Is Urinary Soluble Fas an Independent Predictor of Non-Muscle-Invasive Bladder Cancer? A Prospective Chart Study

Abstract

Objectives: To evaluate whether soluble Fas (sFas) in urine is an independent predictor of non-muscle-invasive bladder cancer (NMIBC). Methods: We performed a prospective chart review which included 128 subjects with NMIBC and 88 controls. The first morning voided urine sample (10-20 ml) was obtained from preoperative patients and controls. Expression levels of sFas in urine were analyzed using enzyme-linked immunosorbent assay. Clinical and pathological data, European Organisation for Research and Treatment of Cancer (EORTC) risk group category, follow-up data and urinary sFas values were gathered from each patient, and each prognostic outcome was evaluated. Results: sFas levels were significantly higher in the urine of patients with NMIBC than of those without NMIBC (p = 0.000). The level was significantly higher in cases with a higher stage or grade or high-risk and recurrent disease than in those with a lower stage or grade or low-risk and nonrecurrent disease (each p < 0.05). Kaplan-Meier estimates revealed a significant difference in time to recurrence based on sFas levels in the urine of the NMIBC patients (log-rank test; p = 0.000). On multivariate Cox regression analysis, EORTC risk group category (hazards ratio [HR] = 3.250, p = 0.000) and urinary sFas level (HR = 1.403, p = 0.015) were the independent predictors of NMIBC recurrence. Conclusions: Our study indicated that urinary sFas assay results may help identify NMIBC patients at risk of tumor recurrence. These data can be used to design a future follow-up schedule and treatment strategy for NMIBC patients.

Correlation and Significance of Urinary Soluble Fas and Vascular Endothelial Growth Factor in Bladder Urothelial Cancer

“…In recent years, the research based on Fas/FasL system has become one of the important advances in the field of molecular biology [ 11 , 12 ], and higher sFas levels in the serum have been investigated in various cancer types [ 4 , 13 , 14 ]. Mizutani et al [ 15 ] reported elevated sFas levels in the serum of patients with bladder cancer and suggested an association of elevated sFas level with poor prognosis in these patients.…”

“…Some research shows that sFas can be detected in the urine or serum of the bladder cancer patients. We [ 4 , 5 ] and Svatek et al [ 6 ] noted that the urinary soluble Fas levels in patients undergoing surveillance for urothelial carcinoma were higher in cancer patients than the control group and that the urinary sFas was an independent predictor of bladder cancer recurrence and invasiveness in patients who had a past history of UC.…”

Novel urinary biomarkers for the detection of bladder cancer: A systematic review

“…Quantification of survivin using ELISA reports a sensitivity of 71-85% with a specificity of 81-95% 12,13,60 . Soluble Fas was reported by two studies and showed varying sensitivity of 51% and 88% which suggesting a lack of reproducibility 16,61 .…”

Panel of Urinary Diagnostic Markers for Non-Invasive Detection of Primary and Recurrent Urothelial Urinary Bladder Carcinoma

“…Cystoscopy is unpleasant, time consuming, and expensive. Therefore, there has been an effort to replace it by a noninvasive diagnostic test, especially in patients with low-risk NMIBC [8,9,10]. However, noninvasive methods of bladder cancer detection still constitute a problem, especially when monitoring patients with a known diagnosis.…”