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Improving the diagnosis of high grade and stage bladder cancer by detecting increased urinary calprotectin expression in tumor tissue and tumor-associated inflammatory response

Investigative and Clinical Urology 2019년 60권 5호 p.343 ~ 350
 ( Sahin Yusuf ) - Bagcilar Training and Research Hospital Department of Urology

 ( Yucetas Ugur ) - Istanbul Training and Research Hospital Department of Urology
 ( Ates Huseyin Aytac ) - Gebze Fatih State Hospital Department of Urology
 ( Erkan Erkan ) - Istanbul Training and Research Hospital Department of Urology
 ( Yucetas Esma ) - Haseki Training and Research Hospital Department of Biochemistry
 ( Temiz Mustafa Zafer ) - Bagcilar Training and Research Hospital Department of Urology
 ( Toktas Mahmut Gokhan ) - Istanbul Training and Research Hospital Department of Urology
 ( Kadihasanoglu Mustafa ) - Istanbul Training and Research Hospital Department of Urology
 ( Topkaya Birsen Cigdem ) - Istanbul Training and Research Hospital Department of Biochemistry

Abstract


Purpose: To investigate whether measurement of urinary calprotectin can serve as a biomarker in the diagnosis of primary bladder cancer and to confirm its diagnostic role in determining high grade and stage disease.

Materials and Methods: Urinary calprotectin was measured in spot urine samples from patients with primary bladder cancer and control subjects. To confirm levels in urine, tissue samples were also obtained from bladder tumor and healthy trigone of bladder by transurethral resection in both groups. Finally, calprotectin levels in tissue and urine of the patients and control subjects were compared and their diagnostic potential was investigated in high grade and stage bladder cancers.

Results: Of 82 participants, 52 were patients with bladder cancer and 30 were control subjects. The two groups were comparable in terms of age, smoking status, and comorbidities. Tissue and urinary calprotectin levels were significantly higher in the bladder cancer group. In subgroup analyses, urinary calprotectin levels were significantly higher in patients with high-grade, muscle-invasive tumors. After receiver operating characteristic analyses, the sensitivity and specificity of urinary calprotectin was 100% and 96.7%, respectively, in the diagnosis of primary bladder cancer. High grade and stage bladder cancers were detected with sensitivity and specificity of 70% and 74.2%, and 80% and 84.8%, respectively.

Conclusions: Urinary calprotectin may be a valuable parameter in the diagnosis of primary bladder cancer with high sensitivity and specificity. Furthermore, it may be useful in the prediction of high grade and stage disease. However, more investigations are needed.

키워드

Biomarkers; Calprotectin; Urinary bladder neoplasms; Urine
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