Diagnosis of bladder cancer by immunocytochemical detection of minichromosome maintenance protein-2 in cells retrieved from urine

K. Saeb-Parsy, A. Wilson, C. Scarpini, M. Corcoran, S. Chilcott, M. McKean, B. Thottakam, B. Rai, G. Nabi, D. Rana, M. Perera, K. Stewart, R. A. Laskey, D. E. Neal, N. Coleman

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Abstract

Background: We tested the accuracy of immunocytochemistry (ICC) for minichromosome maintenance protein-2 (MCM-2) in diagnosing bladder cancer, using cells retrieved from urine. Methods: Adequate samples were obtained from 497 patients, the majority presenting with gross haematuria (GH) or undergoing cystoscopic surveillance (CS) following previous bladder cancer. We performed an initial study of 313 patients, followed by a validation study of 184 patients. In all cases, presence/absence of bladder cancer was established by cystoscopy/biopsy. Results: In the initial study, receiver operator characteristic analysis showed an area under the curve of 0.820 (P<0.0005) for the GH group and 0.821 (P<0.01) for the CS group. Optimal sensitivity/specificity were provided by threshold values of 50 MCM-2-positive cells in GH samples and 200 cells in CS samples, based on a minimum total cell number of 5000. Applying these thresholds to the validation data set gave 81.3% sensitivity, 76.0% specificity and 92.7% negative predictive value (NPV) in GH and 63.2% sensitivity, 89.9% specificity and 89.9% NPV in CS. Minichromosome maintenance protein-2 ICC provided clinically relevant improvements over urine cytology, with greater sensitivity in GH and greater specificity in CS (P=0.05). Conclusions: Minichromosome maintenance protein-2 ICC is a reproducible and accurate test that is suitable for both GH and CS patient groups.

Original languageEnglish
Pages (from-to)1384-1391
Number of pages8
JournalBritish Journal of Cancer
Volume107
Issue number8
DOIs
Publication statusPublished - 9 Oct 2012

Keywords

  • Biomarker
  • Bladder cancer
  • Cytology
  • Immunocytochemistry
  • MCM-2
  • Urothelial carcinoma

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    Saeb-Parsy, K., Wilson, A., Scarpini, C., Corcoran, M., Chilcott, S., McKean, M., Thottakam, B., Rai, B., Nabi, G., Rana, D., Perera, M., Stewart, K., Laskey, R. A., Neal, D. E., & Coleman, N. (2012). Diagnosis of bladder cancer by immunocytochemical detection of minichromosome maintenance protein-2 in cells retrieved from urine. British Journal of Cancer, 107(8), 1384-1391. https://doi.org/10.1038/bjc.2012.381