Background & objective: Bladder cancer is the most common malignancy of all genitourinary tumors. Urine cytology is the "gold standard" for non-invasive diagnosis of bladder cancer, but its sensitivity is low. This study was to explore the clinical value of combined detection with urinary bladder cancer antigen (UBC), hyaluronic acid (HA) and cytokeratin 20 (CK20) in the diagnosis of bladder cancer.
Methods: Urine samples were obtained from 64 patients with bladder cancer and 20 patients with benign urological disease. Urine UBC, HA and CD20 were measured using enzyme-linked immunosorbent assay (ELISA), radioimmunology assay, and reverse transcription polymerase chain reaction (RT-PCR) respectively, before cystoscopy.
Results: UBC, HA and CK20 yielded significantly higher sensitivity in detecting bladder cancer compared to urinary cytology (85.9%, 89.1% and 78.1% vs. 40.6%, P<0.01). The specificity of UBC, HA, CK20 and urinary cytology for the detection of bladder cancer were 85.0%, 80.0%, 80.0% and 95.0%, respectively. The sensitivity of UBC, HA and CK20 were all significantly higher than that of urinary cytology in detecting different histological stages and grades of bladder cancer (P<0.01). The value of UBC had no significant difference in different histological stages and grades of bladder cancer (P>0.05). The sensitivity of HA was significantly higher in G2 and G3 grades than in G1 grade (P<0.01), but not different between G2 and G3 grades(P>0.05). No difference in HA values was observed between different histological types (P>0.05) regarding to HA. The sensitivity of CK20 was significantly elevated with the increase of histological grades and stages. Combined use of UBC, HA and CK20 improved the sensitivity and specificity of detecting bladder cancer to 96.9% (62/64) and 100.0%, respectively.
Conclusions: Combined use of UBC, HA and CK20 can improve the sensitivity and specificity for the detection of bladder cancer in urine, thus it may replace conventional cystoscopy in the primary diagnosis.