Diagnostic and prognostic role of BTA, NMP22, survivin and cytology in urothelial carcinoma.

BACKGROUND: Cytology is a recommended noninvasive urine test for the detection and surveillance of bladder cancer and upper-tract urothelial carcinoma. It is however characterized by poor sensitivity in low-grade tumors. This study aims to determine the diagnostic and prognostic role of BTA, BTA-stat, NMP22, and Survivin. METHODS: Urine samples were collected from a total of 105 patients (bladder cancer (n=61), upper-tract urothelial carcinoma (n=44), and controls (n=52). The samples were directly assessed using cytology, BTA-stat (Qualitative test), BTA (chemiluminescence test), NMP22 (Qualitative test), and Survivin (enzyme-linked immunosorbent assay). Cancer progression and recurrence were assessed after a median follow-up of 32 months (4-47 months). Univariate and multivariate analyses were performed using Kaplan-Meier survival analysis and Cox proportional hazards regression. RESULTS: The triple combination of Survivin + BTA + Cytology was the most promising model for discriminating bladder cancer or upper-tract urothelial carcinoma from controls (UTUC group: the area under the curve value 0.97, sensitivity 86%, specificity 96%; BC group: the area under the curve value 0.86 sensitivity 67%, specificity 96%). Univariate survival analysis, showed Cytology (P=0.02; HR=5.35) and Survivin (HR=3.24; P=0.03) to have a significant association with the progression-free survival, while Survivin (HR=4.15; P=0.04) was statistically associated with cancer-specific survival in the bladder cancer group. The multivariable analysis did not show any of these markers as independent prognostic factors. CONCLUSIONS: These biomarkers showed a higher sensitivity than cytology, but a poorer specificity. All biomarkers exhibited good diagnostic performance in both bladder cancer and upper-tract urothelial carcinoma. Combining Survivin + BTA + Cytology was superior to the use of a single marker or combining other biomarkers.

[Genetic polymorphisms in benign prostatic hyperplasia: Progress in studies].

BPH is a common and frequently-occurring disease of the urinary system. The single nucleotide polymorphism (SNP) is the most common mutation in the genome and has an impact on the pathogenesis, progression and prognosis of BPH in different populations. We reviewed the published literature on BPH-related SNPs, expounded the roles of different SNPs in the development and progression of BPH, and summarized the current status and existing problems in the related studies and the prospects of its clinical application.

[Methods for androgen receptor splice variant-7 detection: Advances in studies].

Treatment strategies for castration-resistant prostate cancer (CRPC) mainly include taxane-based chemotherapy, novel endocrine therapy, and immunotherapy with radium 233. At present, there have been no clinical biomarkers for the prediction of the therapeutic effects and guidance with the medication in the treatment of CRPC. A large number of studies have shown that the androgen receptor splice variant-7 (AR-V7) is associated with the resistance to abiraterone and enzalutamide but not to Taxanes. So AR-V7 is expected to become a clinically useful tumor marker for predicting the clinical efficacy and guiding medication selection. However, the methods for the detection of AR-V7 present a challenge before its clinical application. This review introduces different methods of AR-V7 detection in the existing studies and looks forward to the clinical application of AR-V7 in order to move AR-V7 from the bench to the bedside.