| Objectives: To check the level and expression of adiponectin and adiponectin receptor in bladder urothelial carcinoma,and to explore its association with the development of bladder urothelial carcinoma and its clinical and pathological features such as different stages and grades.To explore the future of adiponectin and metformin intervention in bladder urothelial carcinoma and to lay a theoretical foundation.Methods: In this study,patients with bladder urothelial carcinoma,they had not been treated with any internal medicine,radiotherapy and chemotherapy,which were screened for the first time from March 2018 to November 2018 in the second hospital of Lanzhou University undergoing surgical treatment.Collected serum samples from 23 patients with bladder urothelial carcinoma,and 23 patients from the physical examination center of our hospital as normal control group(all patients were diagnosed by urinary cytology,B-ultrasound,CT and according to symptoms and signs to exclude bladder cancer).Serum adiponectin concentrations were measured by double antibody sandwich enzyme-linked immunosorbent assay(ELISA).The paraffin-embedded tissue of 54 patients with bladder urothelial carcinoma in the pathology library of the hospital was enrolled and sliced.There were 32 cases of non-muscle-invasive bladder cancer(NMIBC),22 cases of muscle-invasive bladder cancer(MIBC),22 cases of low grade,and 32 cases of high grade.At the same time,16 cases of paracancerous bladder tissues(HE staining identified no tumor cells and more than 2cm from the edge of the tumor tissue)were used as controls.The expression levels of adiponectin receptors 1 and 2 in paraffin tissue sections of bladder urothelial carcinoma and paracancerous bladder tissues were detected by immunohistochemical.Fresh surgical specimens from 18 patients with bladder urothelial carcinoma were collected and 9 patients with paracancerous bladder tissue(HE staining identified no tumor cells and more than 2cm from the edge of the tumor tissue)were taken as controls.There were 7 cases of bladder cancer tissue paired with paracancerous bladder tissue.The expression levels of adiponectin receptors 1 and 2 mRNA in fresh tissue of bladder urothelial carcinoma and paracancerous bladder tissues were detected by Real time RCR(RT-PCR).To analyze the correlation between adiponectin and receptor and bladder urothelial carcinoma,clinical stage and histological grade.Results:1.The serum adiponectin level was significantly lower in patients with bladder urothelial carcinoma than in the normal control group(4.8±0.80 vs 5.88±0.97?g/ml).The difference between the two groups was statistically significant(P <0.001).2.In patients with bladder urothelial carcinoma,the serum adiponectin level in the high-grade group was lower than that in the low-grade group(4.40±0.73 vs 5.17±0.69 ?g/ml),the difference between the two groups was statistically significant(P <0.05).The serum adiponectin level in the MIBC group was lower than that in the NMIBC group(4.43±0.64 vs 5.14±0.80 ?g/ml),and the difference between the two groups was statistically significant(P <0.05).3.Serum adiponectin level in patients with bladder urothelial carcinoma was associated with smoking,clinical stage,and histological grade,the difference was statistically significant(P <0.05),and was not correlation with tumor number,tumor size,lymph node metastasis,etc.(P >0.05).4.The expression of AdipoR1?2 in bladder urothelial carcinoma tissues and paracancerous bladder tissue was detected by immunohistochemical.The positive expression rate of AdipoR1 in cancer tissues(85.2%)was lower than that in paracancerous bladder tissue.The difference between the two groups was statistically significant(P <0.01),while the positive expression rate of AdipoR2 was only 12.9%(P >0.05).5.In patients with bladder urothelial carcinoma,The positive rate of AdipoR1 in high-grade group was lower than that in low-grade group(75.0% vs 100%),the difference was statistically significant(P < 0.05).The positive rate of AdipoR1 in MIBC group was lower than that in NMIBC group(72.7% vs 93.8%).There was significant difference between the two groups(P < 0.05).6.The positive rate of AdipoR1 in bladder urothelial carcinoma was negatively correlated with stage(r=-0.29)and grade(r=-0.35),and the difference was statistically significant(P <0.05).7.The relative expression of AdipoR1 mRNA in bladder urothelial carcinoma was lower than that in paracancerous bladder tissue(0.64±0.44 vs 1.09±0.65).There was a significant difference between the two groups(P < 0.05).8.In patients with bladder urothelial carcinoma,the relative expression of AdipoR1 mRNA in MIBC group was lower than that in NMIBC group(0.44±0.20 vs 0.72±0.49).There was no significant difference between the two groups(P >0.05).The relative expression of AdipoR1 mRNA in low-grade group was lower than that in high-grade group(0.56±0.26 vs 0.71±0.55).There was no significant difference between the two groups(P >0.05).9.In bladder urothelial carcinoma,the relative expression of AdipoR1 mRNA was not associated with smoking,age,clinical stage,histological grade,tumor number,tumor size,lymph node metastasis,etc.,and the difference was not statistically significant(P >0.05).Conclusion:1.The serum adiponectin level in bladder urothelial carcinoma is decreased,which is closely related to the occurrence of bladder urothelial carcinoma,the degree of myometrial invasion and histological staging.2.The expression of AdipoR1 mRNA in bladder urothelial carcinoma tissues was lower than that in paracancerous bladder tissue.3.The expression of AdipoR1 and AdipoR2 was different in bladder urothelial carcinoma.The expression of AdipoR1 was higher than that of AdipoR2.The expression of AdipoR1 was negatively correlated with the occurrence of bladder cancer,the degree of muscle invasion and histological stage,the decrease of expression may be a new target for further study of metformin and adiponectin intervention and treatment of bladder urothelial carcinoma in the future. |
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