Diagnostic value of urinary CK-20 RNA and VEGF in bladder cancer

The present study was carried out to evaluate the diagnostic value of urinary cytokeratin 20 [CK-20] RNA and vascular endothelial growth factor [VEGF] in comparison with urine cytology in the detection of bladder cancer. This study included 80 patients with bladder cancer, 20 patients with bilharzial bladder lesions and 20 normal volunteers as control group. CK-20 RNA in urine sediment was detected by reverse transcription polymerase chain reaction [RT-PCR]. VEGF in urine supernatant was detected by ELISA and confirmed by western blotting [WB]. The median value of VEGF and positivity rates of both VEGF and CK-20 in bladder cancer group was significantly higher as compared to benign bladder lesions group and normal control group. There was no significant association between the postivity rates of CK-20 and VEGF with any of the clinicopathological factors except a significant positive association between VEGF positivity and clinical stage. The overall sensitivity, specificity, positive predictive value, negative predictive value were; 66.25%, 92.5%, 94.46%, 57.81% for VEGF, 65.2%, 70%, 80.65%. This article was taken from Ph.D thesis submitted by Ekram Fadl Al-Eryani To: Faculty of Medicine-Ain Shams University. 2005 48.28% for voided urine cytology, and 83.7%, 100%, 100%, 75.47% for CK-20 respectively. Combined sensitivity of cytology, VEGF andCK-20 RNA reached [96.25%] and was higher than the combined sensitivity of cytology and VEGF [90%], or cytology and CK-20 RNA [92.5%], or VEGF and CK-20 [91.25%]. These results indicate that VEGF can be quantitively measured in urine of bladder cancer patients, and its combined use with cytology increases its sensitivity

Assessment of angiogenic factor, vascular endothelial growth factor, serum and urine level changes in superficial bladder tumor immunotherapy by intravesical Bacillus Calmette-Guerin

Bladder tumor is one of the most common genitourinary tumors. Management of non-muscle invasive [NMI] bladder tumors is primarily by transurethral resection [TURBT] followed by intravesical immunotherapy or chemotherapy. Bacillus Calmette-Guerin [BCG] is the most effective adjuvant therapy in NMI bladder tumor. Since angiogenesis is an essential factor in solid tumor progression and vascular endothelial growth factor [VEGF] is an important factor in angiogenesis, the aim of this study is the assessment of angiogenic factor, VEGF, serum and urine level changes in superficial bladder tumor immunotherapy by intravesical BCG. A total of 23 patients with bladder transitional cell carcinoma [TCC] in stage Ta/T1 or carcinoma insitu [CIS], low or high grade, which passed a 2-4 week period from TURBT participated in this study. Blood and urine samples were obtained at first and sixth sessions before instillation of BCG. Enzyme-linked immunosorbent assay [ELISA] method was used to obtain VEGF level in samples. Urine and serum VEGF levels did not change significantly before and after BCG therapy. Changes in VEGF level were significantly different neither in low grade against high grade tumors nor in stage T1 against stage Ta tumors. A significant difference in VEGF level was seen between low grade and high grade tumors in serum after BCG therapy [P=0.007]; but not in urine samples. Although intravesical BCG possesses anti-angiogenic activity, it seems that it exerts its effect through pathways other than VEGF, especially in low grade tumors

Relation of vascular endothelial growth factor [VEGF] to diabetic nephropathy in type 2 diabetic patients

Diabetic nephropathy in type 2 DM is a frequent complication associated with increased morbidity and mortality. The aim of this work is to evaluate the relation of vascular endothelial growth factor to diabetic nephropathy in type 2 diabetic patients and to assess whether its levels is related to the severity of diabetic nephropathy. This study included 38 type 2 diabetic patients grouped into nephropathic and non-nephropathic groups based on urinary albumin excretion [UAE], nephropathic group was further grouped into microalbuminuric and macroalbuminuric subgroups according to the level of UAE. In addition 10 healthy subjects of matched age, sex and body mass index [BMI] served as a control group. All participants underwent clinical examination, laboratory investigations; traditional investigations. UAE and serum and urinary vascular endothelial growth factor [VEGF]. The nephropathic group was of longer duration, had poor glycemic control compared to the non-nephropathic group. Serum and urinary VEGF levels were elevated in all diabetic patients compared to controls and in the nephropathic group versus the non-nephropathic. The elevation was significantly higher in macroalbuminuric group compared to the microalbuminuric group. Furthermore, serum and urine VEGF levels showed a significant positive correlation with serum creatinine and UAE. The hyperglycemic milieu in type 2 diabetes may induce VEGF overproduction that paves the way for diabetic renal insult and hence diabetic nephropathy