Prospective Assessment of Multiple Urinary Biomarkers to Diagnose Recurrence and Progression in Patients with Non‑muscle‑Invasive Bladder Cancer

Bladder cancer (BC) is one of common cancer in males and females, in many cases tumor recurrence and progression can happen in cancer patients having treatment. The objective of the study is to determine if a panel of protein biomarkers can identify and predict tumor recurrence and progression in patients treated for NMIBC. We analyzed 150 urine samples of patients who treated for NMIBC. Quantitative expression of 7 biomarkers including, Angiogenin (ANG), Apolipoprotein E (APOE), Interleukin-8 (IL-8), Matrix metallopeptidase 9 (MMP-9), Matrix metallopeptidase10 (MMP-10), Plasminogen Activator Inhibitor (PAI-1), and Vascular endothelial growth factor (VEGF), were assessed by ELISA and compared between group has patients with bladder cancer recurrence or progression and group hasn’t any recurrence or progression from urine sample during follow-up. Pathologic action confirmed recurrence and progression. In univariate analysis, factors significantly associated with recurrence were prior history of NMIBC with none of the biomarkers associated with NMIBC recurrence. On the other hand, factors significantly associated with tumor progression were higher ANG, higher ApoE, higher IL8, higher MMP10, higher MMP9, higher PAI1, higher VEGF, and tumor number. In multivariate Cox regression analysis, significant variables for progression were ANG, ApoE, and IL-8. We concluded that none of the evaluated urinary biomarkers showed diagnostic accuracy in predicting tumor recurrence of NMIBC. However, tumor progression was associated with higher urinary levels of ANG, ApoE, and IL-8.