Significance of urine BLCA-4 immunoassay in the postoperative surveillance and prognosis evaluation of non-muscle invasive bladder cancer

Abstract

Objective To investigate the significance of urine bladder cancer specific nuclear matrix protein 4 (BLCA-4) immunoassay in postoperative surveillance and prognosis evaluation of non-muscle invasive bladder cancer (NMIBC) . Methods From December 2013 to June 2015, 42 patients with bladder cancer registered in our department underwent transurethral electrocision of the bladder cancers, and were confirmed to have NMIBC by postoperative pathological study. The levels of urine BLCA-4 were measured before and at 1, 3, 6 and 12 months after operation. The recurrence of tumor was monitored monthly by cystoscopy. The relationship between preoperative urine BLCA-4 level and clinicopathological parameters was analyzed. Multivariate COX regression analysis was performed to determine the risk factors for postoperative recurrence of NMIBC. Results The level of urine BLCA-4 in 42 patients reached the nadir at 1 month and gradually increased at 3 months after operation. Elevated urine BLCA-4 levels were noted before cystoscopic confirmation in all patients with recurrence of NMIBC. Positivity of urine BLCA-4 was noted up to (8.1±3.5) months earlier than the confirmation by cystoscopy in these patients. Preoperative urine BLCA-4 level were correlated with tumor grading and clinical staging (both P<0.05) . Multivariate COX regression analysis showed that preoperative over-expression of urine BLCA-4, and positivity in urine BLCA-4 at 3 and 6 postoperative months were risk factors for NMIBC recurrence (all P<0.05) . Conclusion Measurement of urine BLCA-4 level is helpful for postoperative surveillance and prognosis evaluation of NMIBC. Key words: Bladder cancer specific nuclear matrix protein 4; Enzyme-linked immunosorbent assay; Neoplasm recurrence; Prognosis