Comparative Study between Cytology and Telomerase Activity of Urine in Diagnosis of Bladder Cancer

Introduction & Objective : Telomerase is a reverse transcriptase enzyme that is required in immortalized cancer cells. Early detection of telomerase activity in tumors particularly in bladder cancer is promising. The aim of this study was to compare specificity and sensitivity between cytology and telomerase activity in diagnosis of bladder cancer. Materials & Methods : This study was a case-control study and carried out on 33 patients with bladder cancer as case group and 33 patients without bladder cancer as control group who referred to urology clinic in Imam Teaching Hospital of Uremia University of Medical Sciences. From all of the patients two consecutive fresh urine samples were obtained before any interventional treatment for purpose of urine cytology and measurement of telomerase activity. The activity of telomerase enzyme was measured using telomeric repeat amplification protocol (Trap Assay) based on polymerase chain reaction and Elisa systems. Results : Sensitivity of urine cytology was 30% in grade I tumors, 83% in grade II and 52% in grade three tumors. Sensitivity of telomerase enzyme activity was 80% in grade I and 100% in grade II and III tumors. Total Sensitivity of urine cytology was 51.5% and telomerase sensitivity was measured 93%. Also Total specificity of Telomerase enzyme activity was 87.5%. Telomerase enzyme activity and urine cytology weren’t positive in any of the patients without bladder cancer. Conclusion: It is speculated that telomerase activity significantly increase in bladder cancer patients and it is more sensitive than conventional urine cytology method. Measurement of telomerase activity could be a favorable biomarker in bladder cancer diagnosis.