Urological University-Clinic Basel-Liestal, University Hospital Basel, Basel, Switzerland.
University of Basel, Basel, Switzerland.
PLoS One. 2019 Mar 14;14(3):e0213549. doi: 10.1371/journal.pone.0213549. eCollection 2019.
Urinary Calprotectin, a mediator of the innate immune system, has been identified as a biomarker in bladder cancer. Our aim was to investigate the association between sterile leukocyturia and urinary Calprotectin in low-grade and high-grade bladder cancer.
We performed a prospective cross-sectional study including 52 patients with bladder cancer and 40 healthy controls. Definition of sterile leukocyturia was > 5.0 leukocytes per visual field in absence of bacteriuria.
The rate of sterile leukocyturia in low-grade (60.0%) and high-grade (62.0%) bladder cancer was comparable (p = 0.87). However, the median absolute urinary leukocyte count in patients with sterile leukocyturia was significantly higher in high-grade than in low-grade bladder cancer (p < 0.01). Spearman correlation revealed a significant correlation between urinary Calprotectin and leucocyte concentration (R = 0.4, p < 0.001). Median urinary Calprotectin concentration was 4.5 times higher in bladder cancer patients with than in patients without sterile leukocyturia (p = 0.03). Subgroup analysis revealed a significant difference in urinary Calprotectin regarding the presence of sterile leukocyturia in high-grade patients (596.8 [91.8-1655.5] vs. 90.4 [28.0-202.3] ng ml-1, p = 0.02). Multivariate analysis identified the leukocyte concentration to be the only significant impact factor for urinary Calprotectin (OR 3.2, 95% CI 2.5-3.8, p = 0.001). Immunohistochemistry showed Calprotectin positive neutrophils and tumour cells in high-grade bladder cancer with sterile leukocyturia.
Urinary Calprotectin cannot be regarded as a specific tumour marker for bladder cancer, but rather as a surrogate parameter for tumour inflammation.
尿钙卫蛋白是先天免疫系统的介质，已被确定为膀胱癌的生物标志物。我们的目的是研究无菌性白细胞尿与低级别和高级别膀胱癌患者尿钙卫蛋白之间的关系。
我们进行了一项前瞻性的横断面研究，包括 52 例膀胱癌患者和 40 例健康对照者。无菌性白细胞尿的定义为在无细菌尿的情况下，每视野> 5.0 个白细胞。
低级别（60.0%）和高级别（62.0%）膀胱癌患者无菌性白细胞尿的发生率相当（p = 0.87）。然而，在高级别膀胱癌患者中，无菌性白细胞尿患者的绝对尿白细胞计数中位数明显高于低级别膀胱癌患者（p < 0.01）。Spearman 相关分析显示尿钙卫蛋白与白细胞浓度之间存在显著相关性（R = 0.4，p < 0.001）。膀胱癌患者中，有和无无菌性白细胞尿患者的尿钙卫蛋白浓度中位数分别为 4.5 倍（p = 0.03）。亚组分析显示，在高级别患者中，有无无菌性白细胞尿患者的尿钙卫蛋白存在显著差异（596.8 [91.8-1655.5] vs. 90.4 [28.0-202.3] ng/ml，p = 0.02）。多变量分析表明白细胞浓度是尿钙卫蛋白的唯一显著影响因素（OR 3.2，95%CI 2.5-3.8，p = 0.001）。免疫组化显示在有无菌性白细胞尿的高级别膀胱癌中，钙卫蛋白阳性中性粒细胞和肿瘤细胞。
尿钙卫蛋白不能被视为膀胱癌的特异性肿瘤标志物，而可被视为肿瘤炎症的替代参数。
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