Role Of Urinary Cathepsin B And L In The Detection Of Bladder Urothelial Cell Carcinoma

Main Category: Urology / Nephrology
Also Included In: Cancer / Oncology;  Clinical Trials / Drug Trials
Article Date: 23 Dec 2007 - 0:00 PDT

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UroToday.com- This article evaluates three different urinary markers for the detection and staging of non invasive bladder cancer; Cathepsin B and L and NMP-22. Cathepsin B and L and NMP22 were determined in the urine specimens of 188 consecutive subjects with a history of treated urothelial carcinoma of the bladder, 31 with noncancerous urological conditions, and 10 healthy subjects. Cathepsins B and L are widely expressed cysteine proteases implicated in both intracellular proteolysis and extracellular matrix remodeling. However, specific roles remain to be validated in vivo. They have been implicated as markers of other tumors including malignant brain tumors.

In this study, the urinary Cathepsin L level was higher in the 122 patients with cystoscopic evidence of bladder tumor compared with levels in 107 with normal cystoscopy. Higher levels of Cathepsin L were associated with T1 or greater pathologic disease, NMP22 levels, and a positive cytology. The area under the ROC curves from NMP22 and Cathepsin L were similar at 0.79 and 0.7, respectively. Urinary Cathepsin B level was not associated with bladder cancer status.

The authors concluded that Cathepsin L, NMP22, and cytology were independent predictors of pathologic stage and presence of bladder cancer. They recommend further evaluation of Cathepsin L as a urinary marker for bladder cancer. It is unclear, what additional information Cathepsin L may add to the currently available markers including NMP22 and cytology.

Svatek RS, Karam J, Karakiewicz PI, Gallina A, Casella R, Roehrborn CG, Shariat SF

J Urol. ePub: December 12, 2007
doi:10.1016/j.juro.2007.09.037

Reported by UroToday.com Contributing Editor David P. Wood

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