Carbonic Anhydrase IX as a Diagnostic Urinary Marker for Urothelial Bladder Cancer

Urinary biomarkers are needed to improve the management and reduce the cost of urothelial bladder cancer (UBC); however, none have been recommended yet for clinical practice.

This study evaluated carbonic anhydrase IX (CAIX) as a diagnostic urinary biomarker for UBC. CAIX was analyzed by quantitative polymerase chain reaction in urine samples of 196 patients with UBC and 123 controls with hematuria. Paired samples from urine and tumor tissue were evaluated in 16 cases. Data were validated in 155 independent samples.

The sensitivity and specificity of CAIX for UBC detection were 86.2% and 95.1%, respectively (area under the curve [AUC]: 90.5%). There was a significant association of CAIX expression between the paired urine and tumor specimens (p=0.002). CAIX showed a significantly higher predictive accuracy than urinary cytology (90.5% vs 71.7%), specifically in low-grade tumors (90.0% vs 61.8%). CAIX expression decreased with increasing tumor stage and grade. Analyses in an independent validation cohort confirmed the high accuracy of CAIX for diagnosing UBC (AUC: 88.3%).

We evaluated carbonic anhydrase IX (CAIX) as a urinary marker for bladder cancer (BCa) using a large series of patients from a single hospital. We found that urinary CAIX has a high sensitivity and specificity for diagnosing BCa.

Eur Urol. 2015 Jun 29. pii: S0302-2838(15)00518-7. doi: 10.1016/j.eururo.2015.06.015. [Epub ahead of print]

de Martino M1, Lucca I1, Mbeutcha A1, Wiener HG2, Haitel A2, Susani M2, Shariat SF3, Klatte T4.

1 Department of Urology, Medical University of Vienna, Vienna General Hospital, Vienna, Austria.
2 Clinical Institute of Pathology, Medical University of Vienna, Vienna General Hospital, Vienna, Austria.
3 Department of Urology, Medical University of Vienna, Vienna General Hospital, Vienna, Austria; Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX, USA; Department of Urology, Weill Cornell Medical College, New York-Presbyterian Hospital, New York, NY, USA.
4 Department of Urology, Medical University of Vienna, Vienna General Hospital, Vienna, Austria.

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