EVALUATION OF SERUM AND URINARY FIBRONECTIN AS A DIAGNOSTIC MARKER OF BLADDER CANCER

Background:Accurate and sensitive detection of bladder cancer is important to diagnose this deadly disease at an early stage, estimate prognosis, prediction the response to treatment and for monitoring the recurrence. In past few years, laboratory diagnosis and surveillance of urinary bladder cancer have improved significantly. Although, urine cytology remains the gold standard test, many new urinary biochemical markers have been identified.
Objectives:To evaluate the value of fibronectin in serum and urine to detect bladder cancer in different grades and stages.
Methods:Thirty five patients diagnosed as bladder cancer with mean age 61.94±11.66 years and thirty five aged-matched healthy volunteers as control group were included in this study. Serum and urinary fibronectin were measured by ELISA technique.
Results:The mean±SEM serum and urine levels of fibronectin in patients with bladder cancer (33.11±1.90 µg/ml; 33.08±1.12 ng/ml respectively) were significantly higher than the levels in control group (8.57±1.10 µg/ml; 7.58±1.00 ng/ml, respectively). When using a serum fibronectin concentration of 25.65 µg/ml as a cutoff value for the diagnosis of bladder cancer, sensitivity was 71.4%, specificity 100%, the positive predictive value was 100% and the negative predictive value 77.78%, and the sensitivity and specificity of urine fibronectin were (94.3%, 97.1% respectively); when using a urine fibronectin concentration of 20.00 ng/ml as a cutoff value for the diagnosis of bladder cancer. The positive predictive value was 97.05%, and the negative predictive value was 94.44%.
Conclusion:The measurement of fibronectin level in serum and urine is useful in discriminating bladder cancer patients from normal subjects.
Key words:Serum and urinary Fibronectin, Bladder cancer.