DETECTION OF BLADDER-CANCER RECURRENCE BY MICROSATELLITE ANALYSIS OF URINE

A reliable, noninvasive method for monitoring patients with transition al cell carcinoma (TCC) of the bladder would be of great clinical bene fit. Cystoscopy is currently the ''gold standard,'' but it is invasive , expensive and uncomfortable for the patient. Recently, we demonstrat ed a novel approach for the detection of primary bladder cancer based on microsatellite analysis of urine DNA. To determine the feasibility of this technique for following-up patients with TCC, we tested serial urine samples from 21 patients who had been treated for bladder cance r with 20 polymorphic microsatellite markers in a blinded fashion. We detected recurrent lesions in 10 out of 11 patients and correctly pred icted the existence of a neoplastic cell population in the urine of tw o patients, 4 and 6 months before cystoscopic evidence of the tumor. T he assay was negative in 10 of 10 patients who had no evident cancer. Microsatellite analysis of urine sediment represents a novel and poten tially powerful clinical tool for the detection of recurrent bladder c ancer.