NEW YORK, Dec 30 (Reuters Health) -- Two compounds found in urine of
bladder cancer patients could be the basis for a new, non-invasive test for
bladder cancer, according to researchers.
The finding could "improve traditional methods of bladder cancer
surveillance," concludes Dr. Thomas Stanisic of Affiliated Urology Specialists
in Peoria, Illinois. His comments come in response to a study published in the
December issue of the Journal of Urology.
Bladder cancer is the fourth leading cancer in men, and the eighth leading
cancer in women, affecting over 54,000 Americans every year. Patients suspected
of having bladder cancer are usually referred for an invasive procedure where
tissue is removed from the bladder lining and then examined under the
microscope. Researchers have long sought a non-invasive test for bladder cancer
that might ease the way to routine screening and earlier detection.
Investigating this possibility, Spanish researchers led by Dr. Marta
Sanchez-Carbayo of the Hospital General Universitario de Alicante, compared
levels of CYFRA 21-1 and NMP22 -- two compounds found in urine -- in a group of
267 adults. About two thirds of the subjects were either currently battling
bladder cancer or had a previous history of the disease, while one-third were
either healthy or suffered from some other, non-cancerous form of bladder
illness.
According to the investigators, NMP22 and CYFRA 21-1 urine tests correctly
detected 75.7% and 83.8% of bladder cancers, respectively. Using the two markers
in combination, researchers were able to accurately spot nearly 90% of bladder
cancers.
The authors also report low levels of 'false-positive' results -- where a
diagnosis of bladder cancer later turns out to be wrong -- using the two
markers.
Tests involving NMP22 were particularly useful in allowing researchers the
ability to predict the size and spread of bladder tumors, as well as the depth
at which the tumor had penetrated into the bladder wall.
The researchers stress that further investigation is needed to confirm the
tests' effectiveness. However, they are optimistic that the urine test might
someday help patients and their doctors decide on the need for further, invasive
diagnostic testing.
In his accompanying editorial, Stanisic agrees that "although they are a
long way from any direct clinical application, these findings certainly justify
further investigation." He believes that, with time, some form of non-invasive,
urine-based testing will find its way into "day-to-day practice."
