Objectives: To determine the combination of urinary protein markers for noninvasive detection of primary and recurrent urothelial bladder carcinomas. Methods: Urinary concentrations of 27 biomarkers (NSE, ATT, AFABP, Resistin, Midkine, Clusterin, Uromodulin, ZAG2, HSP27, HSP 60, NCAM1/CD56, Angiogenin, Calreticulin, Chromogranin A, CEACAM1, CXCL1, IL13Ra2, Progranulin, VEGFA, CarbAnhydIX, Annexin-V, TIM4, Galectin1, Cystatin B, Synuclein G, ApoA1 and ApoA2) were assessed by enzyme-linked immunosorbent assay or by electrochemiluminiscence immunoassay. Results: During the primary diagnostics, a group of 70 patients with primary occurrence of bladder cancer and 49 healthy control subjects were compared. For this clinical situation, the most accurate combination proved to be the combination of cytology with markers Midkine and Synuclein G (sensitivity 91.8%, specificity 97.5%). During the monitoring of patients with non-muscle invasive bladder cancer (NMIBC), a group of 44 patients with cancer recurrence was compared with the group of 61 patients with a history of NMIBC without current disease. For this clinical situation, the most accurate combination proved to be the combination of cytology and erythrocytes count in urine sediment with markers Midkine, ZAG2, CEACAM1, and Synuclein G (sensitivity 92.68%, specificity 90.16%). A lower accuracy of the diagnostic panel and the necessity to use more markers in the case of recurrence was connected with a different structure of patients. Conclusions: Multi-marker test can significantly improve the bladder cancer detection both during the primary diagnostics and monitoring of patients with NMIBC. This outcome should result in other, larger studies.

Objective-To investigate whether occupational exposure to polycyclic aromatic hydrocarbons and certain plastic monomers increased renal cell carcinomas (RCC) risk.Methods-Unconditional logistic regression was used to calculate RCC risk in relation to exposure.Results-No association between RCC risk and having ever been occupationally exposed to any polycyclic aromatic hydrocarbons or plastics was observed. Duration of exposure and average exposure also showed no association with risk. Suggestive positive associations between RCC risk and cumulative exposure to styrene (P-trend = 0.02) and acrylonitrile (P-trend = 0.06) were found. Cumulative exposure to petroleum/gasoline engine emissions was inversely associated with risk (P-trend = 0.02). Conclusions-Resultsindicate a possible association between occupational styrene and acrylonitrile exposure and RCC risk. Additional studies are needed to replicate findings, as this is the first time these associations have been reported and they may be due to chance.Corresponding Author: Sara Karami, Ph.D., M.P.H., Post-Doctoral Fellow, National Cancer Institute, Division of Cancer Epidemiology & Genetics, Occupational and Environmental Epidemiology Branch, 6120 Executive Blvd, EPS 8121, Rockville, MD 20852, Telephone: (301) Fax: (301) The conflicting results reported for kidney cancer risk in occupational PAH exposure studies warrant additional large-scale studies with expert occupational assessment. Once absorbed in the body, PAHs are capable of entering any tissue that contains fat due to their lipophilic nature. 1 Typically, however, PAHs are stored in the kidneys, liver, and fat and are bioactivated through renal and hepatic metabolic pathways. 1,13,14 In the current study, we sought to investigate the association between renal cell carcinoma (RCC) risk and occupational exposure to PAHs and plastic monomers, as PAHs are occasionally used in the production of rubber and plastic materials. This investigation was carried out in a large, multicenter, renal case--control study with expert retrospective occupational assessment in Central and Eastern Europe, an area with historically heavy industrial exposures and one of the highest rates of RCC in the world. 15 MethodsDetails of the Central and Eastern European Renal Cell Carcinoma (CEERCC) study have been previously reported. 16 Briefly, the CEERCC study is a hospital-based case--control study that was conducted in seven centers across four Central and Eastern European countries. Between August 1999 and January 2003, newly diagnosed and histologically confirmed RCC (IDC-O-2 code 64) cases between 20 and 88 years of age who were living in the study areas for at least 1 year were recruited for participation. Controls were frequency-matched to cases on age, sex, and place of residence, from patients admitted to participating hospitals for diagnoses unrelated to smoking or urological disorders (with the exception of benign prostatic hyperplasia) between August 1998 and March 2003. No single disease made up greater...