The Clinical Relevance of Urinary Soluble Fas (sFas) for Diagnosis of Bilharzial Bladder Cancer
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- Category: Vol. 81, March 2013
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The Clinical Relevance of Urinary Soluble Fas (sFas) for Diagnosis of Bilharzial Bladder Cancer,SANAA EISSA, MENHA SWELLAM, CAMILIA ABDEL MALAK, MOHAMED NOSHI FAHIM, RASHA R. FAKHR EL-DEEN, MOHAMED F. MOUSTAFA, ABEER I. ABDEL FATTAH and MOHAMED ESMAT
Abstract
Purpose: Fas/CD95, a membrane-bound type I protein, plays a key role in induction of apoptosis and in tumorogenesis. Authors adapted and evaluated measurement of urinary sFas using enzyme-linked immunosorbent assay and compared the results with voided urine cytology.
Material and Methods: Voided urine samples were pro-vided from 203 individuals (120 bladder cancer [112 bilhar-zial]; 43 benign urologic disorders [20 bilharzial dysplastic lesions]; 40 healthy volunteers). Urine sediment was used for cytology and the supernatant for estimation of sFas by ELISA.
Results: Receiver operating characteristic curve (ROC) curve was used to determine the best cutoff value for urinary sFas. Positivity rates and mean rank levels for sFas showed significant difference among the three investigated groups (p<0.0001), and was related to bilharzial infection, pathological type, clinical stages and histological grades (p<0.01). The sensitivity of sFas for early detection of bladder cancer especially those with superficial and low grades tumors was superior to urine cytology, moreover, sensitivity of urine cytology was improved when combined with sFas.
Conclusion: Urinary sFas may be used as a novel non-invasive diagnostic marker for bilharzial bladder cancer patients. Further multicentric studies are warranted to corrob-orate these findings and to establish an optimal sFas cut-point.