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JNCI Journal of the National Cancer Institute 1999 91(23):2028-2032; doi:10.1093/jnci/91.23.2028
© 1999 by Oxford University Press
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Journal of the National Cancer Institute, Vol. 91, No. 23, 2028-2032, December 1, 1999
© 1999 Oxford University Press

REPORTS

Diagnosis of Renal Cancer by Molecular Urinalysis

Claus F. Eisenberger, Mark Schoenberg, Cheryl Enger, Steven Hortopan, Shefali Shah, Nan-Haw Chow, Fray F. Marshall, David Sidransky

Affiliations of authors: C. F. Eisenberger, S. Hortopan, N.-H. Chow (Department of Urology, James Buchanan Brady Urological Institute), M. Schoenberg, F. F. Marshall (Department of Urology, James Buchanan Brady Urological Institute, and The Johns Hopkins Oncology Center), C. Enger (The Johns Hopkins Oncology Center), S. Shah (Department of Otolaryngology—Head and Neck Surgery, Division of Head and Neck Cancer Research), D. Sidransky (Department of Otolaryngology—Head and Neck Surgery, Division of Head and Neck Cancer Research, and The Johns Hopkins Oncology Center), The Johns Hopkins Medical Institutions, The Johns Hopkins University School of Medicine, Baltimore, MD.

Correspondence to: David Sidransky, M.D., The Johns Hopkins University School of Medicine, Otolaryngology—Head and Neck Surgery, Head and Neck Cancer Research, 818 Ross Research Bldg., 720 Rutland Ave., Baltimore, MD 21205-2196 (e-mail: dsidrans{at}jhmi.edu).

BACKGROUND: Organ-confined renal malignancies can be cured in the majority of patients, whereas more extensive lesions have a poor prognosis. We sought to develop a noninvasive test for renal cancer detection based on a novel molecular approach. METHODS: Matched urine and serum DNA samples were obtained before surgery from 30 patients with clinically organ-confined solid renal masses (25 with malignant tumors and five with tumors of low malignant potential) and were subjected to microsatellite analysis. Serum samples and urine samples obtained from 16 individuals without clinical evidence of genitourinary malignancy served as controls. RESULTS: Nineteen (76%) of the 25 patients with malignant tumors were found to have one or more microsatellite DNA alterations in their urine specimen, and 15 (60%) were found to have alterations in their serum DNA by microsatellite analysis. In every case, the microsatellite changes in urine or serum were identical to those found in the primary tumor. Three of five patients with tumors of low malignant potential were found to have DNA alterations in their urine, but none displayed alterations in their serum. Moreover, microsatellite alterations were not identified in either the urine or the serum samples from normal control subjects and patients with hematuria due to nephrolithiasis (renal stones). CONCLUSION: These data suggest that microsatellite DNA analysis of urine specimens provides a potentially valuable tool for the early detection of resectable kidney cancer. Furthermore, microsatellite analysis of serum samples reveals evidence of circulating tumor-specific DNA in approximately half of these patients and may reflect the propensity of these tumors to spread to distant sites at an early stage.


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