Comparative Study Between Cytology and Dot-ELISA for Early Detection of Bladder Cancer

Abstract

Schistosomiasis remains one of the major public health problems of the tropics. Conservative estimates place the number of infected individuals at about 200 millions. In Egypt, carcinoma of the urinary bladder associated with schistosomiases is the foremost oncologic problem, because of its high frequency and the late presentation of cases. A newly developed monoclonal antibody CK,K, 0 to keratinized grade 1 squamous cell carcinoma was used in a dot enzyme-linked immunosorbent assay (Dot ELISA) to test urine samples of 118 patients with bladder carcinoma, 291 patients with genitourinary pathology other than bladder carcinoma, in addition to 550 healthy controls. The overall sensitivity of the dot ELISA was 90% among 118 patients with bladder carcinoma. Twenty-seven of 33 transitional cell carcinoma cases (82%), 68 of the 71 squamous cell carcinoma cases (96%), 7 of 10 undifferentiated tumors cases (70%), and 4 of 4 adenocarcinoma were positive with this assay. The specificity was 90% in our sample population. A comparative study of diagnosis by cytology and dot ELISA was carried out in 57 patients with bladder carcinoma. Dot ELISA was found to be superior as a screening tool for high risk groups (P < .001 using chi-square test). Cytology detected 21 % of transitional cell carcinoma, 68% of squamous cell carcinoma, 50% of adenocarcinoma, and 86% of undifferentiated tumors. The dot ELISA assay should be useful for screening high-risk groups because it does not require sophisticated equipment, is noninvasive, does not require highly trained staff, and can be performed in less than 30 minutes. Carcinoma of the bladder is the most common malignant disease in Egypt. It accounts for about 20% to 25% of all cases in both sexes and approximately 38% in males. ' Because of the geographic coincidence of bladder cancer and endemic bilharziasis, a causal relationship has long been speculated and established between the tumor and Schistosoma haematobium infestation. This association defines a distinct clinicopathologic entity quite different from that experienced in the Western world. The tumor is found mostly in relatively young age groups. ' It is commonly a well-differentiated squamous carcinoma, the patients usually present in an advanced stage of the disease with the symptoms of cystitis. Accordingly, radical cystectomy is the treatment of choice. Research and Review, Food and Drug Administration, Belhesda, Maryland: and Biotechnology Research Center and National Cancer Institute, Cairo University, Cairo, Egypt. Manuscript received June 19, 1995; revision accepted August 25, 1995. Address reprint requests to Prof. Attallah: Biotechnology Research Laboratories. Gastroenterology Surgery Center, Mansoura University, Mansoura, Egypt. From the Office of BiologicA considerable effort has been made to improve the methods for detection of bladder carcinoma. Cytology has been an important step in that direction, although its use as a screening tool has technical limitations. One tool that appears to have real potentia...

Quantitative assessment of bladder carcinoma by acid labile DNA assay

“…Therefore, the availability of more effective and noninvasive methods for monitoring bladder carcinoma patients would be desirable. Possible approaches to this include development of novel assay techniques that lie outside the scope of existing cytology5–10 or, alternatively, improvement of cytoanalysis by replacement of subjective qualitative methods with reliable quantitative assessment capable of automation.…”

An office‐based immunodiagnostic assay for detecting urinary nuclear matrix protein 52 in patients with bladder cancer

“…Interestingly, this NMP‐52 has not been described previously in bladder cancer, but further molecular studies are required to confirm its identity. Attallah et al [22] used a dot‐ELISA based on a specific monoclonal antibody to detect a target cytokeratin in urine samples from patients with bladder cancer, with high sensitivity, specificity and efficiency (90%). The dot‐ELISA format does not require sophisticated equipment nor highly trained technical staff, and can be completed in ≈ 30 min.…”

“…To create a simple and rapid assay, a previously described dot‐ELISA [22] was adapted to detect the target urinary NMP‐52 marker. All the steps of the dot‐ELISA were carried out on the surface of a nitrocellulose membrane fixed in a plastic cartridge, and each reagent completely absorbed into the nitrocellulose membrane within 30 s (incubation time).…”

“…To create a simple and rapid assay, a previously described dot-ELISA [22] was adapted to detect the target urinary NMP-52 marker. All the steps of the dot-ELISA were carried out on the surface of a nitrocellulose membrane fixed in a plastic cartridge, and each reagent completely absorbed into the nitrocellulose membrane within 30 s To determine some of the biochemical characteristics of the purified marker, samples of the target NMP-52 marker were treated with protease and one of several other chemical reagents being tested in dot-ELISA, to see if these treatments affected the reactive epitope.…”