Objective: To evaluate the sensitivity and specificity of BTAstat, NMP22, HA, Survivin, CD44v6, VEGF, and VUC in detection of bladder cancer.
Methods: We detect VUC, BTAstat, NMP22, HA, Survivin, CD44v6, VEGF in the urine of 10 normal case (healthy volunteers), 11 benign urological diseases patients and 52 bladder cancer patients. The sensitivity, specificity the coefficient of variation, the examining time duration and the checking costs of each marker and combined markers were assessed to evaluate the clinical value.
Results: There is a significant difference between the cancer group and the two control groups. The overall sensitivity and specificity of urinary tumor markers were: 42.3% and 100% for VUC; 78.8% and 90.5% for BTAstat; 76.9% and 81.0% for NMP22; 86.5% and 90.5% for HA; 67.3% and 85.7% for Survivin; 50.5% and 85.7% for CD44 and 69.2% and 95.2% for VEGF. The highest sensitivity of combined markers was 96.2% for NMP22 + HA and HA + CD44v6, whereas the lowest sensitivity of combined markers was 67.3% for VUC + CD44v6. The highest specificity (95.2%) was the combined use of VUC + NMP22 and combined use of VUC + VEGF, whereas, method that achieved the lowest specificity (66.7%) was the combined use of HA + Survivin. The most convenient examining method was the detection for BTAstat; the lowest cost examining method was the detection for HA; methods which had the best repeatability were the detection for BTAstat and urine cytology examination.
Conclusion: Each marker had achieved its obvious clinical value in diagnosis of bladder cancer. The sensitivity of all the markers was increased with the progression of tumor grades and clinical stages, except the CD44v6. The combined use of BATstat and HA is the best examining method concerning sensitivity, specificity, feasibility and cost in each different method.