TY - JOUR
T1 - Role of urinary cathepsin B and L in the detection of bladder urothelial cell carcinoma
AU - Svatek, Robert S.
AU - Karam, Jose
AU - Karakiewicz, Pierre I.
AU - Gallina, Andrea
AU - Casella, Roberto
AU - Roehrborn, Claus
AU - Shariat, Shahrokh F.
PY - 2008/2
Y1 - 2008/2
N2 - Purpose; We tested the hypothesis that urinary cathepsin B and L are associated with bladder cancer recurrence and invasiveness in patients with a history of nonmuscle invasive urothelial carcinoma of the bladder. Materials and Methods; Cathepsin B and L, and NMP22® were determined in the urine specimens of 188 consecutive subjects with a history of treated urothelial carcinoma of the bladder, 31 with noncancerous urological conditions and 10 healthy subjects. Cathepsin B and L were analyzed as continuous and categorical variables based on their quartile distribution. Results; Urinary cathepsin L was higher in the 122 patients with cystoscopic evidence of bladder tumor compared with levels in 107 with normal cystoscopy (median 5.9, IQR 4.4 vs 3.0, IQR 3.2, p <0.001). Higher levels of cathepsin L were associated with positive cytology assay results, higher NMP22 and T1 or greater pathological stage (each p <0.001). Area under the ROC curves of NMP22 and cathepsin L for bladder cancer detection were 0.704 (95% CI 0.637-0.772) and 0.793 (95% CI 0.736-0.850), respectively. On multivariate analysis cathepsin L, NMP22 and cytology were associated with invasive pathological stage (OR 1.29, 2.42 and 2.76, respectively, p ≤0.002). Urinary cathepsin B was not associated with any outcome variables. Conclusions; Urinary cathepsin L is an independent predictor of bladder cancer presence and invasiveness in patients with a history of urothelial carcinoma of the bladder. Further evaluation of this marker is necessary before its use as an adjunct to cystoscopy for urothelial carcinoma of the bladder. Copyright;
AB - Purpose; We tested the hypothesis that urinary cathepsin B and L are associated with bladder cancer recurrence and invasiveness in patients with a history of nonmuscle invasive urothelial carcinoma of the bladder. Materials and Methods; Cathepsin B and L, and NMP22® were determined in the urine specimens of 188 consecutive subjects with a history of treated urothelial carcinoma of the bladder, 31 with noncancerous urological conditions and 10 healthy subjects. Cathepsin B and L were analyzed as continuous and categorical variables based on their quartile distribution. Results; Urinary cathepsin L was higher in the 122 patients with cystoscopic evidence of bladder tumor compared with levels in 107 with normal cystoscopy (median 5.9, IQR 4.4 vs 3.0, IQR 3.2, p <0.001). Higher levels of cathepsin L were associated with positive cytology assay results, higher NMP22 and T1 or greater pathological stage (each p <0.001). Area under the ROC curves of NMP22 and cathepsin L for bladder cancer detection were 0.704 (95% CI 0.637-0.772) and 0.793 (95% CI 0.736-0.850), respectively. On multivariate analysis cathepsin L, NMP22 and cytology were associated with invasive pathological stage (OR 1.29, 2.42 and 2.76, respectively, p ≤0.002). Urinary cathepsin B was not associated with any outcome variables. Conclusions; Urinary cathepsin L is an independent predictor of bladder cancer presence and invasiveness in patients with a history of urothelial carcinoma of the bladder. Further evaluation of this marker is necessary before its use as an adjunct to cystoscopy for urothelial carcinoma of the bladder. Copyright;
KW - Bladder
KW - Bladder neoplasms
KW - Cathepsins
KW - Tumor markers, biological
KW - Urothelium
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U2 - 10.1016/j.juro.2007.09.037
DO - 10.1016/j.juro.2007.09.037
M3 - Article
C2 - 18076936
AN - SCOPUS:38849155980
SN - 0022-5347
VL - 179
SP - 478
EP - 484
JO - Journal of Urology
JF - Journal of Urology
IS - 2
ER -