| Objective: By comparing the serum free glucose/mannose(G/M)and eight serum monosaccharide levels in patients with bladder cancer and healthy subjects,the value of tumor glucose biomarkers in the adjuvant diagnosis and evaluation of the severity of bladder cancer was observed and analyzed.Methods: 91 patients with bladder cancer were hospitalized and surgically diagnosed in the Affiliated Hospital of Qingdao University from July 1,2018 to May 31,2008.91 healthy persons were examined in the physical examination center of our hospital.Bladder cancer patients were divided into two groups according to tumor TNM staging,39 patients with non-muscle invasive bladder cancer and 32 patients with myometrial invasive bladder cancer.All patients were given 4 m L of elbow venous blood on an empty stomach in the morning on the second day after admission.The healthy check-up person took 4 m L of elbow venous blood on an empty stomach the next morning,and a total of 182 serum samples were separated.First,based on the results of HPLC analysis of the monosaccharide standard,a standard curve of the monosaccharide was drawn to obtain a regression equation.The serum samples were then hydrolyzed,derivatized and analyzed by HPLC,and the liquid chromatogram of the samples was obtained.The concentration of monosaccharides in the samples was calculated,and the concentration of monosaccharides in each group was compared by statistical analysis of variance analysis and correlation analysis.The value of serum G/M and eight monosaccharides(Mannose,Man;Glucosamine,Glc N;Galactosamine,Gal N;Glucuronic acid,Glc A;Glucose,Glc;Galactose,Gal;Xylose,Xyl;Fucose,Fuc)in serum for the diagnosis of bladder cancer and the assessment of the severity of the disease were evaluated by ROC curve.Results:(1)A total of 182 patients were collected.There were 91 cases in bladder cancer group and 91 cases in control group.The basic data of the two groups can be seen in Table 1.Statistical analysis showed that there was no significant difference in the basic data between them(P < 0.05).(2)The G/M value of bladder cancer group was 61.39±20.09 and that of healthy control group was 84.34±16.23.There was a significant difference between the two groups(P?0.0001).The area under the curve of serum G/M in the diagnosis of bladder cancer was 0.83,and the sensitivity and specificity were 85% and 75%.This indicated that the G/M had a high accuracy in the diagnosis of bladder cancer.(3)The G/M value of non-muscular invasive bladder cancer group was 62.92±23.87,and that of healthy control group was 84.34±16.23,with significant difference(P?0.0001).The area under the curve of serum G/M in the diagnosis of non-muscular invasive bladder cancer was 0.81,and the sensitivity and specificity were 86% and 74%.It shows that it has high accuracy in the diagnosis of early bladder cancer.(4)The levels of eight serum monosaccharides(micromol/L)(Man=2689±491.6,Glc N=5022±1567,Gal N=425.2±95.02,Glc A=40.34±28.18,Glc= 8507±2862,Gal=2542±511.8,Xyl=37.31±15.77,Fuc=448.1±116.1)in bladder cancer group were significantly higher than those in healthy control group(Man=2359±353.6,Glc N=4026±1138,Gal N=347±91.72,Glc A= 26.18±14.93,Glc= 6067±1823,Gal= 2071±330.8,Xyl=26.66±3.89,Fuc=376.6±82.3)(P < 0.0001).(5)The levels of eight serum monosaccharides(micromol/L)in patients with non-muscular invasive bladder cancer(Man=2754±551.9,Glc N=5680±1736,Gal N= 454.5±90.42,Glc A=49.91±35.5,Glc=9692±2743,Gal=2611±571.8,Xyl=37.31±15.77,Fuc=448.1±116.1)were higher than those in healthy control group(Man=2359±353.6,Glc N= 4026±1138,Gal N= 347±91.72,Glc A=26.18±14.93,Glc=6067±1823,Gal= 2071±330.8,Xyl=40.15±21.13,Fuc=453.7±122.2)(P< 0.0001).The area under the curve of eight sermonosaccharides for the diagnosis of non-myosomal invasive bladder cancer was Man: 0.73,Glc N: 0.84,Gal N: 0.79,Glc A: 0.76,Glc: 0.76,Glc: 0.89,Gal: 0.8,Xyl: 0.79,Fuc: 0.79,Fuc: 0.7,sensitivity and specificity were Man: 90%,62%,Glc N: 85%,74%,Gal N: 76%,77%,Glc A: 92%,51%,Glc: 89%,85%,Gal: 77%,72%,Xyl: 82%,62%,Fuc: 95%,44%.It is suggested that eight serum monosaccharides are of high value in the diagnosis of early bladder cancer.(6)Serum levels of mannose,glucosamine,galactosamine,glucuronic acid,glucose,galactose(Man,Glc N,Gal N,Glc A,Glc,Gal)in patients with bladder cancer at different stages were different.The levels of six serum monosaccharides(micromol/L)in patients with non-muscular invasive bladder cancer(Man=2754±551.9,Glc N=5680±1332,Gal N=454.5±90.42,Glc A=49.91±35.5,Glc= 9692±2743,Gal=2661±571.8)were higher than those in patients with muscular invasive bladder cancer(Man=2493±389.5,Glc N=4018±1167,Gal N=358.5±50.09,Glc A= 31.3±16.92,Glc=7275±1709,Gal=2345±415.3),and the difference was statistically significant(P < 0.05).Conclurions: The levels of G/M and eight monosaccharides in serum of patients with bladder cancer were different from those of healthy subjects,and the value of TNM staging in bladder cancer was higher than that of mannose,glucosamine,galactosamine,glucuronic acid,glucose and galactose(Man,Glc N,Gal N,Glc A,Glc,Gal).Therefore,the detection of serum monosaccharide levels is helpful for the diagnosis of bladder cancer and the evaluation of the severity of the disease. |
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