Abstract
Aims Bladder cancer–specific nuclear matrix protein-4 (BLCA-4) is a protein expressed mainly in bladder cancer tissues. Therefore, the aim of this study was to investigate its assisting diagnostic potential in non-muscle-invasive bladder cancer (NMIBC). Methods Twenty patients with NMIBC, 20 with benign prostatic hyperplasia (BPH), and 20 normal controls were included in this study. Blood and urine samples were collected from all patients. Moreover, cancer foci and adjacent tissue samples were collected from NMIBC patients, and normal bladder tissue samples were collected from patients with BPH. A competitive enzyme-linked immunosorbent assay was used to determine the BLCA-4 level in serum and urine, and immunohistochemistry was used to examine BLCA-4 expression in bladder cancer, adjacent, and normal tissues. Results Median urinary BLCA-4 levels in the NMIBC, BPH, and normal control groups were 0.759 ng/mL, 0.309 ng/mL, and 0.171 ng/mL, respectively. Urinary BLCA-4 level was significantly higher in the NMIBC group than in the other 2 groups (P < 0.01); meanwhile, the BPH group was higher than the normal control group (P < 0.05). Median serum BLCA-4 levels in the NMIBC, BPH, and normal control groups were 5.680 ng/mL, 5.928 ng/mL, and 5.473 ng/mL, respectively, showing no significant difference among groups (P > 0.05). Conclusion As a new marker of bladder cancer, urinary BLCA-4 level detection might apply for clinical diagnosis or postoperative monitoring for NMIBC.
Highlights
Bladder cancer is one of the most common urinary tumors, and the incidence is increasing with industrial development, increased smoking, and population aging [1]
Konety et al [8, 9] employed an indirect enzyme-linked immunosorbent assay (ELISA) to determine the urinary Bladder cancer–specific nuclear matrix protein-4 (BLCA-4) level in patients with bladder cancer and found that with a cutoff value of 13 optical density units/μg protein, sensitivity and specificity for tumor detection were 96.4% and 100%, respectively, and that urinary Bladder cancer–specific nuclear matrix proteins (BLCAs) level was irrelevant for tumor staging and grading
These results suggested that upregulation of BLCA-4 was correlated with the benign bladder tissue cancerization
Summary
Bladder cancer is one of the most common urinary tumors, and the incidence is increasing with industrial development, increased smoking, and population aging [1]. Bladder cancer–specific nuclear matrix proteins (BLCAs) are expressed in cancer tissue and can be released into the body during cell lyses [4]. Measurement of the BLCA level in body fluids with modern immunologic methods might be valuable to diagnose and monitor patients with bladder cancer. Current studies [5,6,7] state that BLCA-4 has relatively high sensitivity and specificity for bladder tumor diagnosis, presenting a high potential for clinical application. Konety et al [8, 9] employed an indirect enzyme-linked immunosorbent assay (ELISA) to determine the urinary BLCA-4 level in patients with bladder cancer and found that with a cutoff value of 13 optical density units/μg protein, sensitivity and specificity for tumor detection were 96.4% and 100%, respectively, and that urinary BLCA level was irrelevant for tumor staging and grading. Feng et al [10,11,12] prepared a BLCA-4 antigen and used indirect ELISA to test urine samples of patients with bladder
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