Detection of bladder cancer recurrence by microsatellite analysis of urine


A reliable, noninvasive method for monitoring patients with transitional cell carcinoma (TCC) of the bladder would be of great clinical benefit. Cystoscopy is currently the “gold standard,” but it is invasive, expensive and uncomfortable for the patient. Recently, we demonstrated a novel approach for the detection of primary bladder cancer based on microsatellite analysis of urine DNA. To determine the feasibility of this technique for following-up patients with TCC, we tested serial urine samples from 21 patients who had been treated for bladder cancer with 20 polymorphic microsatellite markers in a blinded fashion. We detected recurrent lesions in 10 out of 11 patients and correctly predicted the existence of a neoplastic cell population in the urine of two patients, 4 and 6 months before cystoscopic evidence of the tumor. The assay was negative in 10 of 10 patients who had no evident cancer. Microsatellite analysis of urine sediment represents a novel and potentially powerful clinical tool for the detection of recurrent bladder cancer.

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  1. 1

    Boring, C.C., Squires, T.S. Tong, T. & Montgomery, S. Cancer statistics, 1994. CA Cancer J. Clin. 44, 7–26 (1994).

    CAS  Article  Google Scholar 

  2. 2

    Hudson, M.A. & Catalona, W.J. Urothelial tumors of the bladder, upper tracts and prostate. in Adult and Pediatric Urology, (eds. Gillenwater, J.Y., Grayhack, J.T., Howards, S.S., Duckett, J.W.) 643–694 (Mosby, St. Louis, MO, A1996).

    Google Scholar 

  3. 3

    Papanicolaou, G.N. & Marshall, V.F. Urine sediment smears as a diagnostic procedure in cancers of the urinary tract. Science 101, 519–520 (1945).

    CAS  Article  Google Scholar 

  4. 4

    Murphy, W.M., Soloway, M.S., Jukkola, A.F., Crabtree, W.N. & Ford, K.S. Urinary cytology and bladder cancer: The cellular features of transitional cell neoplasms. Cancer 53, 1555–1565 (1984).

    CAS  Article  Google Scholar 

  5. 5

    Sarosdy, M.F. et al. Results of a multicenter trial using the BTA test to monitor for and diagnose recurrent bladder cancer. J. Urol. 154, 379–384 (1995).

    CAS  Article  Google Scholar 

  6. 6

    Soloway, M.S. et al. Use of a new tumor marker, NMP22 in the detection of occult or rapidly recurring transitional cell carcinoma of the urinary tract following surgical treatment. J. Urol. 156, 363–367 (1996).

    CAS  Article  Google Scholar 

  7. 7

    Mao, L. et al. Molecular detection of primary bladder cancer by microsatellite analysis. Science 271, 659–663 (1996).

    CAS  Article  Google Scholar 

  8. 8

    Fisher, D.E. Apoptosis in cancer therapy: CFossing the threshold. Cell 78, 539–542 (1994).

    CAS  Article  Google Scholar 

  9. 9

    Rouslahti, E. & Reed J.C. Anchorage dependence, integrins, and apoptosis. Cell 77, 477–478 (1994).

    Article  Google Scholar 

  10. 10

    Loh, C.S., Speeding, A.V., Ashworth, M.T., Kenyon, W.E. & Desmond, A.D. The value of exfoliative urine cytology in combination with flexible cystoscopy in the diagnosis of recurrent transitional cell carcinoma of the urinary bladder. Br. J. Urol. 77, 655–658 (1996).

    CAS  Article  Google Scholar 

  11. 11

    Cutler, S.J., Heney, N.M. & Friedell, G.H. Longitudinal study of patients with bladder cancer: Factors associated with disease recurrence and progression. AUA Monographs, (ed. Bonney, W. & Brout, G.) p. 35 (Williams & Wilkins, Baltimore, MD, 1982).

  12. 12

    Hruban, R.H., van der Riet, P., Erozan, Y.S. & Sidransky, D. Molecular biology and the early detection of carcinoma of the bladder: The case of Hubert Horatio Humphrey. N. Engl. J. Med. 330, 1276–1278 (1994).

    CAS  Article  Google Scholar 

  13. 13

    Mao, L., Hruban, R.H., Boyle, J.O., Tockman, M. & Sidransky, D. Detection of onco-gene mutations in sputum precedes diagnosis of lung cancer. Cancer Res. 54, 1634–1637 (1994).

    CAS  Google Scholar 

  14. 14

    Wang, Y. et al. Microsatellite-based cancer detection using capillary array electrophoresis and energy-transfer fluorescent primers. J. Electrophoresis (in the press).

  15. 15

    American Joint Committee on Cancer. Manual for Staging of Cancer, 3rd edn. 171–176 (Lippincott, Philadelphia, PA, 1988).

  16. 16

    The Genome Database, the William H. Welch Library, the Johns Hopkins University, Baltimore, MD. Accessible through the Internet at

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Steiner, G., Schoenberg, M., Linn, J. et al. Detection of bladder cancer recurrence by microsatellite analysis of urine. Nat Med 3, 621–624 (1997).

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