Carbonic anhydrase IX as a diagnostic urinary marker for urothelial bladder cancer.
UNLABELLED
Urinary biomarkers are needed to improve the management and reduce the cost of urothelial bladder cancer (UBC); however, none have been recommended yet for clinical practice. This study evaluated carbonic anhydrase IX (CAIX) as a diagnostic urinary biomarker for UBC. CAIX was analyzed by quantitative polymerase chain reaction in urine samples of 196 patients with UBC and 123 controls with hematuria. Paired samples from urine and tumor tissue were evaluated in 16 cases. Data were validated in 155 independent samples. The sensitivity and specificity of CAIX for UBC detection were 86.2% and 95.1%, respectively (area under the curve [AUC]: 90.5%). There was a significant association of CAIX expression between the paired urine and tumor specimens (p=0.002). CAIX showed a significantly higher predictive accuracy than urinary cytology (90.5% vs 71.7%), specifically in low-grade tumors (90.0% vs 61.8%). CAIX expression decreased with increasing tumor stage and grade. Analyses in an independent validation cohort confirmed the high accuracy of CAIX for diagnosing UBC (AUC: 88.3%).


PATIENT SUMMARY
We evaluated carbonic anhydrase IX (CAIX) as a urinary marker for bladder cancer (BCa) using a large series of patients from a single hospital. We found that urinary CAIX has a high sensitivity and specificity for diagnosing BCa.
['de Martino|Michela|M|', 'Lucca|Ilaria|I|', 'Mbeutcha|Aurelie|A|', 'Wiener|Helene G|HG|', 'Haitel|Andrea|A|', 'Susani|Martin|M|', 'Shariat|Shahrokh F|SF|', 'Klatte|Tobias|T|']
D000951:Antigens, Neoplasm D019540:Area Under Curve D014408:Biomarkers, Tumor D000071231:Carbonic Anhydrase IX D002256:Carbonic Anhydrases D016022:Case-Control Studies D006801:Humans D060787:Neoplasm Grading D009367:Neoplasm Staging D016133:Polymerase Chain Reaction D011237:Predictive Value of Tests D011446:Prospective Studies D012372:ROC Curve D015203:Reproducibility of Results D016482:Urinalysis D001749:Urinary Bladder Neoplasms D019459:Urothelium
Carbonic anhydrase IX Urinary marker Bladder cancer Cytology CA9 Cystoscopy Diagnosis Recurrence