Bladder cancer risk assessment with quantitative fluorescence image analysis of tumor markers in exfoliated bladder cells.
Bonner-RB; Hemstreet-GP III; Fradet-Y; Rao-JY; Min-KW; Hurst-RE
Cancer 1993 Oct; 72(8):2461-2469
A technique for early detection of transitional cell carcinoma (TCC) of the bladder was developed. Cells from voided urine or bladder washing samples were labeled for immunofluorescence using a commercial computer controlled immunostainer that reproducibly performed the sequences of labeling, incubation, and washing. The cells were then double labeled with M344 antibody and 8.7 micromolar Hoechst-33255, and examined under fluorescence using green excitation and a barrier filter to isolate red emissions. Cells that contained intense cherry red granules within the cytoplasm were considered to be positive. The procedure was evaluated using urine samples from 59 patients with TCC, 69 asymptomatic controls, and 159 urologic controls consisting of patients with no history of TCC but current bladder problems, patients with current bladder obstruction, and patients with a past history of TCC who were being monitored for recurrence. More than 90% of the samples from the asymptomatic controls contained no M344 positive cells. Urologic controls without a history of TCC could not be distinguished from the asymptomatic controls. Urologic controls with current bladder obstruction had positive cells in the 5 to 25 positives per 10,000 cells range. The TCC patients showed a wide range of positive rates, approximately half having more than 50 positives/10,000. The sensitivity of the assay for detecting either high or low grade TCC was 78% when compared against the urologic controls. When the assay was combined with DNA ploidy and conventional cytologic analysis, the assay had a sensitivity for detecting low and high grade TCC of 85 and 95%, respectively. The authors conclude that the M344 antibody assay has the potential to detect low grade bladder tumors in symptomatic and asymptomatic individuals. It can also be used for individual risk assessments.
NIOSH-Publication; NIOSH-Grant; Cancer; Bladder-cancer; Clinical-diagnosis; Immunochemistry; Diagnostic-techniques; Risk-analysis
Urology University of Oklahoma Dept of Urology, PO Box 26901 Oklahoma City, OK 73190
University of Oklahoma Hlth Sciences Ctr, Oklahoma City, Oklahoma