE product; G, 320 bp of GAPD internal control.

Reference

References

1. Kim WJ, Chung Jl, Hong JH, Kim CS, Jung Sl, Yoon DK. Epidemiological study for urologic cancer in Korea (1998–2002). Korean J Urol. 2004; 45:1081–8.

2. Raghavan D, Shipley WU, Garnick MB, Russell PJ, Richie JP. Biology and management of bladder cancer. N Engl J Med. 1990; 322:1129–38.

3. Lokeshwar VB, Soloway MS. Current bladder tumor tests: does their projected utility fulfill clinical necessity? J Urol. 2001; 165:1067–77.

4. Nicol TL, Kelly D, Reynolds L, Rosenthal DL. Comparison of Tri-Path thin-layer technology with conventional methods on nongy-necologic specimens. Acta Cytol. 2000; 44:567–75.

5. Bishop JW, Bigner SH, Colgan TJ, Husain M, Howell LP, McIntosh KM, et al. Multicenter masked evaluation of AutoCyte PREP thin layers with matched conventional smears. Including initial biopsy results. Acta Cytol. 1998; 42:189–97.

6. Park YW, Chung JH, Lee HM. A comparison of the availability of the urine ThinPrep(R) test and urine cytology in the diagnosis of bladder cancer. Korean J Urol. 2003; 44:734–8.

7. Jeon CH, Lee SC, Hyun DS, Hong SI, Hong YJ, Chang YH, et al. Evaluation of sensitivity and specificity of MAGE A1–6 RT-nested PCR as a cancer detection method. Korean J Lab Med. 2003; 23:357–62.

8. Lotan Y, Roehrborn CG. Sensitivity and specificity of commonly available bladder tumor markers versus cytology: results of a comprehensive literature review and meta-analyses. Urology. 2003; 61:109–18.

9. Ro JY, Staerkel GA, Ayala AG. Cytologic and histologic features of superficial bladder cancer. Urol Clin North Am. 1992; 19:435–53.

10. Nassar H, Ali-Fehmi R, Madan S. Use of ThinPrep monolayer technique and cytospin preparation in urine cytology: a comparative analysis. Diagn Cytopathol. 2003; 28:115–8.

11. Wright RG, Halford JA. Evaluation of thin-layer methods in urine cytology. Cytopathology. 2001; 12:306–13.

12. van der Bruggen P, Traversari C, Chomez P, Lurquin C, De Plaen E, Van den Eynde, et al. A gene encoding an antigen recognized by cytolytic T lymphocytes on a human melanoma. Science. 1991; 254:1643–7.

13. Chomez P, De Backer O, Bertrand M, De Plaen E, Boon T, Lucas S. An overview of the MAGE gene family with the identification of all human members of the family. Cancer Res. 2001; 61:5544–51.

14. Zammatteo N, Lockman L, Brasseur F, De Plaen E, Lurquin C, Lobert PE, et al. DNA microarray to monitor the expression of MAGE-A genes. Clin Chem. 2002; 48:25–34.

15. Yamada A, Kataoka A, Shichijo S, Kamura T, Imai Y, Nishida T, et al. Expression of MAGE-1, MAGE-2, MAGE-3/-6 and MAGE-4a/-4b genes in ovarian tumors. Int J Cancer. 1995; 64:388–93.

16. Kocher T, Zheng M, Bolli M, Simon R, Forster T, Schultz-Thater E, et al. Prognostic relevance of MAGE-A4 tumor antigen expression in transitional cell carcinoma of the urinary bladder: a tissue microarray study. Int J Cancer. 2002; 100:702–5.

17. Patard JJ, Brasseur F, Gil-Diez S, Radvanyi F, Marchand M, Francois P, et al. Expression of MAGE genes in transitional-cell carcinomas of the urinary bladder. Int J Cancer. 1995; 64:60–4.

18. Bar-Haim E, Paz A, Machlenkin A, Hazzan D, Tirosh B, Carmon L, et al. MAGE-A8 overexpression in transitional cell carcinoma of the bladder: identification of two tumour-associated antigen peptides. Br J Cancer. 2004; 91:398–407.

19. Trott PA, Edwards L. Comparison of bladder washings and urine cytology in the diagnosis of bladder cancer. J Urol. 1973; 110:664–6.

20. Matzkin H, Moinuddin SM, Soloway MS. Value of urine cytology versus bladder washing in bladder cancer. Urology. 1992; 39:201–3.

21. Harris MJ, Schwinn CP, Morrow JW, Gray RL, Browell BM. Exfoliative cytology of the urinary bladder irrigation specimen. Acta Cytol. 1971; 15:385–99.

22. Zein T, Wajsman Z, Englander LS, Gamarra M, Lopez C, Huben RP, et al. Evaluation of bladder washings and urine cytology in the diagnosis of bladder cancer and its correlation with selected biopsies of the bladder mucosa. J Urol. 1984; 132:670–1.

23. Badalament RA, Hermansen DK, Kimmel M, Gay H, Herr HW, Fair WR, et al. The sensitivity of bladder wash flow cytometry, bladder wash cytology, and voided cytology in the detection of bladder carcinoma. Cancer. 1987; 60:1423–7.

24. Uh KW, Kim KS. Comparative examination on bladder washings and urine for the diagnosis of bladder cancer in cytology. Korean J Urol. 1980; 21:143–6.

25. Eissa S, Labib RA, Mourad MS, Kamel K, El-Ahmady O. Comparison of telomerase activity and matrix metalloproteinase-9 in voided urine and bladder wash samples as a useful diagnostic tool for bladder cancer. Eur Urol. 2003; 44:687–94.

26. Planz B, Jochims E, Deix T, Caspers HP, Jakse G, Boecking A. The role of urinary cytology for detection of bladder cancer. Eur J Surg Oncol. 2005; 31:304–8.

27. Mungan NA, Kulacoglu S, Basar M, Sahin M, Witjes JA. Can sensitivity of voided urinary cytology or bladder wash cytology be improved by the use of different urinary portions? Urol Int. 1999; 62:209–12.

28. Murphy WM, Crabtree WN, Jukkola AF, Soloway MS. The diagnostic value of urine versus bladder washing in patients with bladder cancer. J Urol. 1981; 126:320–2.