Urinary BLCA-4 Level is Useful to Detect Upper Urinary Tract Urothelial Cell Carcinoma

Objective: Upper urinary tract urothelial cell carcinomas (UUT-UCCs) are rare but usually invasive at diagnosis. Early diagnosis of UUT-UCCs is thus warranted. UUT has the same embryological origin with bladder and BLCA-4 is a highly sensitive and specific marker for bladder cancer. We intend to investigate the viability of BLCA-4 in detecting UUT-UCCs. Material and methods: Urines from 30 UUT-UCC patients, 10 ureteral polyp patients, 20 infected patients with incarcerated ureteral stones, and 30 normal controls were included. BLCA-4 antibody was produced and applied in an indirect ELISA assay. Results: Urinary BLCA-4 is significantly higher in UUT-UCC group than "Polyp" group (P = 0.0017), "Infection" group (P <0.0001), or "Normal" group (P < 0.0001). The "Polyp" group is also higher than "Infection" group (P = 0.015), or "Normal" group (P = 0.0009). ROC curve revealed at cut-off of 5.5 x 10(-4) A, sensitivity was 93.3% and specificity was 100%. When grouped as ureteral mass vs normal, same cut-off value yielded 93.3% sensitivity and 83.3% specificity. At 2.4 x 10(-4) A, sensitivity was 56.7% and specificity was 97.2%. Conclusions: Urinary BLCA-4 is also highly specific in UUT-UCCs detection. For incidentally identified ureteral mass, BLCA-4 can be considered an auxiliary indicator besides biopsy. (c) 2012 AEU. Published by Elsevier Espana, S.L. All rights reserved.