Diagnostic and prognostic role of BTA, NMP22, survivin and cytology in urothelial carcinoma

Yu Wen Gong, Yi Ran Wang, Guang Rui Fan, Qian Niu, You Li Zhao, Hanzhang Wang, Robert Svatek, Ronald Rodriguez, Zhi Ping Wang

Research output: Contribution to journalArticlepeer-review

6 Scopus citations


Background: Cytology is a recommended noninvasive urine test for the detection and surveillance of bladder cancer and upper-tract urothelial carcinoma. It is however characterized by poor sensitivity in low-grade tumors. This study aims to determine the diagnostic and prognostic role of BTA, BTA-stat, NMP22, and Survivin. Methods: Urine samples were collected from a total of 105 patients (bladder cancer (n=61), upper-tract urothelial carcinoma (n=44), and controls (n=52). The samples were directly assessed using cytology, BTA-stat (Qualitative test), BTA (chemiluminescence test), NMP22 (Qualitative test), and Survivin (enzyme-linked immunosorbent assay). Cancer progression and recurrence were assessed after a median follow-up of 32 months (4-47 months). Univariate and multivariate analyses were performed using Kaplan-Meier survival analysis and Cox proportional hazards regression. Results: The triple combination of Survivin + BTA + Cytology was the most promising model for discriminating bladder cancer or upper-tract urothelial carcinoma from controls (UTUC group: The area under the curve value 0.97, sensitivity 86%, specificity 96%; BC group: The area under the curve value 0.86 sensitivity 67%, specificity 96%). Univariate survival analysis, showed Cytology (P=0.02; HR=5.35) and Survivin (HR=3.24; P=0.03) to have a significant association with the progression-free survival, while Survivin (HR=4.15; P=0.04) was statistically associated with cancer-specific survival in the bladder cancer group. The multivariable analysis did not show any of these markers as independent prognostic factors. Conclusions: These biomarkers showed a higher sensitivity than cytology, but a poorer specificity. All biomarkers exhibited good diagnostic performance in both bladder cancer and upper-tract urothelial carcinoma. Combining Survivin + BTA + Cytology was superior to the use of a single marker or combining other biomarkers.

Original languageEnglish (US)
Pages (from-to)3192-3205
Number of pages14
JournalTranslational Cancer Research
Issue number7
StatePublished - Jul 2021


  • Biomarkers
  • Combined detection
  • Diagnosis
  • Prognosis
  • Urothelial carcinoma (UC)

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Cancer Research


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