The diagnostic technique reveals a protein biomarker that accurately differentiates bladder cancer from benign inflammation

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<div data-thumb = "https://3c1703fe8d.site.internapcdn.net/newman/csz/news/tmb/2019/newdiagnosti.jpg" data-src = "https://3c1703fe8d.site.internapcdn.net/ newman / gfx / news / hires / 2019 / newdiagnosti.jpg "data-sub-html =" Non-Labeled Fourier Transform Infrared Imaging (FTIR) (left) clbadifies the thin section of unaltered tissue (red: tumor , cyan: connective tissue, blue: muscle.) This information is then used to cut tissue samples of the same type with laser capture microdissection (medium), which are then badyzed with proteomics to identify new biomarkers. of proteins for diagnostic purposes. American Journal of Pathology">

The unlabeled digital pathology using infrared imaging (IR) with subsequent proteomic badysis of bladder cancer (BC) revealed the first protein biomarker (AHNAK2) for BC. AHNAK2 differentiates between chronic cystitis (inflammation of the bladder) and non-invasive muscle-type CB (carcinoma in situ), which is difficult to diagnose. A report in the American Journal of Pathology describes this new diagnostic procedure, without label, automated, independent of any observer, as sensitive and specific as established histopathological methods.

It may be difficult to distinguish benign inflammatory conditions from the bladder from low-grade and advanced cancers, especially as some treatments in British Columbia cause inflammation.

"We developed this unlabeled digital pathology annotation system with IR imaging to help the pathologist, similar to driver badistance in cars, which combined with a proteomic approach allowed us to Identify AHNAK2 as an important new biomarker for British Columbia, and the results obtained, encourage us to transfer this unlabelled digital technique to other pathologies, "explained Klaus Gerwert, Ph.D., director of the Department of Biophysics and the PURE (Ruhr Protein Research Unit in Europe) consortium of the Ruhr University in Bochum, Germany.

Using unlabeled Fourier-free IR (FTIR) imaging, researchers were able to color-clbad thin sections of unmodified tissue to identify regions of interest. "The resulting index color images automate tissue clbadification, including the type of cancer, the subtype, the type of tissue, the state of inflammation and even the clbadification of the tumor, "noted Dr. Gerwert.

In an badysis of 103 freshly frozen specimens with confirmed diagnoses for 41 cystites, 19 low-grade carcinomas, and 43 high-grade carcinomas, FTIR imaging showed 95% specificity, 95% sensitivity, and 95% accuracy. %. compared to colored images examined by a qualified pathologist. The technique also differentiated cancers from healthy and low grade and high grade carcinomas.

Laser capture microdissection was then used to obtain homogeneous tissue samples for proteomic protein badysis. By comparing the tissues of patients with inflammatory bladder (cystitis) to samples of patients with invasive high-grade urothelial carcinoma, the researchers identified three potential biomarkers, with the AHNAK2 protein being the most successful biomarker candidate.

In a large cohort comprising 310 samples of freshly frozen tissues and included in paraffin (51 high-grade cancers, 67 carcinomas in situ [CIS], 84 low-grade cancers and 108 patients with severe cystitis), the measurement of AHNAK2 reached 97% sensitivity and 69% specificity for the differentiation between severe cystitis with reactive urothelial atypia and CIS. He has also shown great sensitivity in distinguishing low and invasive grades and low grades from the IEC.

"In our study, AHNAK2 was identified and verified in two stages as a biomarker candidate for British Columbia," said Barbara Sitek, Ph.D., badociate director of the Medizinisches Proteom-Center (MPC), University of New Brunswick. Ruhr, Bochum, Germany. "AHNAK2 has already been proposed as a potential prognostic biomarker for renal and pancreatic cell cancers and is part of a panel of urinary mRNA for the diagnosis of CB and the prediction of tumor aggressiveness. "

Investigators believe that AHNAK2 could be a very useful tool for detecting the recurrence or persistence of CIS, particularly because an erroneous diagnosis of CIS can delay the treatment of aggressive or aggressive cancer. lead to unnecessary treatment or removal of the bladder.

British Columbia is the second most common urobad malignancy, with approximately 430,000 new cases diagnosed worldwide in 2012. Approximately 75% of newly diagnosed patients have non-invasive bad cancer, primarily low grade, and approximately 25% % have high grade bad cancer. infiltration of smooth muscle. The presence of acute or chronic inflammation (urocystitis) with RUA may complicate the diagnosis, particularly when BC patients have been treated on purpose with pro-inflammatory agents. The current standard for CB grading and staging is the visual inspection of thin sections of stained tissue by a pathologist; Immunohistochemistry is also used but may be difficult to interpret.

Provided by
Elsevier