The Expression Of Survivin MRNA In Exfoliated Cells In Preoperative Or Postoperative Urine Of Patients With Transitional Cell Carcinoma Of Bladder

【Objective】In this study the expression of survivin mRNA in exfoliated cells in preoperative and postoperative urine of patients with BTCC was analysized to investigate the correlation between the expression of survivin mRNA and pathological grades or clinical stages and the correlation between the expression and relapse.【Methods】(1) 10 healthy volunteers were classified to normal control group. Real-time fluorescent quantitation polymerase chain reaction (FQ-PCR) was used to detect the expression of survivin mRNA in exfoliated cells in urine of 18 patients with initial BTCC and the uric samples were gathered before operation,one week after operation,one month after operation and six months after operation. Expression variance was analysized according to pathological grades and clinical stages. (2) By the same method, the expression of survivin mRNA in exfoliated cells in urine of 30 patients with initial BTCC six months after operation was detected, then these patients were followed up by 15 months. The expression of survivin mRNA in exfoliated cells in urine of the recurring patients before they were re-operated was detected.【Results】(1) Survivin mRNA was expressed significantly in exfoliated cells in urine of the preoperative patients with BTCC. The relative copies varied according to the different pathological grades (gradeⅠ: 55.95±3.70, gradeⅡ: 80.50±4.29 and gradeⅢ: 151.57±11.94) in the experimental group, which was markedly higher than that of the control group (13.12±2.25) (P<0.05). The relative copies also varied according to the different clinical stages (muscle noninvasived bladder cancer: 78.64±34.10 and muscle invasived bladder cancer: 130.73±36.93) in the experimental group, which was significantly higher than that of the control group (P<0.05). (2) The relative copies of survivin mRNA in the preoperative patients was 96.01±42.33,which was significantly higher than that of the patients one week after operation (25.30±1.51) (P<0.05), and there was no significance between patients a month (13.20±1.49) or six months (13.90±1.36) after operation and the control group (P>0.05), but which was significantly lower than that of the patients one week after operation (P<0.05). (3) In 18 patients with BTCC, the expression of survivin mRNA in urine of one case six months after operation (42.55) was significantly higher than those of others, which was proved recurring by cystoscopy and imageology seven months and a half after operation. (4) In the 30 follow-up patients, the relative copies of survivin mRNA in six months and 15 months after operation of the non-recurring group were 11.97±3.08 and 12.87±2.53 respectively, However, the relative copies of survivin mRNA in six months after operation and pre-reoperation of the recurring group were 14.08±0.50 and 97.83±27.47 respectively. In the recurring group, the expression of survivin mRNA after recurrence was markedly higher than that before recurrence (P<0.05), while there was no significant difference in the non-recurring group (P>0.05).【Conclusion】(1) Survivin mRNA was expressed significantly in exfoliated cells in urine of the preoperative patients with BTCC. There was significant correlation between the pathological grades or the clinical stages and the expression quantity. Detecting survivin mRNA in the urine can be used to diagnose BTCC and to judge the malignancy of BTCC. (2) The expression of survivin mRNA in exfoliated cells in the preoperative and postoperative urine of the patients with BTCC presents a process from high to low, however the expression of survivin mRNA was higher again in recurring patients. Detecting survivin mRNA in urine not only can be used to diagnose initial BTCC, but also be used to monitor recurrence after operation. It's possible to be an early-diagnostic marker forecasting recurrence.