Bardowska Klaudia, Krajewski Wojciech, Kołodziej Anna, Kościelska-Kasprzak Katarzyna, Bartoszek Dorota, Żabińska Marcelina, Chorbińska Joanna, Kubacki Filip, Królicki Tomasz, Krajewska Magdalena, Szydełko Tomasz, Kamińska Dorota
Department of Nephrology and Transplantation Medicine, Wroclaw Medical University, Wrocław, Poland.
University Centre of Excellence in Urology, Wroclaw Medical University, Wrocław, Poland.
World J Urol. 2025 Feb 10;43(1):114. doi: 10.1007/s00345-025-05485-9.
To prospectively evaluate prognostic capabilities of non-muscle invasive bladder cancer (NMIBC) biomarkers for predicting disease recurrence or progression after radical TURB (transurethral resection of bladder tumor).
Evaluated biomarkers included blood: plasminogen activator inhibitor 1 (PAI-1), soluble urokinase plasminogen activator receptor (suPAR), interleukin 8 (IL-8) and urine: IL-8, vascular endothelial growth factor (VEGF) and apolipoprotein E (APOE). Blood and urine samples acquired before TURB for NMIBC from 223 subjects were analysed. The primary outcome was tumor recurrence or progression.
After 3 months follow-up with cystoscopy or TURB- 92 patients were tumor free (Group 1). In 131 subjects (Group 2) a recurrence of NMIBC (n = 120) or progression to muscle invasive bladder cancer (MIBC) (n = 11) has been observed. No major clinical differences between these two groups were spotted. The group 2 has presented with significantly higher concentrations of blood IL-8 and suPAR as well as urine VEGF and APOE. The serum IL-8 and urinary VEGF showed the highest prognostic abilities with AUROC of 0.611 (95% CI: 0.534-0.687, p = 0.0044) and 0.632 (95% CI: 0.557-0.707, p = 0.0006), respectively. Multivariable machine learning models which included all investigated biomarkers and European Organisation for Research and Treatment of Cancer (EORTC) risk scores have allowed to discriminate the two patient entities with AUROC of 0.84 (95% CI: 0.73-0.95, p < 0.0001).
The assessed biomarkers alone have shown unsatisfactory prognostic capabilities to be used for prognostication of outcomes after TURB. More complex multivariable prediction models may improve their prognostic performance.
The study was retrospectively registered at clinicaltrails.gov with National Clinical Trial number (NCT): NCT06235853.
前瞻性评估非肌层浸润性膀胱癌（NMIBC）生物标志物对预测根治性经尿道膀胱肿瘤切除术（TURB）后疾病复发或进展的预后能力。
评估的生物标志物包括血液中的纤溶酶原激活物抑制剂1（PAI-1）、可溶性尿激酶型纤溶酶原激活物受体（suPAR）、白细胞介素8（IL-8）以及尿液中的IL-8、血管内皮生长因子（VEGF）和载脂蛋白E（APOE）。对223例接受NMIBC的TURB术前采集的血液和尿液样本进行分析。主要结局是肿瘤复发或进展。
在膀胱镜检查或TURB随访3个月后，92例患者无肿瘤（第1组）。在131例受试者（第2组）中，观察到NMIBC复发（n = 120）或进展为肌层浸润性膀胱癌（MIBC）（n = 11）。两组之间未发现重大临床差异。第2组血液中IL-8和suPAR以及尿液中VEGF和APOE的浓度显著更高。血清IL-8和尿液VEGF显示出最高的预后能力，其受试者工作特征曲线下面积（AUROC）分别为0.611（95%置信区间：0.534 - 0.687，p = 0.0044）和0.632（95%置信区间：0.557 - 0.707，p = 0.0006）。包含所有研究生物标志物和欧洲癌症研究与治疗组织（EORTC）风险评分的多变量机器学习模型能够区分这两组患者，AUROC为0.84（95%置信区间：0.73 - 0.95，p < 0.0001）。
单独评估的生物标志物在用于预测TURB术后结局方面显示出不令人满意的预后能力。更复杂的多变量预测模型可能会改善其预后性能。
该研究在clinicaltrails.gov上进行了回顾性注册，国家临床试验编号（NCT）：NCT06235853。
