Diagnostic Value of Chronic Inflammatory Factors in Nonmuscle Invasive Bladder Cancer

Chronic inflammation in urothelial tissues can lead to DNA damage and cancer formation. Inflammatory reactions in bladder cancer (BC) probably depend on the stages and grades of tumors. The aim of this research was to find out if there is a relationship between the serum levels of selected inflammatory factors and the pathological grades/stages of tumors in new cases of non-muscle invasive urothelial bladder carcinoma patients.

Blood samples were collected from 40 newly diagnosed non-muscle invasive urothelial bladder carcinoma patients (before the surgery) and 40 normal individuals without the signs of acute and chronic diseases or cancer. All patients had proven BC and were sampled prior to the initial transurethral resection of bladder tumor and any medical intervention. Finally, the levels of selected inflammatory factors such as C-reactive protein (CRP), interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-α) were measured using enzyme-linked immunosorbent assay kits.

Based on the results, the levels of IL-6 (3.041.32± vs. 0.76±0.23), TNF-α (18.5±5.24 vs. 10.52±2.67), and CRP (807.09±564.86 vs. 132.08±53.76) were significantly higher in samples obtained from cancer patients compared to the control group, respectively (P<0.001). In addition, changes in these markers were associated with tumor stages and grades (P<0.001). Eventually, there was a significant increase in the risk of non-muscle invasive bladder cancers (NMIBC) with elevated levels of IL-6 (odds ratio [OR]: 5.93) and TNF-α (OR: 2.39).

Overall, the results revealed a desirable relationship between the levels of inflammatory factors and tumor stages/ grades in NMBIC cases. These data may suggest that IL-6 and TNF-α are responsible for predisposing epithelial cells to genotoxic agents and cancer development. Finally, IL-6 and TNF-α, together with CRP are valuable inflammatory factors for the diagnosis of new BC cases.