Performance of urinary survivin as a non-invasive molecular marker of bladder carcinoma in a schistosomiasis endemic area
Objective: To compare the sensitivity, specificity, positive predictive value, negative predictive value of urinary survivin and that of urine cytology in the diagnosis of bladder carcinoma in a schistosoma endemic area.
Design and setting: This is a 12-month prospective study of patients with features of bladder carcinoma as study group and patients with other urologic conditions and healthy volunteers as control group.
Participants: Patients with features of bladder carcinoma formed the study group, while patients with other urological conditions and healthy volunteers formed the control group.
Results: There were 52 patients in study group and 36 patients in control group. The mean ages of patients in the study and control groups were 47.17 ± 17.00 and 44.19 ± 18.89 years respectively. There were 48 males and 4 females in the study group, giving a male: female ratio of 12:1. Thirty-one (60 %) of the patients were farmers and 44 patients (85%) had history suggestive of schistosomiasis at childhood. The sensitivity of urine cytology and survivin in the study were 29.1% and 100.0% respectively. The specificity of urine cytology and survivin were 100.0%
and 100.0% respectively (p= 0.05). The marker was associated with false positive (FP) results in patients with prostate cancer.
Conclusion: Urinary survivin is highly sensitive, specific and predictive of bladder carcinoma in our environment. The marker is associated with false positive results in patients with prostate cancer.
Funding: By authors
Keywords: survivin, urinary bladder carcinoma, schistosomiasis, sensitivity, specificity