Urine Test Detects Bladder Cancer

A simple urine test has been developed that can detect urothelial carcinoma of the urinary bladder (UCB) and may greatly improve the patient’s quality of life.

The urine test, which detects a protein, will allow new patients to be quickly and easily diagnosed as well as allowing existing patients already undergoing treatment to be more easily monitored.

Scientists at the University of Surrey (Guildford, UK) collected prospectively urine samples for the biomarker study between 2006 and 2009. They used various techniques including immunohistochemistry, gene expression profiling, and for the detection of the protein they used both Western blots and enzyme-linked immunosorbent assays (ELISA). The mean age of the 466 patients with UCB included in the study was 72 years (range 29-94 years), and for the 52 non-UCB control subjects the mean age was 71 years (range 34-88 years).

For detecting the engrailed homeobox protein-2 (EN2) in the ELISA, a monoclonal mouse anti-EN2 antibody, APS1, was generated (Antibody Production Services Ltd.; Haywards Heath, UK) using the synthetically produced EN2 C-terminal 100 amino acids (Biosynthesis Inc., Lewisville, TX, USA). The mean urinary EN2 concentration in patients with UCB was 197 ng/mL, whereas that for control subjects was 34 ng/mL. Higher grade tumors were associated with higher mean urinary EN2 concentrations of 192 ng/mL for Grade 2 and 215 ng/mL for Grade 3, while than Grade 1 tumors, the mean was 168 ng/mL.

The authors concluded that the simple urine test had an extremely high sensitivity for the detection of bladder cancer which was an improvement on all other urine tests and which approached the sensitivity of cystoscopy. The amount of EN2 in the patients’ urine corresponded to the aggressiveness and volume of their cancer. EN-2 has been detected in individuals with recurrent bladder cancer as well.

Hardev Pandha, MD, PhD, a senior author of the study, said, “Bladder cancer is one of the most expensive cancers to manage. During the course of treatment, patients can endure multiple invasive procedures, used to monitor the success of surgeries and drug therapy programs. This simple test challenges the need for such routine and invasive procedures, greatly improving the experience for patients and saving the UK National Health Service (NHS) a considerable amount of money.” The study was published in the June 2013 issue of the European Journal of Cancer.


Related Links:

University of Surrey
Antibody Production Services Ltd
Biosynthesis Inc