Diagnostic potential of urinary α1-antitrypsin and apolipoprotein e in the detection of bladder cancer

Virginia Urquidi, Steven Goodison, Shanti Ross, Myron Chang, Yunfeng Dai, Charles J. Rosser

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

Purpose: The ability to reliably diagnose bladder cancer in voided urine samples would be a major advance. Using high throughput technologies, we identified a panel of bladder cancer associated biomarkers with potential clinical usefulness. In this study we tested 4 potential biomarkers for the noninvasive detection of bladder cancer. Materials and Methods: We examined voided urine specimens from 124 patients, including 63 newly diagnosed with bladder cancer and 61 controls. Concentrations of proteins were assessed by enzyme-linked immunosorbent assay, including α1-antitrypsin, apolipoprotein E, osteopontin and pentraxin 3. Data were compared to the results of urinary cytology and the BTA Trak® enzyme-linked immunosorbent assay based bladder cancer detection assay. We used the AUC of ROC curves to compare the usefulness of each biomarker to detect bladder cancer. Results: Urinary levels of α1-antitrypsin, apolipoprotein E and bladder tumor antigen were significantly increased in subjects with bladder cancer. α1-Antitrypsin (AUC 0.9087, 95% CI 0.8555-0.9619) and apolipoprotein E (AUC 0.8987, 95% CI 0.8449-0.9525) were the most accurate biomarkers. The combination of α1-antitrypsin and apolipoprotein E (AUC 0.9399) achieved 91% sensitivity, 89% specificity, and a positive and negative predictive value of 89% and 90%, respectively. Multivariate regression analysis highlighted only apolipoprotein E as an independent predictor of bladder cancer (OR 24.9, 95% CI 4.22-146.7, p = 0.0004). Conclusions: Alone or in combination, α1-antitrypsin and apolipoprotein E show promise for the noninvasive detection of bladder cancer (OR 24.9, 95% CI 4.22-146.7, p = 0.0004). Larger, prospective studies including more low grade, low stage tumors are needed to confirm these results.

Original languageEnglish (US)
Pages (from-to)2377-2383
Number of pages7
JournalJournal of Urology
Volume188
Issue number6
DOIs
StatePublished - Dec 1 2012
Externally publishedYes

Fingerprint

Apolipoproteins
Urinary Bladder Neoplasms
Area Under Curve
Biomarkers
Apolipoproteins E
Enzyme-Linked Immunosorbent Assay
Apolipoprotein E3
Urine
Osteopontin
Neoplasm Antigens
Tumor Biomarkers
ROC Curve
Cell Biology
Multivariate Analysis
Regression Analysis
Prospective Studies
Technology
Sensitivity and Specificity

Keywords

  • alpha 1-antitrypsin
  • apolipoproteins A
  • diagnosis
  • urinary bladder
  • urinary bladder neoplasms

ASJC Scopus subject areas

  • Urology

Cite this

Diagnostic potential of urinary α1-antitrypsin and apolipoprotein e in the detection of bladder cancer. / Urquidi, Virginia; Goodison, Steven; Ross, Shanti; Chang, Myron; Dai, Yunfeng; Rosser, Charles J.

In: Journal of Urology, Vol. 188, No. 6, 01.12.2012, p. 2377-2383.

Research output: Contribution to journalArticle

Urquidi, Virginia ; Goodison, Steven ; Ross, Shanti ; Chang, Myron ; Dai, Yunfeng ; Rosser, Charles J. / Diagnostic potential of urinary α1-antitrypsin and apolipoprotein e in the detection of bladder cancer. In: Journal of Urology. 2012 ; Vol. 188, No. 6. pp. 2377-2383.
@article{2957b16d701f4bf8a38f0442adb4a70f,
title = "Diagnostic potential of urinary α1-antitrypsin and apolipoprotein e in the detection of bladder cancer",
abstract = "Purpose: The ability to reliably diagnose bladder cancer in voided urine samples would be a major advance. Using high throughput technologies, we identified a panel of bladder cancer associated biomarkers with potential clinical usefulness. In this study we tested 4 potential biomarkers for the noninvasive detection of bladder cancer. Materials and Methods: We examined voided urine specimens from 124 patients, including 63 newly diagnosed with bladder cancer and 61 controls. Concentrations of proteins were assessed by enzyme-linked immunosorbent assay, including α1-antitrypsin, apolipoprotein E, osteopontin and pentraxin 3. Data were compared to the results of urinary cytology and the BTA Trak{\circledR} enzyme-linked immunosorbent assay based bladder cancer detection assay. We used the AUC of ROC curves to compare the usefulness of each biomarker to detect bladder cancer. Results: Urinary levels of α1-antitrypsin, apolipoprotein E and bladder tumor antigen were significantly increased in subjects with bladder cancer. α1-Antitrypsin (AUC 0.9087, 95{\%} CI 0.8555-0.9619) and apolipoprotein E (AUC 0.8987, 95{\%} CI 0.8449-0.9525) were the most accurate biomarkers. The combination of α1-antitrypsin and apolipoprotein E (AUC 0.9399) achieved 91{\%} sensitivity, 89{\%} specificity, and a positive and negative predictive value of 89{\%} and 90{\%}, respectively. Multivariate regression analysis highlighted only apolipoprotein E as an independent predictor of bladder cancer (OR 24.9, 95{\%} CI 4.22-146.7, p = 0.0004). Conclusions: Alone or in combination, α1-antitrypsin and apolipoprotein E show promise for the noninvasive detection of bladder cancer (OR 24.9, 95{\%} CI 4.22-146.7, p = 0.0004). Larger, prospective studies including more low grade, low stage tumors are needed to confirm these results.",
keywords = "alpha 1-antitrypsin, apolipoproteins A, diagnosis, urinary bladder, urinary bladder neoplasms",
author = "Virginia Urquidi and Steven Goodison and Shanti Ross and Myron Chang and Yunfeng Dai and Rosser, {Charles J.}",
year = "2012",
month = "12",
day = "1",
doi = "10.1016/j.juro.2012.07.094",
language = "English (US)",
volume = "188",
pages = "2377--2383",
journal = "Journal of Urology",
issn = "0022-5347",
publisher = "Elsevier Inc.",
number = "6",

