Suh Yoon Seok, Ko Kwang Jin, Kim Tae Heon, Lee Hyo Serk, Sung Hyun Hwan, Cho Won Jin, Lee Kyu-Sung
Department of Urology, Center for Prostate Cancer, Research Institute and Hospital of National Cancer Center, Goyang, Korea.
Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Int Neurourol J. 2017 Dec;21(4):270-281. doi: 10.5213/inj.1732794.397. Epub 2017 Dec 31.
The aim of this study was to investigate urinary nerve growth factor (NGF) as a biomarker of treatment efficacy and recurrence in overactive bladder (OAB) patients.
We enrolled 189 OAB subjects who visited our outpatient clinic from February 2010 to February 2015. All subjects with OAB received antimuscarinic treatment. A 3-day voiding diary and questionnaire were collected from each patient. Urinary levels of NGF were evaluated at baseline, the beginning of antimuscarinic treatment, and the end of antimuscarinic treatment. Urinary NGF was normalized to urine creatinine (Cr). Between-group comparisons of baseline characteristics were made using the Mann-Whitney U-test. Multivariate logistic regression analyses were used to predict responses to anticholinergic treatment and recurrence. The Wilcoxon signed-rank test with the Bonferroni correction was used for intragroup comparisons. A receiver operating characteristic curve was used to analyze the utility of this biomarker.
Urinary levels of NGF/Cr tended to decrease in patients who responded to treatment (n=62), but this was not significant (P=0.260). Urinary NGF levels were higher at baseline in patients who did not experience recurrence than in those who did (P=0.047). In those who did not experience recurrence (n=29), urinary NGF/Cr decreased at the end of treatment compared to baseline, and this reduction was maintained at 12 weeks after the end of treatment (P<0.05).
Urinary NGF is a potential biomarker for predicting the outcome of antimuscarinic treatment in OAB patients. This may provide useful information when deciding to stop antimuscarinic treatment in responders.
本研究旨在探讨尿神经生长因子(NGF)作为膀胱过度活动症(OAB)患者治疗疗效和复发的生物标志物。
我们纳入了2010年2月至2015年2月期间到我院门诊就诊的189例OAB患者。所有OAB患者均接受抗胆碱能治疗。收集每位患者的3天排尿日记和问卷。在基线、抗胆碱能治疗开始时和抗胆碱能治疗结束时评估尿NGF水平。尿NGF以尿肌酐(Cr)进行标准化。使用Mann-Whitney U检验对基线特征进行组间比较。多因素逻辑回归分析用于预测对抗胆碱能治疗的反应和复发情况。采用经Bonferroni校正的Wilcoxon符号秩检验进行组内比较。使用受试者工作特征曲线分析该生物标志物的效用。
治疗有反应的患者(n = 62)尿NGF/Cr水平有下降趋势,但差异无统计学意义(P = 0.260)。未复发患者的基线尿NGF水平高于复发患者(P = 0.047)。在未复发的患者(n = 29)中,与基线相比,治疗结束时尿NGF/Cr下降,且在治疗结束后12周仍保持下降(P < 0.05)。
尿NGF是预测OAB患者抗胆碱能治疗结局的潜在生物标志物。这在决定对有反应者停止抗胆碱能治疗时可能提供有用信息。