Hemoglobinuria detection in 195 urology patients.

There is a definite need for the development of a specific and sensitive diagnostic test for the detection of hematuria in patients with bladder and kidney cancer. It is well established that hemoglobin in the urine may be indicative of bladder and/or kidney cancer as well as other types of lesions of the urinary tract. We have developed a specific and sensitive immunological assay for the detection of human hemoglobin in urine. This test has several important advantages over the currently used chemical tests. A mouse monoclonal antibody specific for human hemoglobin was produced and used in the development of a double-antibody biotinylated enzyme-linked immunosorbent assay (ELISA) that specifically detected hemoglobin in the urine of 195 urology patients. The results from this assay were compared with data from an evaluation of the same specimen using a polyclonal antibody biotinylated ELISA (PE) as well as a dipstick test in a blind screening study. The monoclonal antibody biotinylated ELISA (ME) possessed a much higher level of sensitivity and specificity over the dipstick test. In addition, we determined that monoclonal as well as polyclonal antibody can detect not only normal hemoglobin but also abnormal hemoglobins in urine. Of the total 195 urology patients in all diagnostic categories, the ME test was positive for detection of hemoglobin in 28 more patients (35% more) than were detected by the dipstick test. Importantly, four of these 28 patients detected by the ME but undetected by the dipstick were patients with bladder or kidney cancer.(ABSTRACT TRUNCATED AT 250 WORDS)