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Volume 4 No. 3, July 2009 |
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The Use of Urinary Soluble Fas for Detection of Tumor Recurrence in Patients with Superficial Bladder Cancer Mohamed A Elbendary(1) & Mohamed AS Attia(2)
Urology(1)
and Clinical Pathology(2) Departments, Faculty of
Medicine, Tanta University, Tanta, Egypt
Aim: To examine the use of urinary soluble Fas (sFas) as a non
invasive marker for the detection of tumor recurrence in patients
with superficial bladder carcinoma. Patients & Methods: The study
included 30 patients with cystoscopically diagnosed and resected pTa/T1
lesions who were scheduled for regular cystscopic follow up with or
without intravesical BCG instillation. Ten healthy volunteers were
also enrolled in the study as a control group. Urine samples were
collected for determination of sFas level in both patients and
control groups. These samples were taken once in the control group
and just before every cystoscopic examination in the patients group
over a period of 18 months. We used a commercially available,
quantitative, enzyme-linked immunoadsorbent assay (ELISA) for
determining urinary sFas levels. The diagnosis of tumor recurrence
was based on histopathological examination during the follow up
cystoscopy and all cystoscopic and urinary sFas data were reported
for each patient during each follow up visit. Results: During the
follow up, cystoscopy revealed recurrent tumors in 12 patients. At
the time of recurrence, patients showed a significantly elevated
mean urinary sFas levels (91.8ng/ml±18.2) compared to the control
group (53.3ng/ml±7.2), p=0.00. Meanwhile, at the time of diagnosis
of recurrence, a significantly higher mean sFas level
(91.8ng/ml±18.2) was found in those patients compared to their mean
levels during recurrence free time (65.4ng/ml ±19.8), p=0.00.
Additionally, higher levels of urinary sFas were correlated with
higher tumor stage and grade. Conclusions: Urinary sFas can be used
to detect tumor recurrence during the follow up of patients with
superficial bladder cancer. This noninvasive test can be of value
during the intervals between the scheduled cystoscopic examinations.
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