Urinary survivin mRNA expression and urinary nuclear matrix protein 22 BladderChek[R] and urine cytology in the detection of transitional cell carcinoma of the bladder

To compare the diagnostic performance of urine cytology [UC], survivin mRNA expression, and the NMP22 BladderChek[R] [NMP22BC] test for the detection, grading and staging of transitional cell carcinoma [TCC] of the bladder. Voided urine samples collected from 25 healthy controls and 80 patients diagnosed with TCC of the bladder were subjected to UC, the NMP22BC test and reverse-transcription real-time PCR for survivin mRNA expression. Survivin mRNA expression showed the highest sensitivity [87.5%] followed by the NMP22BC test [61.3%] while UC exhibited the lowest sensitivity [40%]. All three urine markers had a similar specificity of 96% [95% CI 80.5-99.3%]. Survivin mRNA expression was the only urine marker that showed a significant difference in relation to tumour histological grade [X[2] 8.5, p = 0.015]. None of the three urine markers was significantly related to tumour pathological stages. The diagnostic sensitivity of urinary urviving mRNA expression was superior to that of UC and the NMP22BC test and correlates with tumour pathological grade but not stage