Objective: In a trial to improve the diagnostic efficacy of conventional urine cytology we determine survivin RNA and matrix metalloproteinase 2 and 9 in urine of bladder cancer cases.Method: Voided urine specimens were collected from patients with histologically confirmed bladder urothelial carcinoma (Group 1; n = 46), urological patients without urothelial carcinoma (Group 2; n = 20), and healthy volunteers (Group 3; n = 20). Urine cytology, survivin RNA was estimated by qualitative nested RT-PCR and MMP-2, MMP-9 activity were detected by gelatin zymography. The expression of survivin RNA and matrix metalloproteinase 2 and 9 in bladder cancer was compared with benign and normal cases.Results: Positivity rates of survivin RNA and MMPs zymography were significantly different among the 3 groups. Urine survivin detection by qualitative nested RT-PCR showed 76.1% sensitivity and 95% specificity. The overall sensitivity, specificity of urinary MMP zymography was 67.3%, 90% respectively. The combined use of urine cytology with urine survivin or MMPs zymography increased sensitivity of urine cytology from 50% to 84.7%. The highest sensitivity (95.6%) was obtained on combining the three markers.Conclusion: Survivin RNA and MMPS zymography can be considered as promising noninvasive markers for bladder cancer early detection. Combined use of the three markers improved the sensitivity for detecting bladder cancer.

中文翻译：

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联合使用survivin mRNA和基质金属蛋白酶2和9在排尿中检测膀胱癌的价值。

目的：在一项提高常规尿液细胞学诊断功效的试验中，我们确定了膀胱癌病例尿液中的存活蛋白 RNA 和基质金属蛋白酶 2 和 9。方法：从组织学确诊为膀胱尿路上皮癌的患者（第 1 组；n = 46）、没有尿路上皮癌的泌尿外科患者（第 2 组；n = 20）和健康志愿者（第 3 组；n = 20）收集排空尿液样本。尿液细胞学、survivin RNA通过定性巢式RT-PCR估计，MMP-2、MMP-9活性通过明胶酶谱检测。膀胱癌中survivin RNA和基质金属蛋白酶2和9的表达与良性和正常病例进行比较。结果：survivin RNA 和 MMPs 酶谱的阳性率在 3 组之间有显着差异。通过定性巢式 RT-PCR 检测尿液存活蛋白显示 76.1% 的灵敏度和 95% 的特异性。尿MMP酶谱的总体敏感性、特异性分别为67.3%、90%。尿液细胞学与尿液存活蛋白或 MMPs 酶谱的联合使用使尿液细胞学的敏感性从 50% 增加到 84.7%。结合三个标记获得最高灵敏度 (95.6%)。结论：Survivin RNA 和 MMPS 酶谱可以被认为是有前途的膀胱癌早期检测的无创标志物。三种标志物的联合使用提高了检测膀胱癌的灵敏度。