Urine bladder cancer

Bladder tumor-associated antigen (BTA), a human complement factor H, is produced by bladder cancer cells (men two to three times as often as women). Cancer cells are sometimes seen in urine samples by microscope cytoscopy (examination of the bladder with an instrument inserted into the urethra), which can reveal abnormal areas. Biopsy is needed to confirm the diagnosis. Early stage cancer confined to the bladder wall can often be removed with a cytoscope. If several tumors are present, they are removed by infusing the bladder with a solution containing bacteria able to stimulate the immune system. 

The most common BTA test is an immunoassay-based assay that uses monoclonal antibodies to detect the presence of bladder tumor-associated antigen in urine. In clinical studies, the BTA test was compared with cytoscopy-voided urine for the detection of recurrent bladder cancer. The sensitivity of BTA appeared su-... 

The utility of protein expression mapping using 2D gel electrophoresis and mass spectrometry has been demonstrated for several experimental systems. One application has been to assess the differences in protein expression between normal and cancerous cells. For example, expression mapping has been used to identify protein markers for bladder cancer (Ostergaard et al., 1999). This was accomplished by identifying proteins released into the urine of patients with and without bladder cancer using 2D electrophoresis and mass spectrometry. 

Rasmussen, El. El., Omtofit, T. F., Wolf, EL, and Celis, J. E. (1996). Towards a comprehensive database ofproteins from the urine ofpatients with bladder cancer. J. Urol. 155, 2113-2119. 

The answer is i. (Katzwng, p 984.) Bacille Calmette-Guerin vaccine is a nonspecific stimulant of the reticuloendothelial system. It is an attenuated strain of Mycobacterium fruvis that appears most effective in small, localized bladder tumors. This agent is approved for intravesicular use in bladder cancer. Adverse reactions are associated with the renal system, such as problems with urination, infection, and cystitis. 

Sidransky, D., Eschenbach, A. V., Tsai, Y. C., Jones, P., Summerhayes, I. etal.. Identification of p53 gene mutations in bladder cancers and urine samples. Science 252, 706-709 (1991). 

Cancer. Studies found no relationship between endogenous p-cresol levels in the urine and the occurrence of large bowel cancer (Bone et al. 1976) or bladder cancer (Renwick et al. 1988) in humans. There are no data available regarding the carcinogenicity of exogenous cresols in humans. No cancer bioassays have been conducted in animals, but the results of a promotion study in mice suggested that cresols can be cancer promoters. Cresols have some ability to interact with mammalian DNA in vitro, but it is impossible to assess the potential hazard to humans without more information. 

BCG immunotherapy has been most successful in the treatment of bladder cancers. It is instilled directly into the bladder, where it is held for 2 hours before urination. 

Table 4. Air and urine levels and haemoglobin adduct levels measured in 1990 among chemical workers employed at a plant where excess bladder cancer incidence was observed...

Moreover, Cellis et al. have been working on identifying protein markers that may be valuable for diagnosis and follow-up of bladder cancer patients. To achieve this goal, they have focused on the establishment of a comprehensive 2D gel database of urine proteins. 

I think we should urinate more often. At least that s what recent research into the incidence of bladder cancer would imply. A study of some fifty thousand men, reported in The New England Journal of Medicine in 1999, showed that those who consumed more fluids, and presumably urinated more often, had a lower incidence of the disease. 

Lokeshwar, V.B. et al., Tumor-associated hyaluronic acid a new sensitive and specific urine marker for bladder cancer, Cancer Res., 57, 773, 1997. 

Tompsett (T3) achieved a separate elution from cation or anion resin columns of several tryptophan metabolites which were then determined colorimetrically. Finally, Boyland and Williams (B18) quantitatively adsorbed on inactivated charcoal anthranilic acid, kynurenine, 3-hy-droxyanthranilic acid, 3-hydroxykynurenine, and the sulfuric acid ester derivatives of the two latter compounds from urine of normal controls and of patients with bladder cancer. After elution, the compounds were separated by gradient chromatography on Celite columns and determined colorimetrically or spectrophotometrically. 

Hemorrhagic cystitis and bladder cancer are well-known complications of cyclophosphamide. The damage to the urinary bladder epithelium is caused by acrolein, a metabolite of cyclophosphamide that is excreted in the urine. In bone marrow transplant recipients, prior administration of busulfan, which itself causes hemorrhagic cystitis, can increase this risk (23). Mesna (2-mercaptoethane sodium sulfonate) is used to prevent this adverse effect. It is excreted by the kidney, and it binds and detoxifies acrolein in the urine mesna also prevents the breakdown of acrolein precursors. Intravesical prostaglandin E2 has been suggested as an alternative treatment (23). 

BTA stat. test strip. A niulticenter trial compared the BTA stat. test with voided urine cytology studies in 499 patients undergoing surveillance cystoscopy for recurrent bladder cancer. The BTA stat. test identified 40% of patients with positive cystoscopy results, and cytology detected 17%. A positive test may provide a higher degree of suspicion for recurrence. A quantitative test in ELISA format, BTA TRAK, is also availabie. 

Eissa S, SweUam M, Sadek M, et al. Comparative evaluation of the nuclear matrix protein, fibronectin, urinary bladder cancer antigen and voided urine cytology in the detection of bladder tumors. J Urol 2002 168 465-69. 

Kageyama S, Isono T, Iwaki H, Wakabayashi Y, Okada Y, et al. Identification by proteomic analysis of cal-reticulin as a marker for bladder cancer and evaluation of the diagnostic accuracy of its detection in urine. Clin Chem 2004 50 857-66. 

The next application to be discussed is that of urine cytology, in which epithelial cells contained in urine are analyzed for abnormalities. Urine cytology is not carried out routinely in the US, even though urine samples are collected frequently and, in 2005, bladder cancer was the fifth most common cancer among males, and the eighth most common cancer among females. Presumably, routine urine... 

Normal human urine contains both squamous cells from the distal urethra, and urothelial cells from the Uning of the bladder. The former ceU type may be further subdivided into glycogen-containing and glycogen-free squamous cells. Here, we aim to establish that IR spectral methods, followed by multivariate data analysis, can distinguish between these cells types. Our ultimate intention is to establish this methodology as a low-cost, automated test for bladder cancer. 

Thus, in assessing potential bladder cancer risk for humans based on studies in rodents, consideration of a threshold dose response is the foremost consideration. The differences in composition of the urine, anatomic differences, and especially exposure differences between rodents and humans must be taken into account. Furthermore, the evidence for a relationship for urinary tract calculi to an increased risk of bladder cancer is relatively weak and is complicated by the usual association of bacterial cystitis with the presence of long-standing calculi. Urinary precipitate and crystals are not relevant to human carcinogenesis, in contrast to rodents. 

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