SCREENING AND DETECTION
Micro satellite urinary sediment (MAUS) testing
development consists of a urine test which will screen
for either early detection or recurrence of bladder cancer
The micro satellite urinary sediment test uses molecular
biology to diagnose bladder cancer. The bladder cancer
research effort at the Johns Hopkins Medical Institutions
has been grounded in clinical and translational research
for over 50 years. In the late 1940's Drs. Jewett and
Strong conceived the first staging system for superficial
and invasive bladder cancer at Johns Hopkins which is
still used today.
Group
A
Submucosal infiltration
|
Group
B
Muscular infiltration |
Group
C
Perivesical infiltration |
No.
of cases 3
Metastases 0
Perivesical lymph only 0
Perivesical fixation only 0
Potentially curable 100% |
No.
of cases 15
Metastases 1
Perivesical lymph only 1
Perivesical fixation only 0
Potentially curable 86.6% |
No.
of cases 89
Metastases 52
Perivesical lymph only 6
Perivesical fixation only 8
Potentially curable 26% |
Jewett Staging Diagram Journal of Urology
1946 55: 366
Recent efforts in bladder cancer research
have focused on finding the molecular origins of the
disease. This important research conducted in the laboratory
of Bladder Cancer Research member and University Professor, Dr.
David Sidransky, has focused on understanding the
relationship between genetic alterations in the bladder
cancer cell and a tumor's ability to recur and progress.
Multiple publications have
shown that alterations of specific genes on chromosome
9 probably contribute to the development of most bladder
cancers. Detailed molecular maps of bladder cancers have
been constructed in the laboratory and provide preliminary
work for understanding how bladder tumors arise and recur.
These observations have led Dr. Sidransky's group to the
novel application of specific molecular analytic laboratory
techniques to diagnose bladder cancers. Specific types
of molecular abnormalities can be identified in the urine
of bladder cancer patients utilizing a new diagnostic bladder
cancer test developed in Dr. Sidransky's laboratory. This
test, called micro satellite analysis is
a very sensitive and accurate identifier of bladder cancer
cells in voided urine. Pilot studies have already demonstrated
that this test can correctly diagnose bladder cancer in
greater than 90%of patients, six month earlier than conventional
diagnostic testing. Ongoing studies will help define the
clinical role of this new test for bladder cancer detection
and prevention.
Industrial monitoring program is
a cancer detection program that uses the micro-satellite
urine test to monitor individuals who have been occupationally
exposed to chemicals that are linked to bladder cancer.
Exposure to chemical carcinogens significantly increases
ones risk for developing bladder cancer. Approximately
one-fourth to one-third of all cases of bladder cancer
are believed to be caused by occupational exposure (Catalona,
1991). Those individuals at greatest risk include textile
workers, painters, leather and metal workers and workers
in the rubber industries (Brettschneider & Orihuela,
1990). All of these occupations carry a high risk of
exposure to chemical carcinogens.
The Johns Hopkins Bladder Cancer Research Center has
established a surveillance program that provides periodic
screening for bladder cancer. One current industrial
monitoring research protocol provides for yearly screening
utilizing micro-satellite analysis and cytology of voided
urine in a high risk population of workers exposed to
a pesticide.
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