Free Ferrous Protoporphyrin and Reactive Oxygen Species Status of Voided Urine Predicts Higher Stage in Urothelial Carcinoma

Abstract

This study was conducted to evaluate the correlation between the free ferrous protoporphyrin and reactive oxygen species (FH and ROS) combined test and the tumor grade and stage in a pathologically confirmed uroepithelial carcinoma (UC) patient population. Patients and Methods:In this retrospective study, we enrolled patients newly diagnosed with UC between May 2020 and June 2021. All patients were classified as FH(+) and ROS(+), FH(+) and ROS(-), or FH(-) and ROS(-), based on the FH and ROS combined test of voided urine. Demographic information, pathological results, and status of the FH and ROS combined test were reviewed retrospectively. The relationship between FH and ROS combined test status and tumor stage and grade was evaluated using logistic regression. Results: This study included 120 UC patients with a median age of 69 years (interquartile range [IQR] 62-77 years). Eighteen patients (15%) were diagnosed with upper tract urothelial carcinoma, and the others (85%) were diagnosed with bladder cancer. The pathological stages for those with FH(+) and ROS(+) at diagnosis were 25.0% Ta, 45.8% T1, and 29.2% ≥T2. The pathological stages for those with FH(+) and ROS(-) at diagnosis were 23.5% Ta, 35.3% T1, and 41.2% ≥T2. The pathological stages for those with FH(-) and ROS(-) at diagnosis were 52.6% Ta, 26.3% T1, and 21.1% ≥T2. After adjusting for clinical factors, including age, sex, and smoking history, FH(+) and ROS(-) were independent risk factors for muscle-invasive UC (≥T2 stage) at diagnosis (odds ratio [OR] 3.379; 95% confidence interval [CI] 1.103-10.355; P=0.033) in the univariate and multivariate logistic regression analyses. Conclusion: Among patients with newly diagnosed UC, FH(+) and ROS(-) might have an association with a more advanced pathological stage. This finding may help differentiate between patients with aggressive diseases and those who may benefit from organ-sparing surgery.

Preoperative Free Ferrous Protoporphyrin and Reactive Oxygen Species Status of Voided Urine Predicts Potential Recurrence Risk in NMIBC

“…Moreover, as it turns out, the correlation does exist. It is worth mentioning that our results are different from those of Zhao et al 11 Because our results show that the status of FH(+) /ROS(+) is associated with high-grade and higher stage (T1) pathologic outcomes.…”

“…Zhao et al investigated the free ferrous protoporphyrin and reactive oxygen species (FH and ROS) status to evaluate the relationship between pathological stage and grade of Urothelial Carcinoma for the first time. 11 The combined test aims to evaluate the prognosis and formulate further treatment plans. The reactive oxygen species (ROS) that are generated by mitochondrial respiration are potent inducers of oxidative damage and mediators of aging.…”

“…10 In a recent study, Zhao et al proposed that FH(+) and ROS(-) at diagnosis predict a higher pathological stage in patients with Urothelial Carcinoma. 11 Therefore, the potential of ROS and FH expression status in predicting survival in patients with NMIBC was further explored in our study, whether combining ROS and FH test add value to BC diagnosis.…”