Fakhry F Ibrahim and Magdy M Ghannam
Aim of the study: This work aims to search for markers suitable for the screening of bladder cancer, which should be specific, sensitive, reproducible, non-invasive and at acceptable cost.
Patients and methods: The study included 45 patients diagnosed as bladder cancer (30 TCC, 15 SCC) of different stages and grades, 20 patients with various urothelial diseases, besides 15 healthy volunteers of matched age and sex to the malignant group. A random midstream urine sample was collected in a sterile container for the determination of telomerase by RT-PCR, keratin 20 by RT-PCR and immunohistochemical staining, urine cytology in addition to DNA dielectric properties.
Results: All parameters (telomerase, K20, cytology and DNA dielectric properties) for the malignant group showed significant difference from both the benign and the control groups. With respect to the grade, only K20 showed a significant positive correlation with grade in both TCC and SCC.
Conclusion: K20 is the best candidate as screening test for the diagnosis of bladder cancer, representing the highest sensitivity and specificity, beside the radiological and histopathological studies.
As a method, RT-PCR is superior to immunostaining for the detection of bladder cancer, meanwhile K20 immunohistochemistry (IHC) results were much better than urine cytology as a bladder cancer screening test. Haematuria and inflammation reduced the specificity of telomerase assay, which reduced its validity as a tumor marker of bladder cancer. The studied DNA has a dielectric dispersion in the frequency range used. There is change in the electric properties of DNA of bladder cancer patients. The dielectric properties of DNA may be used as valuable supplementary markers in diagnosis of bladder cancer.
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