Finding a Better Way to Identify Bladder Cancer

Urothelial bladder cancer, the fourth most common cancer in men and the eighth most common in women, accounts for more than 54,000 new cases and 11,200 deaths annually. Cystoscopy and cytology, used to detect this transitional cell cancer in situ, have significant drawbacks, including relatively low sensitivity, patient discomfort, and infection risks. Now, a new U.S./European research consortium wants to create a simple, cost-effective, noninvasive diagnostic test to replace cystoscopy and cyto

Ted Agres

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One of the most promising markers is survivin, an enzyme inhibitor of apoptosis (IAP) that is selectively overexpressed in human cancers and correlates highly with the disease but not with healthy tissue. The protein is produced by the gene survivin, the smallest member of genetic apoptosis inhibitors. In addition to bladder cancer, the protein survivin is abundantly found in cancers of the colon, brain, lung, skin, and others. However, it is generally not detected in normal tissue adjacent to the malignancies.

Altieri, a pathology professor at Yale University School of Medicine, and a research team discovered survivin in 1997.1 In his latest research, Altieri's group has developed a 1-step system for detecting survivin in voided urine using a polyclonal antibody protocol.2 In this preliminary study, survivin was detected in the urine samples of all 46 patients with new or recurrent bladder cancer. In addition, survivin was not found in 32 ...

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