期刊
BRITISH JOURNAL OF CANCER
卷 117, 期 4, 页码 583-587出版社
SPRINGERNATURE
DOI: 10.1038/bjc.2017.210
关键词
cystoscopy; cytology; non-invasive prognostic marker; recurrence; TERT; transurothelial bladder resection; urine; urothelial bladder cancer
类别
资金
- French Ministry of Health (PHRC National)
Background: Urothelial bladder cancer (UBC) is characterised by a high risk of recurrence. Patient monitoring is currently based on iterative cystoscopy and on urine cytology with low sensitivity in non-muscle-invasive bladder cancer (NMIBC). Telomerase reverse transcriptase (TERT) is frequently reactivated in UBC by promoter mutations. Methods: We studied whether detection of TERT mutation in urine could be a predictor of UBC recurrence and compared this to cytology/cystoscopy for patient follow-up. A total of 348 patients treated by transurethral bladder resection for UBC were included together with 167 control patients. Results: Overall sensitivity was 80.5% and specificity 89.8%, and was not greatly impacted by inflammation or infection. TERT remaining positive after initial surgery was associated with residual carcinoma in situ. TERT in urine was a reliable and dynamic predictor of recurrence in NMIBC (P<0.0001). In univariate analysis, TERT positive-status after initial surgery increased risk of recurrence by 5.34-fold (P = 0.0004). TERT positive-status was still associated with recurrence in the subset of patients with negative cystoscopy (P = 0.034). Conclusions: TERT mutations in urine might be helpful for early detection of recurrence in UBC, especially in NMIBC.
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