| Objectives: This study aims to examine a possible relationship between the serum levels of adiponectin and leptin and the various clinicopathological parameters, notably the tumor size, clinicopathological grade, stage and metastases in bladder urothelial carcinoma patients, to explore the efficiency of adiponectin and leptin for the prediction and diagnosis of bladder urothelial carcinoma, and try to analyze the mechanisms of the two adipocytokines involved in the development of bladder cancer. Adiponectin and leptin belong to a polypeptide hormone secreted by white adipose tissue, playing roles in the glucolipid metabolism, inflammation, immu nity, cell growth, cell proliferation, apoptosis and angiogenesis. Urinary bladder cancer is the common malignant tumor which has two characteristics of high incidence and recurrence rate. Until now we haven’t find a research about the relationship of the serum levels of adiponectin and leptin and bladder cancer. Methods: We all collected 106 cases of diagnosis of bladder cancer patients from the second hospital of Lanzhou University and 70 cases as healthy control group from medical examination center of the second hospital of Lanzhou University, after some cases ruled out, finally the study included 33 bladder urothelial carcinoma patients, 20 healthy subjects, case group recruited the new diagnosed patients with bladder urothelial carcinoma, without any treatment before surgery, the two groups excluded diabetes, hypertension patients or the ones with severe liver, kidney, heart disease, and severe infection history, surgical history and any other history of malignancy. Serum adiponectin and leptin levels were determined with a specific ELISA assay. We compared serum adiponectin and leptin levels between case group and healthy control group, and between the subgroups with different clinicopathological characteristics in the case group, and between the subgroups of smokers and non-smokers in case group and healthy control group respectively, then analysed the relationships among the serum adiponectin, leptin, leptin/adiponectin ratio levels and clinicopathological features in bladder urothelial carcinoma.We evaluated the correlations between the serum levels of adiponectin and leptin and the risk of bladder urothelial carcinoma, and further analysed the possibility of the two adipocytokines as promising biomarkers for bladder urothelial carcinoma. Results: There were no statistical differences in age, height, weight, BMI, waist circumference, systolic pressure, diastolic blood pressure, fasting blood glucose, blood lipids between case group and healthy control group. Serum adiponectin levels in bladder urothelial carcinoma patients were 4.88±0.88μg/ml,while serum adiponectin levels in healthy control group were5.85±0.99μg/ml, serum adiponectin levels in case group were lower than the healthy control group( P=0.001), there was no statistical difference in leptin levels between case group and healthy control group( P=0.413), there was no statistical difference in leptin / adiponectin ratio between case group and healthy control group(P=0.804); In case group, there were no statistical differences in the levels of serum adiponectin, serum leptin and leptin / adiponectin ratio between subgroups of smokers and non-smokers(P=0.281, P=0.528, P=0.545, respectively), in healthy control group, there was no statistical difference in the serum adiponectin levels between subgroups of smokers and non-smokers(P=0.569), whereas the levels of serum leptin and leptin / adiponectin ratio in the subgroup of smokers was higher than the subgroup of non-smokers(P=0.042, P=0.032, respectively). In case group, serum adiponectin levels in subgroup of low-grade was higher than in subgroup of high-grade(P=0.003), serum adiponectin levels in subgroup of TNM stage I(non-muscular-invasion bladder cancer) was higher than in subgroup of TNM stage II/III/IV(muscular-invasion bladder cancer)(P<0.001), and serum adiponectin levels in subgroup of tumors with diameter < 3 cm was still higher than in subgroup of tumors with diameter≥3 cm((P=0.013), in case group, there were no statistical differences in serum leptin levels between subgroups with different clinicopathological characteristics including clinicopathological grade, stage and the tumor size(P=0.800, P=0.419, P=0.591, respectively);In case group, serum adiponectin levels was negatively correlated to BMI and waist circumference(r=-0.348, P<0.05 and r=-0.55,P <0.01, respectively), serum adiponectin levels was positively correlated to high-density lipoprotein(r=0.347,P <0.05), serum adiponectin levels was negatively correlated to tumor stage(TNM stage I/II/III/IV)( r=-0.734,P <0.001), there were no correlations between systolic pressure, diastolic blood pressure, fasting blood glucose and serum adiponectin levels, in healthy control group, serum adiponectin levels was negatively correlated to BMI(r=-0.764, P <0.001), serum adiponectin levels was negatively correlated to triglycerides(r=-0.525,P <0.05), there were no correlations between systolic pressure, diastolic blood pressure, fasting blood glucose, waist circumference and serum adiponectin levels, there were no associations between BMI, waist circumference, systolic pressure, dias tolic blood pressure, fasting blood glucose, blood lipids and serum leptin levels either in case group or in healthy control group. When binary logistic regression was performed, we found the lowest serum adiponectin levels were significantly associated with an increased risk of bladder cancer after adjustment for possible confounding factors(in three segment, OR=53.259, 95% CI: 1.661-1707.994, P<0.05, in four segment, OR=75.507,95% CI: 2.002-2848.190,P<0.05,), whereas serum leptin levels didn’t affect the risk of bladder cancer. Draw the receiver-operating characteristic curves(ROC) of serum adiponectin and leptin levels, when serum adiponectin concentration was 5.63 μg/ml, the sensitivity was 81.8%, the specificity was 60%, when serum adiponectin concentration was 5.83μg/ml, the sensitivity was 90.9%, the specificity was 55%, when serum leptin concentration was 2.2297 ng/ml, the sensitivity was 90.9%, the specificity was 25%. Conclusion: Serum adiponectin levels were reduced in the bladder urothelial carcinoma patients and negatively correlated with BMI, in bladder urothelial carcinoma patients, serum adiponectin levels were higher in low-grade, TNM stage I(non-muscular-invasion bladder cancer) tumor and tumors with diameter < 3 cm patients compared to high-grade, TNM stage II/III/IV(muscular-invasion bladder cancer) and tumors with diameter≥3 cm patients, suggested that lower serum adiponectin levels were associated with an increased risk for bladder urothelial carcinoma. We was unsatisfactory with the results of leptin, while adiponectin may predict and diagnose the disease as a biomarker of bladder cancer. |
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