Abstract 1946: Urinary cell-free microRNA panel in detection of urothelial carcinoma of the urinary bladder
Authors: Juracek Jaroslav , Peltanova Barbora , Mlcochova Hana , Stanik Michal , Machackova Tana , Fedorko Michal , Iliev Robert , Mlcochova Jitka , Sana Jiri , Ozanova Zuzana , Dolezel Jan , Slaby Ondrej 
Published: July 2016

Abstract
Urothelial carcinoma of the urinary bladder (UCUB) is the most common malignancy of the urinary system. Although about 80% of cases is a non-muscle invasive form of UCUB a high rate of local recurrence and progression to invasive form is observed. Early-stage tumors have very good prognosis, but current diagnostic methods (cystoscopy and urine cytology) suffer from low sensitivity. This reflects a large number of relapse, which occurs in almost 70% of superficial UCUB. This has led to the development of multiple molecular urinary biomarkers, but none are sufficiently robust to enter clinical practice. In this study we aimed to develop a clinically applicable, specific and sensitive panel of urine microRNAs enabling early detection of UCUB and prediction of risk of progression to muscle-invasive form.
In the first phase of study we have analyzed expression profiles of 1733 miRNAs in urine supernatant of 16 UCUB patients (6 invasive, 5 high-grade non-invasive, 5 low-grade non-invasive), 17 controls, 10 RCC patients and 4 urinary tract infections (UTI) using Affymetrix miRNA microarrays. MicroRNAs able distinguish between UCUB and control groups were further validated using specific TaqMan assays and qRT-PCR method on independent cohort of 100 UCUB patients, 40 controls and 25 RCC patients (training phase - 40 UCUB, 15 controls, 10 RCC; validation phase - 60 UCUB, 25 controls, 15 RCC, 20 UTI).
Global expression profiling revealed set of 76 miRNAs significantly differentially expressed in urine of UCUB patients (P &lt; 0,01) compared to healthy controls, thereof 64 highly up-regulated and 12 down-regulated. These miRNAs showed specificity for UCUB even when compared to other examined cohorts (RCC, UTI). Moreover 23 miRNAs were able distinguish invasive and non-invasive forms of UCUB (P &lt; 0,01) and 18 miRNAs high-grade and low-grad non-invasive (p &lt; 0,01). Set of 12 miRNAs with highest specificity and expression level was validated in training phase of study. Based on training phase results the panel of 3 miRNAs was profiled. Validation phase confirmed diagnostic potential and ability of this urine miRNA-based panel to differentiate between UCUB patients and controls with high sensitivity and specificity (AUC = 0,857, sensitivity = 82%, specificity = 80%).
Our data have shown that urinary microRNAs could serve as sensitive and specific biomarkers of UCUB and could be useful tool to increase sensitivity of standard cytological examination and to decrease high costs for long-term follow-up of UCUB patients. This work was supported by Ministry of Health of the Czech Republic, grant nr. 15-33158A, 15-34553A, 15-31627A and 15-34678A. All rights reserved.
Citation Format: Jaroslav Juracek, Barbora Peltanova, Hana Mlcochova, Michal Stanik, Tana Machackova, Michal Fedorko, Robert Iliev, Jitka Mlcochova, Jiri Sana, Zuzana Ozanova, Jan Dolezel, Ondrej Slaby. Urinary cell-free microRNA panel in detection of urothelial carcinoma of the urinary bladder. [abstract]. In: Proceedings of the 107th Annual Meeting of the American Association for Cancer Research; 2016 Apr 16-20; New Orleans, LA. Philadelphia (PA): AACR; Cancer Res 2016;76(14 Suppl):Abstract nr 1946.