The clinical relevance of urine and serum Vascular Endothelial Grow Factor and Tissue Polypeptide Antigen in patients with superficial urothelial cancer treated by immunotherapy BCG
Article published in Urologia Polska 2006/59/2.

authors

Anna Kołodziej ¹, Romuald Zdrojowy ¹, Michał Wróbel ¹, Bartosz Małkiewicz ¹, Paweł Sedlaczek ², Janusz Dembowski ¹, Tadeusz Niezgoda ¹, Tomasz Szydełko ¹, Jerzy Lorenz ¹: ¹ Katedra i Klinika Urologii i Onkologii Urologicznej Akademii Medycznej we Wrocławiu
² Katedra i Zakład Immunologii Akademii Medycznej we Wrocławiu

keywords

bladder, bladder cancer, BCG immunotherapy, VEGF, TPA

summary

Objectives. Vascular Endothelial Growth Factor (VEGF) is a main angiogenic factor. Tissue Polypeptide Antigen is a marker of high cell proliferation.

The aim of this work is a comparison of urine and serum VEGF and TPA concentrations in patients with superficial bladder cancer treated by TURB and BCG immunotherapy.

Material and methods. Material consists of urine and serum samples taken from 66 patients with superficial bladder cancer treated by TURB and BCG immunotherapy at Urological Clinic in Wroclaw from January 1995 to June 2005. Serum and urine samples were taken before TURB and VEGF and TPA concentrations were measured by ELISA. The control (reference) group consisted of 14 healthy volunteers. The results were analysed with respect to clinicopathological parameters (T and G) and the clinical course of disease - recurrence rate and progression.

Results. In the mean time 52 months (range 12-112) 36 from 66 (56%) tumors recurred and 18 from 66 (27.3%) progressed.

Both, VEGF and TPA serum concentrations didn't differ between patients and healthy volunteers, and between tumors of various stages and grades. There was also no difference in serum concentrations of VEGF and TPA between patients with disease recurrence and progression during follow up in comparison with patients without recurrence and without progression respectively.

Urinary levels of VEGF and TPA were significantly higher in bladder cancer patients then in healthy controls. They were higher in patients with tumor of higher stage and grade. Significantly higher VEGF and TPA concentrations were identified in patients with future disease recurrence or progression.

Conclusion. VEGF and TPA serum concentrations didn't differ between patients and healthy volunteers, and between tumors of various stages and grades. We could not find a difference between VEGF, TPA levels and clinical course of disease.

The results of this study suggest that elevation of urine VEGF level was significantly correlated with tumor stage and grade and could be used as a new predictor of recurrence and disease progression in patients with high - risk superficial urothelial cancer.

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