}

TY - JOUR

T1 - Diagnostic potential of urinary α1-antitrypsin and apolipoprotein e in the detection of bladder cancer

AU - Urquidi, Virginia

AU - Goodison, Steven

AU - Ross, Shanti

AU - Chang, Myron

AU - Dai, Yunfeng

AU - Rosser, Charles J.

PY - 2012/12/1

Y1 - 2012/12/1

N2 - Purpose: The ability to reliably diagnose bladder cancer in voided urine samples would be a major advance. Using high throughput technologies, we identified a panel of bladder cancer associated biomarkers with potential clinical usefulness. In this study we tested 4 potential biomarkers for the noninvasive detection of bladder cancer. Materials and Methods: We examined voided urine specimens from 124 patients, including 63 newly diagnosed with bladder cancer and 61 controls. Concentrations of proteins were assessed by enzyme-linked immunosorbent assay, including α1-antitrypsin, apolipoprotein E, osteopontin and pentraxin 3. Data were compared to the results of urinary cytology and the BTA Trak® enzyme-linked immunosorbent assay based bladder cancer detection assay. We used the AUC of ROC curves to compare the usefulness of each biomarker to detect bladder cancer. Results: Urinary levels of α1-antitrypsin, apolipoprotein E and bladder tumor antigen were significantly increased in subjects with bladder cancer. α1-Antitrypsin (AUC 0.9087, 95% CI 0.8555-0.9619) and apolipoprotein E (AUC 0.8987, 95% CI 0.8449-0.9525) were the most accurate biomarkers. The combination of α1-antitrypsin and apolipoprotein E (AUC 0.9399) achieved 91% sensitivity, 89% specificity, and a positive and negative predictive value of 89% and 90%, respectively. Multivariate regression analysis highlighted only apolipoprotein E as an independent predictor of bladder cancer (OR 24.9, 95% CI 4.22-146.7, p = 0.0004). Conclusions: Alone or in combination, α1-antitrypsin and apolipoprotein E show promise for the noninvasive detection of bladder cancer (OR 24.9, 95% CI 4.22-146.7, p = 0.0004). Larger, prospective studies including more low grade, low stage tumors are needed to confirm these results.

AB - Purpose: The ability to reliably diagnose bladder cancer in voided urine samples would be a major advance. Using high throughput technologies, we identified a panel of bladder cancer associated biomarkers with potential clinical usefulness. In this study we tested 4 potential biomarkers for the noninvasive detection of bladder cancer. Materials and Methods: We examined voided urine specimens from 124 patients, including 63 newly diagnosed with bladder cancer and 61 controls. Concentrations of proteins were assessed by enzyme-linked immunosorbent assay, including α1-antitrypsin, apolipoprotein E, osteopontin and pentraxin 3. Data were compared to the results of urinary cytology and the BTA Trak® enzyme-linked immunosorbent assay based bladder cancer detection assay. We used the AUC of ROC curves to compare the usefulness of each biomarker to detect bladder cancer. Results: Urinary levels of α1-antitrypsin, apolipoprotein E and bladder tumor antigen were significantly increased in subjects with bladder cancer. α1-Antitrypsin (AUC 0.9087, 95% CI 0.8555-0.9619) and apolipoprotein E (AUC 0.8987, 95% CI 0.8449-0.9525) were the most accurate biomarkers. The combination of α1-antitrypsin and apolipoprotein E (AUC 0.9399) achieved 91% sensitivity, 89% specificity, and a positive and negative predictive value of 89% and 90%, respectively. Multivariate regression analysis highlighted only apolipoprotein E as an independent predictor of bladder cancer (OR 24.9, 95% CI 4.22-146.7, p = 0.0004). Conclusions: Alone or in combination, α1-antitrypsin and apolipoprotein E show promise for the noninvasive detection of bladder cancer (OR 24.9, 95% CI 4.22-146.7, p = 0.0004). Larger, prospective studies including more low grade, low stage tumors are needed to confirm these results.

KW - alpha 1-antitrypsin

KW - apolipoproteins A

KW - diagnosis

KW - urinary bladder

KW - urinary bladder neoplasms

UR - http://www.scopus.com/inward/record.url?scp=84869089972&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84869089972&partnerID=8YFLogxK

U2 - 10.1016/j.juro.2012.07.094

DO - 10.1016/j.juro.2012.07.094

M3 - Article

VL - 188

SP - 2377

EP - 2383

JO - Journal of Urology

JF - Journal of Urology

SN - 0022-5347

IS - 6

ER -