New, simple test may help detect bladder cancer

Researchers at the Friedrich Schiller University of Jena, Germany, are exploring the potential of oncofetal fibronectin (fFN) as a new marker for bladder cancer. If successful, the test would be a simple urine dipstick test involving a monitor that measures the concentration of the protein in a sample. It would produce results in about 20 minutes.

"The protein is a cell matrix glycoprotein that is overexpressed in fetal tissue and some tumors," first author Kirsten Junker, MD, told Urology Times, explaining why her laboratory decided to explore the protein in bladder cancer.

She said the test was well established in Europe as a means of determining early miscarriage.

To succeed as a bladder cancer marker and possible test for recurrence, it would have to generate data that show greater sensitivity than that of current bladder cancer tests-cytology, the BTA stat, and NMP22 tests. Initial data show fFN to have some advantages and some disadvantages when compared to these tests. Initial trials show its sensitivity to all tumors is 84%, compared to cytology's 52.8%, the BTA stat test's 81.7%, and the NMP22 test's 57.9%. Its specificity is weaker at 51% compared to BTA stat's 45% and NMP22's 70%.

The test's sensitivity varies according to tumor grade. Whereas it was 62% for pTa tumors, it was 100% sensitive to pT1 and pT2-4 tumors. The specificity was lower: 30% for pTa tumors, 80% for pT1 tumors, and 59.1% for pT2-4 tumors.

Dr. Junker acquired these data by administering the test to 67 tumor patients, 33 healthy controls, and 62 controls with other urologic conditions such as BPH, cystitis, and kidney stones. She noted that the comorbid conditions had significant effects on the test's specificity and sensitivity and said this was one of the findings she intended to pursue.

"We have to find out why there is lower specificity in BPH patients," she told Urology Times at the AUA annual meeting yesterday.

"I think fFN is a highly sensitive and specific quantitative biomarker with a higher sensitivity than cytology, BTA stat, and NMP22. It represents a promising marker for detecting bladder cancer," she said.