Masanobu Horie

Detection of Bladder Cancer by Measuring CD44v6 Expression in Urine With Real-time Quantitative Reverse Transcription Polymerase Chain Reaction

OBJECTIVE To examine urinary CD44v6 total ribonucleic acid (RNA) expression in patients with bladder cancer using real-time quantitative reverse transcription polymerase chain reaction (qRT-PCR) and evaluate its potential as a novel marker of bladder cancer. METHODS We used the bladder cancer cell line T24 and determined CD44v6 expression in cancer cells using in situ hybridization and immunohistochemistry. Subsequently, we obtained urine samples from 21 patients with bladder cancer and 25 patients without bladder cancer (controls). We extracted total RNA from the urine samples, measured CD44v6 total RNA expression in both groups using qRT-PCR, and compared the expression between groups. We also compared the sensitivity, specificity, and concordance rate between CD44v6 total RNA expression analysis by qRT-PCR and cytologic analysis, UroVysion fluorescent in situ hybridization, bladder tumor antigen identification, and nuclear matrix protein 22 measurements. RESULTS We observed increased CD44v6 expression in bladder cancer cells using in situ hybridization and immunohistochemistry. CD44v6 total RNA expression was significantly higher in the urine samples of patients with bladder cancer than in those of controls. We calculated the cutoff value from the receiver operating characteristic curve and obtained sensitivity and specificity values of 85.7% and 72.0%, respectively, for qRT-PCR analysis. CONCLUSION Our results suggest that CD44v6 total RNA levels in urine can serve as a potential noninvasive biomarker of bladder cancer.

Improved protocol for extraction of genomic DNA from formalin-fixed paraffin-embedded tissue samples without the use of xylene.

*Corresponding author: Arizumi Kikuchi, Daiyukai Second Medical and Science Research Laboratory, 25 Azaicho, Ichinomiya-City, Aichi 491-0113, Japan, Phone: +81-586-533661, Fax: +81-586-533771, E-mail: akikuchi@daiyukai.or.jp Takahiro Sawamura and Osami Daimaru: Daiyukai Second Medical and Science Research Laboratory, Ichinomiya-City, Japan Masanobu Horie: Daiyukai Daiichi Hospital, Ichinomiya-City, Japan Kazutoshi Sasaki and Noriyuki Okita: Roche Diagnostics, Tokyo, Japan Letter to the Editor

Clinical implications of measurement of bone mineral content by dual energy X-ray absorptiometry(DEXA).

透析患者195例中評価可能な115例を対象に, 腎性骨異栄養症 (広義のROD) の疼痛scoreとDEXA骨密度測定の意義を検討するため, 測定部位別骨密度すなわち, 中手骨, 腰椎 (L2-L4), 大腿骨の骨密度と各種骨パラメータ検査値, および中手骨のmicrodensitometry (MD法) のパラメータの相関性と有用性を検討した. 透析歴で5年未満, 10年未満, 15年未満, 15年以上の4群間でDEXAによる骨塩量を中手骨, 腰椎, 大腿骨で測定値を比較すると, 中手骨でのみ群間で有意差を認めた. 10年以上の長期透析群の骨密度の検討では男性では10年未満に比して有意に低値を示したが, 女性群の10年未満の症例ですでに骨密度は低下していて長期透析群と同程度であった. また疼痛scoreによる患者群別でも中手骨の骨密度が群間で有意差を認めたが腰椎では差を認めなかった. DEXAによる各部位の骨塩量を目的変量として多変量解析すると, 中手骨では疼痛score, 透析歴, 年齢の順で寄与率が高く, 大腿骨頸部では, C-PTH, 年齢, Ca×P, calcitoninに, 腰椎ではC-PTH, 年齢に高い結果を得た. DEXAによる骨塩量の測定でも, 透析歴および疼痛scoreを反映する骨塩量の変化は皮質骨主体の中手骨で認められ, 腰椎のDEXA骨密度は治療効果の経過観察に適している可能性があることが示唆された.

ENDOSCOPIC AND FLUOROSCOPIC PYELOURETEROTOMY FOR URETEROPELVIC JUNCTION OBSTRUCTION AND URETERAL STRICTURE

Endoscopic or fluoroscopic pyeloureterotomy was performed in a total of 32 patients (34 ureters) with ureteropelvic junction obstruction (UPJO) or ureteral stricture from March 1985. Cold incision was performed, using a flexible knife over a guidewire, endoscopically on 23 ureters and fluoroscopically on 11 ureters. The mean operation time was 98.9 +/- 48.3 minutes. Twenty-five (74%) of the 34 ureters showed relief of subjective symptoms, normalized urinalysis and radiographical improvement of hydronephrosis with a mean follow-up period of 11.7 +/- 10.0 months (range: 3-43). The clinical results by etiology were as follows: primary UPJO, 13/16 (81%); secondary UPJO, 4/4 (100%); ureteral stricture, 6/7 (85%); obliteration of ureteral implantation, 2/7 (29%). No major complication was noted with this endourological technique. This endourological technique might be clinically useful for the treatment of UPJO and ureteral strictures.