We investigated the feasibility of profiling and measuring the concentration of
clusterin in urine and serum for individuals with
transitional cell carcinoma (TCC) of the bladder and comparing it with nontumor controls. In addition, we analyzed the correlation of expression of
clusterin in specimens of TCC to various clinicopathologic parameters and prognosis of
bladder cancer. Blood and urine samples were used from 68 patients with TCC of the bladder and from 61 patients with benign
urological diseases.
Enzyme-linked
immunosorbent assays (ELISA) were performed for
clusterin from serum and urine. Quantitation of
clusterin mRNA was carried out in 68
bladder tumor specimens from
radical cystectomy or transurethral resection and 26 normal bladder specimens from BPH patients by using RT-PCR method. Correlation for the expression of
clusterin mRNA with clinicopathologic parameters was analyzed. Serum and urine
clusterin was significantly higher in individuals with
bladder cancer than control (p = 0.001). Sensitivity and specificity of serum and urine
clusterin as a
tumor marker for TCC of the bladder was found to be 80%, 91%, 87.1% and 96.7% respectively.
Clusterin expression was significantly higher in TCC specimens than normal tissue specimens (P < 0.001). Expression of
clusterin was significantly higher in patients with invasive TCC of the bladder than that in patients with superficial TCC and control (P < 0.001). Overexpression of
clusterin mRNA was significantly associated with
tumor recurrence and overall survival (p < 0.001). The recurrence-free survival time of patients with overexpression of
clusterin was significantly shorter than that of patients with weak expression of
clusterin (9.8 months vs. 35.2 months).
Clusterin may be considered as a potential diagnostic and prognostic
biomarker for
bladder cancer using urine, serum and/or molecular biology techniques.