TY - JOUR
T1 - External validation of a multiplex urinary protein panel for the detection of bladder cancer in a multicenter cohort
AU - Chen, Li Mei
AU - Chang, Myron
AU - Dai, Yunfeng
AU - Chai, Karl X.
AU - Dyrskjøt, Lars
AU - Sanchez-Carbayo, Marta
AU - Szarvas, Tibor
AU - Zwarthoff, Ellen C.
AU - Lokeshwar, Vinata
AU - Jeronimo, Carmen
AU - Parker, Alexander S.
AU - Ross, Shanti
AU - Borre, Michael
AU - Ørntoft, Torben F.
AU - Jaeger, Tobias
AU - Beukers, Willemien
AU - Lopez, Luis E.
AU - Henrique, Rui
AU - Young, Paul R.
AU - Urquidi, Virginia
AU - Goodison, Steve
AU - Rosser, Charles J.
N1 - Publisher Copyright:
© 2014 AACR.
PY - 2014/9/1
Y1 - 2014/9/1
N2 - Background: Because of the faltering sensitivity and/or specificity, urine-based assays currently have a limited role in the management of patients with bladder cancer. The aim of this study was to externally validate our previously reported protein biomarker panel from multiple sites in the United States and Europe.Methods: This multicenter external validation study included a total of 320 subjects (bladder cancer = 183). The 10 biomarkers (IL8, MMP9, MMP10, SERPINA1, VEGFA, ANG, CA9, APOE, SDC1, and SERPINE1) were measured using commercial ELISA assays in an external laboratory. The diagnostic performance of the biomarker panel was assessed using receiver operator curves (ROC) and descriptive statistical values.Results: Utilizing the combination of all 10 biomarkers, the area under the ROC for the diagnostic panel was noted to be 0.847 (95% confidence interval, 0.796-0.899), outperforming any single biomarker. The multiplex assay at optimal cutoff value achieved an overall sensitivity of 0.79, specificity of 0.79, positive prediction value of 0.73, and negative prediction value of 0.84 for bladder cancer classification. Sensitivity values of the diagnostic panel for high-grade bladder cancer, low-grade bladder cancer, muscle invasive bladder cancer, and non-muscle invasive bladder cancer were 0.81, 0.90, 0.95, and 0.77, respectively.Conclusions: Urinary levels of the biomarker panel enabled discrimination of patients with bladder cancer and controls, and the levels of biomarker subsets were associated with advancing tumor grade and stage.Impact: If proven to be reliable, urinary diagnostic biomarker assays can detect bladder cancer in a timely manner such that the patient can expect improvements in overall survival and quality of life.
AB - Background: Because of the faltering sensitivity and/or specificity, urine-based assays currently have a limited role in the management of patients with bladder cancer. The aim of this study was to externally validate our previously reported protein biomarker panel from multiple sites in the United States and Europe.Methods: This multicenter external validation study included a total of 320 subjects (bladder cancer = 183). The 10 biomarkers (IL8, MMP9, MMP10, SERPINA1, VEGFA, ANG, CA9, APOE, SDC1, and SERPINE1) were measured using commercial ELISA assays in an external laboratory. The diagnostic performance of the biomarker panel was assessed using receiver operator curves (ROC) and descriptive statistical values.Results: Utilizing the combination of all 10 biomarkers, the area under the ROC for the diagnostic panel was noted to be 0.847 (95% confidence interval, 0.796-0.899), outperforming any single biomarker. The multiplex assay at optimal cutoff value achieved an overall sensitivity of 0.79, specificity of 0.79, positive prediction value of 0.73, and negative prediction value of 0.84 for bladder cancer classification. Sensitivity values of the diagnostic panel for high-grade bladder cancer, low-grade bladder cancer, muscle invasive bladder cancer, and non-muscle invasive bladder cancer were 0.81, 0.90, 0.95, and 0.77, respectively.Conclusions: Urinary levels of the biomarker panel enabled discrimination of patients with bladder cancer and controls, and the levels of biomarker subsets were associated with advancing tumor grade and stage.Impact: If proven to be reliable, urinary diagnostic biomarker assays can detect bladder cancer in a timely manner such that the patient can expect improvements in overall survival and quality of life.
UR - http://www.scopus.com/inward/record.url?scp=84907164391&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84907164391&partnerID=8YFLogxK
U2 - 10.1158/1055-9965.EPI-14-0029
DO - 10.1158/1055-9965.EPI-14-0029
M3 - Article
C2 - 24920641
AN - SCOPUS:84907164391
SN - 1055-9965
VL - 23
SP - 1804
EP - 1812
JO - Cancer Epidemiology Biomarkers and Prevention
JF - Cancer Epidemiology Biomarkers and Prevention
IS - 9
ER -