Urinary Hyaluronan as a Marker for the Presence of Residual Transitional Cell Carcinoma of the Urinary Bladder

Abstract

ObjectiveThe purpose of this report is to evaluate the value of urinary hyaluronan (HA) as a maker of residual transitional cell carcinoma (TCC). Patients and methodsUrine samples were collected from 83 patients hospitalized for transurethral resection (TUR). Patient ages ranged from 36 to 86 years. Samples were taken both before and after surgery. HA analysis was performed using an “ELISA-like” fluorometric assay. ResultsPatients were divided into two groups: a control group whose previous diagnosis was negative for tumors (n=22) and another with positive diagnosis for tumors (n=61) which was further sub-divided into with and without residual tumor. After the second procedure 47 individuals did not display residual tumor, whereas 14 (23%) did. The average HA in the control group was 8.3μg/L pre- and 7.1 post-operatively, hence, no change occurred (p=0.471). In the group with TCC patients, the HA dropped from 885.5μg/L to 215.3μg/L with residual tumors and from 234.3μg/L to 11.2μg/L for those without residual tumor. Using a cut-off value of 20μg/L, the sensitivity to detect residual tumor is 92.9% and specificity is 83%. ConclusionHA in addition to being one of the best markers for the initial evaluation of bladder carcinoma can be used to determine the presence of a residual tumor. This is associated with poor prognosis.