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Abstract
Purpose
In bladder cancer screening, many methods such as urinary cytology, bladder tumor antigen, and nuclear matrix protein-22 are well known. To learn the value of urinary melanoma antigen gene expression (MAGE) in bladder cancer screening, we compared the urinary MAGE test with irrigated urinary cytology.
Materials and Methods
From July 2000 to July 2007, a total of 142 patients were enrolled in this study. We divided these patients into 2 groups. Eighty-eight patients with bladder cancer were included in group I. Group II consisted of 54 patients who had been treated for bladder cancer and had no evidence of tumor by cystoscopy and irrigated urinary cytology. Urinary cytology, urinary MAGE test, and cystoscopy were performed in all patients. The urinary MAGE test was done by reverse transcriptase polymerase chain reaction (RT-PCR). Sensitivity and specificity were investigated according to cancer grade and stage.
Results
The overall sensitivity of the urinary MAGE test and urinary cytology was 69.3% (61/88) and 53.4% (47/88), respectively (p=0.03). The specificity of the urinary MAGE test and urinary cytology was 75.9% (41/54) and 83.3% (45/54), respectively (p=0.34). The sensitivity of each test in superficial tumors (Ta, T1) was 65.5% (38/58) and 46.6% (27/58), respectively (p=0.04). In advanced disease (≥T2), the sensitivity of the tests was 76.7% (23/30) and 66.7% (20/30), respectively (p=0.39). The sensitivity of the urinary MAGE test in grade 1 tumors (60.5%, 23/38) was significantly higher (p=0.01) than that of urinary cytology (31.6%, 12/38).
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Table 1.
Primer sequences used for melanoma antigen gene A1-6 reverse transcriptase (RT)-nested polymerase chain reaction (PCR)
Table 2.
Comparison of overall sensitivity and specificity of urinary cytology and the MAGE test
| MAGE (%) | Cytology (%) | p-value | |
|---|---|---|---|
| Sensitivity | 61/88 (69.3) | 47/88 (53.4) | 0.03 |
| Specificity | 41/54 (75.9) | 45/54 (83.3) | 0.34 |
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