Abstract
Background:The gold standard for initial clinical diagnosis of bladder cancer involves cystoscopic examination of bladder and histological evaluation of tissues. There is a critical need to identify non-invasive and sensitive biomarkers. Early detection is essential challenge in diagnosis and surveillance of bladder carcinoma. Exosomes are nano- sized vesicles present in many biological fluids and have significant role in cancer. Thus, quantification of exosomes in different stages of bladder cancer may be of critical concern for clinical diagnosis and prognosis. Methods:Tumor derived exosomes levels in urine and serum samples of 70 bladder cancer Egyptian patients from stages T0-T3 and 12 healthy control people were measured using ELISA technique. Results:When compared to health subjects, exosomes levels in bladder cancer patients were increased in urine and serum samples at different stages of the disease. A gradual increase in tumor derived exosomes in serum (1.21, 3.31, 4.71, 6.47µg/ml) and urine (1.59, 2.84, 4.75, 6.67µg/ml) was observed comparative to invasiveness of tumor (T0-T3). Serum was more specific (100%) sample for detection of exosomes in bladder cancer. Conclusion: our findings suggest that tumor derived exosomes may offer a convenient tool for early diagnosis and monitoring of bladder cancer.
Highlights
In Egypt, bladder cancer accounts for approximately 19% of the total incidence of cancers, and it is one of the common type of cancer in men and second most prevalent in females (Antoni et al, 2017)
The gold standard for initial clinical diagnosis of bladder cancer involves cystoscopic examination of bladder and histological evaluation of tissue obtained by transurethral resection (TUR) (Babjuk et al, 2013)
Urinary tumor derived exosomes levels Statistically significant differences have been observed between urinary exosomes levels of healthy control group (0.59 μg/ml) and all bladder cancer patients (3.96 μg/ml)
Summary
In Egypt, bladder cancer accounts for approximately 19% of the total incidence of cancers, and it is one of the common type of cancer in men and second most prevalent in females (Antoni et al, 2017). Exosomes and microvesicles (apoptotic bodies and ectosomes) are extracellular vesicles (EVs) secreted by variety of human cells and have a significant role in cellular communications as transport of nucleic acids and proteins. They have been emerged as novel mediators of tumor progression over recent decades (Gangoda et al, 2015). Exosomes derived from tumors could change phenotype of normal cells by introducing proteins and RNAs developing metastasis, carcinogenesis, proliferation and angiogenesis (Vaderet al., 2014) They induce immune-suppression, and preparation of pre-metastatic niches in secondary organs (Ramteke et al, 2015). Conclusion: our findings suggest that tumor derived exosomes may offer a convenient tool for early diagnosis and monitoring of bladder cancer
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