Diagnostic value of urinary CK-20 RNA and VEGF in bladder cancer

ABSTRACT

The present study was carried out to evaluate the diagnostic value of urinary cytokeratin 20 [CK-20] RNA and vascular endothelial growth factor [VEGF] in comparison with urine cytology in the detection of bladder cancer. This study included 80 patients with bladder cancer, 20 patients with bilharzial bladder lesions and 20 normal volunteers as control group. CK-20 RNA in urine sediment was detected by reverse transcription polymerase chain reaction [RT-PCR]. VEGF in urine supernatant was detected by ELISA and confirmed by western blotting [WB]. The median value of VEGF and positivity rates of both VEGF and CK-20 in bladder cancer group was significantly higher as compared to benign bladder lesions group and normal control group. There was no significant association between the postivity rates of CK-20 and VEGF with any of the clinicopathological factors except a significant positive association between VEGF positivity and clinical stage. The overall sensitivity, specificity, positive predictive value, negative predictive value were; 66.25%, 92.5%, 94.46%, 57.81% for VEGF, 65.2%, 70%, 80.65%. This article was taken from Ph.D thesis submitted by Ekram Fadl Al-Eryani To Faculty of Medicine-Ain Shams University. 2005 48.28% for voided urine cytology, and 83.7%, 100%, 100%, 75.47% for CK-20 respectively. Combined sensitivity of cytology, VEGF andCK-20 RNA reached [96.25%] and was higher than the combined sensitivity of cytology and VEGF [90%], or cytology and CK-20 RNA [92.5%], or VEGF and CK-20 [91.25%]. These results indicate that VEGF can be quantitively measured in urine of bladder cancer patients, and its combined use with cytology increases its sensitivity