A Novel Cost-effective Method for Diagnosis of Bladder Cancer by Detecting ErbB3 Expression in Urine

Date 24 November 2018
Event ESMO Asia 2018 Congress
Session Poster display - Cocktail
Topics Bioethics, Legal, and Economic Issues
Translational Research
Presenter Xu Chen
Citation Annals of Oncology (2018) 29 (suppl_9): ix74-ix78. 10.1093/annonc/mdy435
Authors X. Chen1, S. Wang2, C. Liu1, J. Chen1, D. Wang1, M. Huang3, J. Song3, S. Cai3, S. Qiu1
  • 1The Department Of Urology, The Frist Affiliated Hospital of Sun Yat-Sen University, 510080 - Guangzhou/CN
  • 2The Department Of Urology, The Frist Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510080 - Guangzhou/CN
  • 3The Medical Department, 3D Medicines Inc. Shanghai, P.R. China, 201114 - Shanghai/CN



Currently, an ideal noninvasive biomarker is still lacking for the diagnosis of bladder cancer (BC). Epidermal Growth Factor Receptor 3 (ErbB3) can be detected in 56.3% of bladder tumor cases, and its expression is associated with disease stage and survival in patients with bladder carcinoma. Here, we assessed whether ErbB3 in urine could be used to diagnose BC.


We collected morning urine samples of 39 treatment-naïve BC patients and 26 healthy controls, recruited from the First Affiliated Hospital of Sun Yat-sen University from August 2016 to December 2017. ErbB3 expression in urine was measured by enzyme-linked immunosorbent assay analysis. Receiver operating characteristic (ROC) curve was established to evaluate the potential diagnostic values of ErbB3.


The levels of ErbB3 in urine were significantly higher in patients with BC than in healthy controls (P < 0.05). ROC curves showed the optimum diagnostic cutoff was 48.33 pg/ml (area under curve [AUC], 0.781 [95% CI 0.667-0.895], sensitivity 71.8% and specificity 88.5%). In patients with BC, the levels of urine ErbB3 were higher in patients with high grade than patients with low grade (p = 0.013), and showed diagnostic accuracy in distinguishing high grade from low grade (cutoff value, 90.58 pg/ml; AUC, 0.873 [95% CI 0.758-0.988], sensitivity 88.9% and specificity 81%). To estimate whether patients were diagnosed with muscle invasive, though the specificity was up to 96.8%, the sensitivity of ErbB3 was barely unsatisfactory (62.5%) (cutoff value, 396.66 pg/ml; AUC, 0.859 [95% CI 0.708-1.000]). Moreover, the levels of urine ErbB3 were higher in patients with lower grade BC than normal controls (83.28 pg/ml vs 33.31 pg/ml) though there was no significant difference on ErbB3 expression (p = 0.06). However, ErbB3 might be utilized to distinguish healthy controls and tumor with non-muscle invasion, as ErbB3 expression presented statistical sense (p < 0.05).


Based on current results, urine ErbB3 may be promising in the diagnosis of BC and distinguishing higher tumor grade and these results warrant further research.

Editorial acknowledgement

Clinical trial identification

Legal entity responsible for the study

The First Affiliated Hospital of Sun Yat-sen University.


National Natural Science Foundation of China (Grant No. 81572522) Pearl River S&T Nova Program of Guangzhou (Grant No. 201710010057.) Science and Technology Planning Project of Guangdong Province, China (Grant No. 2016A020215235.)


All authors have declared no conflicts of interest.