Identification and validation of AIB1 and EIF5A2 for noninvasive detection of bladder cancer in urine samples.

We previously demonstrated that amplified in breast cancer 1 (AIB1) and eukaryotic initiation factor 2 (EIF5A2) overexpression was an independent predictor of poor clinical outcomes for patients with bladder cancer (BCa). In this study, we evaluated the usefulness of AIB1 and EIF5A2 alone and in combination with nuclear matrix protein 22 (NMP22) as noninvasive diagnostic tests for BCa. Using urine samples from 135 patients (training set, controls [n = 50] and BCa [n = 85]), we detected the AIB1, EIF5A2, and NMP22 concentrations using enzyme-linked immunosorbent assay. We applied multivariate logistic regression analysis to build a model based on the three biomarkers for BCa diagnosis. The diagnostic accuracy of the three biomarkers and the model were assessed and compared by the area under the curve (AUC) of the receiver operating characteristic. We validated the diagnostic accuracy of these biomarkers and the model in an independent validation cohort of 210 patients. In the training set, urinary concentrations of AIB1, EIF5A2, and NMP22 were significantly elevated in BCa. The AUCs of AIB1, EIF5A2, NMP22, and the model were 0.846, 0.761, 0.794, and 0.919, respectively. The model had the highest diagnostic accuracy when compared with AIB1, EIF5A2, or NMP22 (p < 0.05 for all). The model had 92% sensitivity and 92% specificity. We obtained similar results in the independent validation cohort. AIB1 and EIF5A2 show promise for the noninvasive detection of BCa. The model based on AIB1, EIF5A2, and NMP22 outperformed each of the three individual biomarkers for detecting BCa.

Does chromophobe renal cell carcinoma have better survival than clear cell renal cell carcinoma? A clinical-based cohort study and meta-analysis.

BACKGROUND: It is controversial whether chromophobe renal cell carcinoma (chRCC) or clear cell renal cell carcinoma (ccRCC) is associated with better survival. We conducted a clinical-based cohort study and meta-analysis to evaluate the prognostic role of histology between chRCC and ccRCC. METHODS: A cohort of 1540 patients (166 with chRCC and 1374 with ccRCC) were selected from Sun Yat-sen University and The Cancer Genome Atlas databases. The clinicopathological parameters and overall survival (OS) were compared between patients with chRCC and those with ccRCC. For the meta-analysis, we searched the PubMed, Cochrane Library, and Ovid databases for studies comparing OS or cancer-specific survival (CSS) between chRCC and ccRCC. RESULTS: The cohort study revealed that patients with chRCC were younger (median 52 vs. 55 years, P < 0.001), were more commonly female (47.0 vs. 33.0%, P < 0.001), and had a larger tumor size (mean 7.1 vs. 5.9 cm, P < 0.001), and they had a lower stage compared with those with ccRCC. Five-year OS rates for chRCC and ccRCC were 90.3 and 75.3%, respectively (P < 0.001). We found significantly better survival for chRCC in stratification analysis by age, sex, tumor size, and stage. Similar results were observed on both univariate [hazard ratio (HR), 0.30; 95% confidence interval (CI) 0.16-0.55, P < 0.001] and multivariate analyses (HR 0.42; 95% CI 0.23-0.79, P = 0.006). Ten studies were included in our meta-analysis. Eight of them provided data on univariate analysis. The pooled HR was statistically significant for OS (pooled HR 0.49; 95% CI 0.30-0.79, P = 0.004) and CSS (pooled HR 0.49; 95% CI 0.37-0.64, P < 0.001). Seven studies reported the HR on multivariate analysis. The pooled HR was also statistically significant for OS (pooled HR 0.63; 95% CI 0.51-0.77, P < 0.001) and CSS (pooled HR 0.72; 95 % CI 0.57-0.90, P = 0.003). These data indicate that patients with chRCC had better outcomes than those with ccRCC. CONCLUSIONS: Our large cohort study and meta-analysis confirmed that chRCC had better survival than ccRCC.