Detection of human telomerase reverse transcriptase messenger RNA in urine of high risk patients as a non invasive molecular diagnostic tool for urinary bladder cancer in Egyptians

Introduction and Objectives: Bladder cancer is an important national health problem as it is the leading cancer in men in Egypt. Cystoscopy and biopsy, currently remains the gold standard procedure for diagnosis, yet, it is invasive and costly. Urinary cytopathology remains to be the only non-invasive alternative method for diagnosis. Although it is tumour specifi c, yet it has a poor sensitivity, especially for low grade tumours. Detection of Telomerase enzyme in exfoliated urinary cells is a potentially good molecular diagnostic marker in bladder cancer, since the catalytic subunit of this enzyme (hTERT) proved to be essential for cellular immortality and oncogenesis. Subjects and Methods: The study comprised 39 patients (36 with urothelial carcinomas and 3 cases were squamous cell carcinoma) with bladder cancer and 22 non cancer control (including 14 patients with benign urological disorders and 8 healthy volunteers). The urine sample was split into two aliquots one was used to undertake RNA extraction and hTERT/GAPDH RT-PCR semiquantitative assay and the second for cytological examination. Cystoscopy was considered the reference standard for the identifi cation of bladder cancer. Results: The hTERT/GAPDH RT-PCR test showed signifi cantly higher diagnostic sensitivity than cytology (84% Vs. 75% p