Expression of Engrailed-2 (EN2) protein in bladder cancer and its potential utility as a urinary diagnostic biomarker.

R. Morgan, R.T. Bryan, S. Javed, F. Launchbury, M.P.A. Zeegers, K.K. Cheng, N.D. James, D.M. Wallace, C.D. Hurst, D. G. Ward, M.A. Knowles, H. Pandha

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Despite significant advances in our understanding of the molecular pathology of bladder cancer, it remains a significant health problem with high morbidity and mortality associated with muscle-invasive bladder cancer (stages T2+), and high costs associated with the surveillance of non-muscle-invasive bladder cancer (NMIBC, stages Ta/T1/Tis). Moreover, current diagnostic biomarkers are suboptimal and of poor utility for low grade disease and surveillance. In this study, we show that the Engrailed-2 (EN2) transcription factor is expressed in, and secreted by, bladder cancer cell lines and patient tumour specimens, justifying an evaluation of urinary EN2 as a diagnostic biomarker in bladder cancer using archived samples from an established biospecimen collection. In patients with NMIBC, urinary EN2 was detected in most cases with an overall sensitivity of 82% and specificity of 75%. The sensitivity for stage Ta and T1 tumours was 71% and 76%, respectively, and 94% for stage T2+ tumours. This compares favourably with existing markers. The sensitivity for tumour grades 1, 2 and 3 was 69%, 78% and 87%, respectively. Thus urinary EN2 has the potential to be a more sensitive and specific protein biomarker for NMIBC than currently available tests. 

Original languageEnglish
Pages (from-to)2214-2222
Number of pages9
JournalEuropean Journal of Cancer
Volume49
Issue number9
DOIs
Publication statusPublished - Jun 2013

Keywords

  • Bladder cancer
  • EN2
  • Biomarker
  • Diagnostic
  • TRANSCRIPTION FACTOR
  • SURVEILLANCE
  • ASSOCIATION
  • PROGRESSION
  • MARKERS

Cite this

Morgan, R., Bryan, R. T., Javed, S., Launchbury, F., Zeegers, M. P. A., Cheng, K. K., James, N. D., Wallace, D. M., Hurst, C. D., Ward, D. G., Knowles, M. A., & Pandha, H. (2013). Expression of Engrailed-2 (EN2) protein in bladder cancer and its potential utility as a urinary diagnostic biomarker. European Journal of Cancer, 49(9), 2214-2222. https://doi.org/10.1016/j.ejca.2013.01.019