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Non-invasive prediction of recurrence in bladder cancer by detecting somatic TERT promoter mutations in urine
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Non-invasive prediction of recurrence in bladder cancer by detecting somatic TERT promoter mutations in urine
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Journal Article
Non-invasive prediction of recurrence in bladder cancer by detecting somatic TERT promoter mutations in urine
2017
Overview
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.
Publisher
Nature Publishing Group UK,Nature Publishing Group
Subject
/ Adult
/ Aged
/ Biomedical and Life Sciences
/ Carcinoma, Transitional Cell - genetics
/ Carcinoma, Transitional Cell - pathology
/ Carcinoma, Transitional Cell - surgery
/ Carcinoma, Transitional Cell - urine
/ Cytology
/ Female
/ Humans
/ Male
/ Mutation
/ Neoplasm Recurrence, Local - genetics
/ Neoplasm Recurrence, Local - pathology
/ Neoplasm Recurrence, Local - urine
/ Oncology
/ Patients
/ Population Surveillance - methods
/ Surgery
/ Telomerase reverse transcriptase
/ Urinary Bladder Neoplasms - genetics
/ Urinary Bladder Neoplasms - pathology
/ Urinary Bladder Neoplasms - surgery
/ Urinary Bladder Neoplasms - urine
/ Urine
