BLCA-4Expression In The Body Fluids And Tissues Of Patients With Invasive Bladder Cancer

Objective:Bladder cancer is the most common malignant tumor of urinary system inour country. Currently cystoscopy and urine cytology examination are theuseful methods of diagnosis and follow-up for bladder cancer. But cystoscopyis a invasive detection and the high cost make patients feel discomfortable. Itmake patients difficult to accept so as to limits its application. The specificityof urine cytology examination is high,but the sensitivity is low. It is easy toappear false negatives and make missed diagnosis,causing a great impact onprognosis. In recent years, along with the development of molecular biologyand the proteomics,we docover many new tumor markers for bladdercancer,such as BTA, NMP,ImmunoCyt,UroVysion and FDP etc. Although themost important tumor markers for bladder cancer have high sensitivity andspecificity,it can not get satisfactory results. Some problems make the tumorcannot be widely used in clinical practice such as the harsh experimentalconditions,expensive,the high rate of false positives and easily affected bysubjective factors.In recent years, BLCA-4become a research focus for manyscholars,which is a kind of BLCAS family. The study proves it havesomething todo wih cancer cell proliferation,survival and the formation ofblood vessels and so on.The study on the basis of the urine in have highersensitivity and specificity, which is not affected by other urinary benigndiseases. But there is few research for it and at present it is only researched onurine.The study of BLCA-4on the same patients,body fluids(serum,urine)andorganization has not yet been reported. This experiment use the BLCA-4asthe marker,detecting its expression in invasive bladder cancer, urinary benign diseases and normal persons,assessing its value in the diagnosis of bladdercancer.BLCA-4as a new bladder cancer markers,it provides research forclinical use.Methods:Detecting the expression of BLCA-4in experimental group(72invasivebladder cancer patients,serum,urine and organization),control group(78prostate hyperplasia patients,normal persons and urinary calculi patients,serum,urine and organization)by ELISA, Immunohistochemistry and WesternBlotting. Through SPSS17.0statistical software,Comparison between groupsuse Kruskal-Wallis H,ANOVA and T test method. P<0.05was consideredstatistically significant.Results:ELISA result: The content of BLCA-4in bladder cancer urine is0.793ng/ml and hyperplasia of prostate group is0.319,urinary calculi group is0.238and the normal group is0.194（P<0.05）.The content of BLCA-4inbladder cancer is obviously higher than other groups.The content of BLCA-4in T2a1.409,T2b is1.675and T3+T4is1.582. The content of BLCA-4inhigh differentiation of bladder cancer is1.416and poor differentiation ofbladder cancer is1.817. The expression of BLCA-4has no difference betweenthe bladder cancer classification stage (P＞0.05). The data has statisticallysignificant between tumor size＜2cm（0.966） and≥2cm（1.809）(P＜0.05).The data of the cut-off is0.620ng/ml.In urine,the BLCA-4positive rate ofinvasive bladder cancer is91.3%（22/24）and the specificity is100%.Inserum,the content of invasive bladder cancer is5.808and hyperplasia ofprostate group5.718, urinary calculi group5.076and normal controls is4.995.The expression of BLCA-4has no difference in serum(P＞0.05)（Fig1、2、3、4，Tab1、2、3).Immunohistochemistry result: The positive rate of BLCA-4expressionin invasive bladder cancer organization（77.8%）is obviously higher than thegroup of hyperplasia of prostate（2.56%）.The positive rate of BLCA-4expression in high and poor differentiation cancer is65%and93.7%.In T2a,T2b and T3+T4is64.3%、72.7%�'�100%.The expression of BLCA-4hasdifference between the bladder cancer classification stage (P＜0.05); Thepositive rate of BLCA-4expression in tumor adjacent tissues is50%（36/72）and has no difference with age（P=0.801）, sex（P=0.289）, the number oftumor（P=0.526）, tumor size（P=0.076） and surgical way（P=0.848）（P＞0.05）(Fig7、8、9，Tab5).Western-Blotting result: The expression of BLCA-4in invasive bladdercancer is0.828±0.267, tumor adjacent tissues0.591±0.259and the hyperplasiaof prostate is0.242±0.116.It has difference in the organization of bladdercancer, tumor adjacent tissues and the hyperplasia of prostate(P＜0.05)(Fig5、6，Tab4).Conclusions:1.BLCA-4has high sensitivity and specificity in urine in invasive bladdercancer, but has low sensitivity and specificity in serum.2.The expression of BLCA-4has certain correlation in invasive bladdercancer and tumor size3.The expression of BLCA-4in invasive bladder cancer organization hasdifference between the bladder cancer classification stage and has nodifference with age, sex, the number of tumor, tumor size and surgical way.4.The expression of BLCA-4has difference in the organization ofinvasive bladder cancer, tumor adjacent tissues and the hyperplasia of prostatetissues.