Abstract
Using proteomic analysis, we previously identified calreticulin (CRT) as a potentially useful urinary marker for bladder cancer. Now, we have also identified γ‐synuclein (SNCG) and a soluble isoform of catechol‐o‐methyltransferase (s‐COMT) as novel candidates for tumor markers in bladder cancer, by means of proteomic analysis. In the process of establishing a superior tumor marker system, we investigated the diagnostic value of a combination assay of these three proteins. Voided urine samples were obtained from 112 bladder cancer and 230 control patients. Urinary CRT, SNCG, and s‐COMT were measured as a combined marker by quantitative western blot analysis. Relative concentration of each protein was calculated and the diagnostic value of a concomitant examination of these markers was evaluated by receiver operator characteristic analysis. With the best diagnostic cutoff, the overall sensitivity of the combined markers was 76.8% (95% confidence interval, 69–81%) with a specificity of 77.4% (72–80%), while those of a single use of CRT were 71.4% and 77.8%, respectively. When evaluated in relation to tumor characteristics, such as grade, stage, size, and outcome of urinary cytology, the diagnostic capacity of the combined markers was equal to or better than that of CRT in all categories. Concomitant use of CRT, SNCG, and s‐COMT had higher sensitivity for detection of bladder cancer than did single use of CRT. Our study suggests that use of this panel of markers will improve the diagnosis of bladder cancer and may allow the development of a protein microarray assay or multi‐channel enzyme‐linked immunosorbent assay.
AAbbreviations:
- VUC
voided urine cytology
- BTA
bladder tumor antigen
- NMP22
nuclear matrix protein‐22
- 2DE
two‐dimensional electrophoresis
- CRT
calreticulin
- SNCG
γ‐synuclein
- s‐COMT
soluble isoform of catecol‐o‐methyltransferase
- UTI
urinary tract infections
- SDS
sodium dodecyl sulfate
- PAGE
polyacrylamide gel electrophoresis
- Cl
confidence interval
- ROC
receiver operator characteristic
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