Moussa Omar, Abol-Enein Hassan, Bissada Nabil K, Keane Thomas, Ghoneim Mohamed A, Watson Dennis K
Department of Pathology and Laboratory Medicine, Medical University of South Carolina, Charleston, South Carolina 29425, USA.
J Urol. 2006 Jun;175(6):2312-6. doi: 10.1016/S0022-5347(06)00254-0.
Survivin, a member of the inhibitor of apoptosis gene family, is expressed in most common cancers. We investigated the expression pattern of survivin in the tumors of patients with bladder cancer and assessed the diagnostic potential of RT-PCR detection of survivin mRNA in urine.
RT-PCR was used to analyze mRNA expression of survivin in 161 cases of bladder cancer, including TCC in 97, SCC in 53 and adenocarcinoma in 11, and their matched nontumor tissues. Urine specimens (50 ml) were collected from 84 patients in whom bladder cancer was documented by transurethral resection or biopsy, 41 with nonbladder cancer urological diseases and 42 healthy volunteers. Total RNA was extracted from urine sediments and RT-PCR was performed for survivin.
Survivin expression was detected in all bladder cancer tissues. In contrast, survivin was not detectable in normal urothelium specimens. Urinary survivin was detected in urine samples from 51 of 53 patients with TCC, 22 of 25 with SCC and 6 of 6 with adenocarcinoma. Overall sensitivity was 94%. Survivin mRNA was not detected in any healthy volunteers. Positive results were obtained in 2 patients with renal cell carcinoma, 1 with hematuria and 1 with a contracted bladder but in none with other urological diseases. Overall specificity was 95%.
Survivin mRNA detection in urine sediment using RT-PCR shows high sensitivity and specificity for bladder cancer. It may prove useful for the routine screening and monitoring of patients.
生存素是凋亡抑制基因家族的成员之一，在大多数常见癌症中均有表达。我们研究了膀胱癌患者肿瘤组织中生存素的表达模式，并评估了逆转录聚合酶链反应（RT-PCR）检测尿液中生存素mRNA的诊断潜力。
采用RT-PCR分析161例膀胱癌组织中生存素的mRNA表达，其中包括97例移行细胞癌、53例鳞状细胞癌和11例腺癌，以及与之匹配的非肿瘤组织。收集了84例经尿道切除术或活检确诊为膀胱癌患者、41例非膀胱癌泌尿系统疾病患者和42例健康志愿者的尿液标本（50毫升）。从尿沉渣中提取总RNA，并进行生存素的RT-PCR检测。
所有膀胱癌组织均检测到生存素表达。相比之下，正常尿路上皮标本中未检测到生存素。53例移行细胞癌患者中有51例、25例鳞状细胞癌患者中有22例、6例腺癌患者中有6例的尿液样本中检测到尿生存素。总体敏感性为94%。所有健康志愿者的尿液中均未检测到生存素mRNA。2例肾细胞癌患者、1例血尿患者和1例膀胱挛缩患者检测结果为阳性，其他泌尿系统疾病患者均为阴性。总体特异性为95%。
采用RT-PCR检测尿沉渣中的生存素mRNA对膀胱癌具有较高的敏感性和特异性。这可能对患者的常规筛查和监测有用。
