| Objective: To examine the levels of urinary soluble B7-H3(s B7-H3) of bladder cancer patients and normal individuals, and analyze their possible function in the detection of bladder cancer.Methods: A total of 65 bladder cancer patients and 63 normal individuals were recruited in this study. Enzyme-linked immunosorbent assay(Elisa) was used to assess whether there were s B7-H3 in the urine and their concentrations. Analyze the differences in the levels of urinary s B7-H3 between bladder cancer patients and normal individuals, and the connection between the levels of urinary s B7-H3 of bladder cancer patients and their clinical significances, clinical pathological type and grade. The ROC curves were used to estimate the ability of s B7-H3 in the detection of bladder cancer and analyzed their clinical significances.Results:(1) Compared with normal individuals, the levels of s B7-H3 were significantly higher in bladder cancer patients(0.260±0.848 vs 0.188±0.388ng/ml, p=0.014).(2) No statistical difference was found between the levels of urinary s B7-H3 of bladder cancer patients and their ages(p=0.181), genders(p=0.256) and incidences(p=0.590).(3) The levels of s B7-H3 in the muscle invasive bladder cancer(MIBC) group were significantly higher than those in the non- muscle invasive bladder cancer(NMIBC) group(p<0.001), and the same result was found between the high-grade group and the low-grade group(p<0.001).(4) According to the ROC curves we developed, in bladder cancer versus normal samples, the sensitivity of urinary s B7-H3 was 23.1%, and the specificity was 98.4% at the cutoff value of 1.224ng/ml, and the AUC was 0.626(p=0.014; 95%CI: 0.529-0.723).(5) In NMIBC versus normal samples, urinary s B7-H3 had an AUC of 0.558(p=0.347; 95%CI: 0.445-0.672), achieved sensitivity of 91.2% and specificity of 41.3% at a cutoff value of 0.291ng/ml. Furthermore, in MIBC versus normal samples, at a cutoff value of 1.224ng/ml, the AUC of urinary s B7-H3 was 0.829(p<0.001; 95%CI: 0.743-0.914), the sensitivity was 48.4% and the specificity was 98.4%.(6) In MIBC versus NMIBC samples, urinary s B7-H3 had an AUC of 0.921(p<0.001; 95%CI: 0.850-0.993), achieved sensitivity of 87.1% and specificity of 91.2% at a cutoff value of 0.280ng/ml.Conclusions:(1) Soluble B7-H3 was detectable in the urine of both normal individuals and bladder cancer patients.(2) The levels of urinary s B7-H3 were significantly higher in bladder cancer patients than those in normal individuals, and they were associated with their clinical pathological type and grade.(3) On the basis of ROC curves, the capability of urinary s B7-H3 in the detection of bladder cancer was low, especially to the NMIBC. However, urinary s B7-H3 may be available as a biomarker in the detection of MIBC and in the differential diagnosis of NMIBC and MIBC. |
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