The Clinical Significance In Diagnosis Of Bladder Transitional Cell Cancer By Urinary Fibronectin Detection

Objective: It was our destination to explored the device which was convenientfor handling, objective, noninvasive, high sensitivity and specificity for the detectionof bladder cancer. Different urinary tumor markers for the diagnosis of bladder cancerare being researched in the last few years. In this study, our main objective was toevaluate the clinic applied value of urine fibronectin (Fn) in the patients with bladdercarcinoma.Methods: The study included 88 subjects. Urinary Fn was detected by ELISAtechnique in 45 cases of bladder transitional cell cancer (groupA), 24 cases of otherurogenital diseases (groupB) and 19 cases of healthy subjects (groupC). Meanwhilewe carried out the analysis of creatin (Cr) in urine and calculated the urinary Fn/Crratio. Analysed the discrepancy of urinary Fn and Fn/Cr among three groups andamong tumor grades and stages. To descriptive analysis of urinary Fn and Fn/Crconcentrations among 23 superficial bladder cancer patients, t4 patients with highdifferentiated bladder cancer and 19 healthy subjects. Sensitivity and specificity ofthe urinary Fn/Cr compared to the other urinary tumor markers cited in the literature,including the urinary cytology.Results: The urinary Fn and Fn/Cr ratio were significantly higher in bladdercancer (Fn 209.3±125.0μg/L, Fn/Cr 46.4±26.5mg/mol)than in other urogenitaldiseases (Fn 114.3±83.6μg/L, Fn/Cr 28.2±22.7 mg/mol)and the healthy subjects(Fn 75.2±35.31μg/L, Fn/Cr 14.7±8.8 mg/mol) (P＜0.01, P＜0.05). The optimal cut-off was established at 133.5μg/L for urinary Fn and 34mg/mol for Fn/Cr. The sensitivityand specificity of urinary Fn were 68.9％and 72.1％, respectively in the patients withbladder cancer, while urinary Fn/Cr ratio were 75.6％and 79.1％respectively.Moreover, the urinary Fn and Fn/Cr concentrations were 110.7±74.1μg/L, 204.7±60.0μg/L, 358.3±134.1μg/L and 29.7±19.5 mg/mol, 49.1±28.9 mg/mol,66.5±21.8 mg/mol for Ta-1,T2,T3-4, respectively. The urinary Fn and Fn/Crconcentrations were 94.3±66.8μg/L,206.8±100.7μg/L,285.7±101.1μg/L and23.8±16.6 mg/mol, 49.2±21.5 mg/mol, 64.6±24.2 mg/mol for G1,G2,G3respectively, urinary Fn and Fn/Cr ratio had obvious discrepancy among tumorgrades and stages (P＜0.05, P＜0.05). The urinary Fn was not significantly higher insuperficial bladder cancer patients (110.7±74.1μg/L) than in patients with highdifferentiated bladder cancer (94.3±66.8μg/L) and the healthy subjects (75.2±35.3μg/L) (P＞0.05), but Fn/Cr was different between superficial bladder cancerpatients (29.7±19.5 mg/mol) and the healthy subjects (14.7±8.8 mg/mol)(0.01＜P＜0.05). The concentration of Fn and Fn／Cr in primary tumors (216.5±105.4μg/L, 50.2±29.7 mg/mol) were greater than in recurrent tumors (199.5±150.3μg/L, 41.0±21.6 mg/mol). However, no statistically significant differenceswere found (P＞0.05). Otherwise, overall sensitivity was 75.6％for Fn/Cr and 53.3％for urinary cytology. Combined sensitivity of voided urinary cytology with Fn/Crtogether was higher than that of Fn/Cr alone.Conclusions: Urinary Fn and Fn/Cr ratio have significant diagnostic value inthe patients with bladder cancer. Urinary Fn was claimed to be a potential role in thediagnosis and prognosis of bladder cancer. Obvious relationship between urinary Fnand the stages or grades has been noted. Determining urinary Fn values may give anidea about the invasive potential of the tumor and may to estimate the prognosis.However, as with the other urinary tumor markers, the test performance was not sufficient to replace cystoscopy. The tests can be considered as the scale formonitoring the curative effect, but urinary Fn and Fn/Cr were not recommended topredict the recurrence.