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Open Access Research article

Expression and biological-clinical significance of hTR, hTERT and CKS2 in washing fluids of patients with bladder cancer

Letizia Mezzasoma1*, Cinzia Antognelli1, Chiara Del Buono1, Fabrizio Stracci2, Emanuele Cottini3, Giovanni Cochetti3, Vincenzo N Talesa1 and Ettore Mearini3

Author Affiliations

1 Department of Experimental Medicine, Division of Cell and Molecular Biology, University of Perugia, Via Del Giochetto 06122 Perugia, Italy

2 Department of Medical-Surgical Specialties and Public Health, Division of Public Health University of Perugia, Via Del Giochetto 06122 Perugia, Italy

3 Department of Medical-Surgical Specialties and Public Health, Division of Urology and Andrology, University of Perugia, Didactic and Scientific District of Terni, Santa Maria General Hospital, Italy

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BMC Urology 2010, 10:17  doi:10.1186/1471-2490-10-17

Published: 4 October 2010

Abstract

Background

at present, pathogenesis of bladder cancer (BC) has not been fully elucidated. Aim of this study is to investigate the role of human telomerase RNA (hTR), human telomerase reverse transcriptase (hTERT) and CDC28 protein kinase regulatory subunit 2 (CKS2) in bladder carcinogenesis and their possible clinical significance;

Methods

the transcript levels of hTR, hTERT and CKS2 were quantified by Real time reverse transcriptase chain reaction in exfoliated cells from bladder washings of 36 patients with BC and 58 controls. The statistical significance of differences between BC bearing patients and control groups, in the general as well as in the stratified analysis (superficial or invasive BC), was assessed by Student's t test. Non parametric Receiver Operating Characteristics analysis (ROC) was performed to ascertain the accuracy of study variables to discriminate between BC and controls. The clinical value of concomitant examination of hTR, hTERT and CKS2 was evaluated by logistic regression analysis;

Results

a significant decrease in hTR and a significant increase in hTERT or CKS2 gene expression were found between BC bearing patients and controls, as well as in the subgroups analysis. The area under the curve (AUC) indicated an average discrimination power for the three genes, both in the general and subgroups analysis, when singularly considered. The ability to significantly discriminate between superficial and invasive BC was observed only for hTR transcript levels. A combined model including hTR and CKS2 was the best one in BC diagnosis;

Conclusions

our results, obtained from a sample set particularly rich of exfoliated cells, provide further molecular evidence on the involvement of hTR, hTERT and CKS2 gene expression in BC carcinogenesis. In particular, while hTERT and CKS2 gene expression seems to have a major involvement in the early stages of the disease, hTR gene expression, seems to be more involved in progression. In addition, our findings suggest that the studied genes have a clinical role in discriminating between BC and controls in the general as well as in the stratified analysis, when singularly considered. A combined model improved over the single marker BC diagnosis.