Diagnostic value of urinary molecular markers in XXXX .

@entity1 @entity5 @entity5450 @entity150 @entity3 @entity1495 @entity2040
OBJECTIVES: In an attempt to find a more sensitive and specific non-invasive diagnostic assay for the detection of @entity150 cells, the authors assayed the exfoliated cells from @entity1 's voided urine and bladder washing fluids for the presence of telomerase, an enzyme that maintains a cell's chromosomal length, metalloproteinase-9 ( @entity1495 ), which has been associated with @entity5 cell invasion and @entity3 . Their results were compared with both voided urine cytology (VUC) and bladder wash cytology (BWC) for the detection of @entity150 cells. MATERIALS AND METHODS: The authors used preoperative voided morning urine samples from 110 subjects for telomerase, @entity1495 ( @entity1495 ) and cytology. Bladder wash samples were obtained for telomerase and cytology. Of 110 cases 73 were histologically diagnosed as @entity150 , whereas the remaining 16 had benign @entity5450 . A group of 21 healthy volunteers were also enrolled in this study. Cystoscopy was done for all @entity1 as the reference standard for the identification of @entity150 . Biopsy of any suspicious lesion was performed for histopathological examination. RESULTS: Receiver-operator characteristics (ROC) curves were used to determine the optimal threshold values for telomerase activity in urine, bladder wash and @entity1495 [0.05, 0.088 and 0.51 (ng/ml), respectively]. The levels and the positivity rates of telomerase activity and @entity1495 were significantly higher in the malignant group compared to either the benign group or normal controls. @entity150 @entity1 with positive cytology revealed positive telomerase activity in urine, bladder wash, and @entity1495 in 92%, 87% and 61%, respectively. Also, these positive rates were significantly higher in bilharzial @entity150 cases (88%, 89%, 69%, respectively) compared to non-bilharzial cases (50%, 62.5%, 50%). The overall sensitivity and specificity were 83% and 88.6%, 86.3% and 78.3% for telomerase activity in urine, and in bladder wash, respectively. 66.6% and 80% for @entity1495 , 58.5% and 100% for voided urine cytology and 64.4% and 100% for bladder wash cytology. Combined sensitivity of VUC with the 2 biomarkers together was higher than either combined sensitivity of VUC with one of the biomarkers or than that of the biomarker alone. CONCLUSION: Urinary telomerase and @entity1495 had superior sensitivities over VUC; moreover, combined use of these markers increased the sensitivity of cytology from 58.46% to 95%. The higher sensitivities of markers in bilharzial @entity150 than non-bilharzial type highlight their clinical utility in screening @entity1 with @entity2040 .
