A methylation assay for the detection of non-muscle-invasive bladder cancer (NMIBC) recurrences in voided urine
BJU International , Volume 109 - Issue 6 p. 941- 948
OBJECTIVE To develop a methylation-specific multiplex ligation-dependent probe amplification (MS-MLPA) assay for the detection of non-muscle invasive bladder cancer (NMIBC) recurrences in voided urine. PATIENTS AND METHODS Genes frequently methylated in NMIBC tumours (n= 37) were selected to develop a BC-specific MS-MLPA assay. Genes methylated in blood from patientswith BC (n= 29) and genes methylated in urine from patients with no history of BC (n= 46) were excluded. A four-gene panel with the highest predictive value was selected from the initial assay. This four-gene panel was tested and validated on urine from patients with a histologically confirmed recurrence (n= 68 test set; n= 49 validation set) and urine samples from patients without BC (n= 91, test set) and urine from recurrence-free BC (rec-free BC) patients (n= 60, validation set). A model was developed to predict the probability of having a recurrence based on methylation of the four-gene panel and a threshold probability with the highest sensitivity and specificity was determined. The outcome of the model was validated on BC urine samples (n= 65) and on urine samples from rec-free BC patients (n= 29). RESULTS The BC MS-MLPA assay consisted of 23 methylation probes. The selected four-gene panel included: APC-a, TERT-a, TERT-b, and EDNRB. This panel reached an area under the receiver operating characteristic curve (AUC) of 0.82 (test set) and AUC 0.69 (validation set). Sensitivity and specificity for the detection of a concomitant tumour were 63.3% and 58.3% respectively (test set) and 72.3% and 55.2%, respectively (validation set). CONCLUSIONS We have developed a methylation detection assay specifically for the detection of recurrences in patients with NMIBC in voided urine. The findings are promising and improvement of this test could eventually contribute to a more individualized patient friendly surveillance.
|bladder cancer, methylation, surveillance, urine|
|This work was funded by the European Commission 7th Framework Programme; grant id fp7/201663 - Prediction of bladder cancer disease course using risk scores that combine molecular and clinical risk factors (UROMOL)|
|Organisation||Department of Pathology|
Zuiverloon, T.C.M, Beukers, W, van der Keur, K.A, Munoz, J.R, Bangma, C.H, Lingsma, H.F, … Zwarthoff, E.C. (2012). A methylation assay for the detection of non-muscle-invasive bladder cancer (NMIBC) recurrences in voided urine. BJU International, 109(6), 941–948. doi:10.1111/j.1464-410X.2011.10428.x