Significance of total and lipid bound sialic acid in serum and urine as markers for bladder cancer

ABSTRACT

The reliability of serum total sialic acid [TSA], serum lipid bound sialic acid [LSA]. and urinary sialic acid / creatinine ratio [TSA / Cr. ratio] as markers for bladder cancer for grading, staging and follow-up purposes was evaluated in 10 healthy controls and 70 patients with bladder cancer, 25 of them with superficial tumors were evaluated after treatment with TUR for follow up. We found that TSA. LSA and TSA / Cr. ratio levels were significantly higher in patients with bladder cancer [56.9 +/- 8.9 mg /dl, 22.3 +/- 2.3 mg /dl and 37.2 +/- 16.1 ug/mg creatinine respectively] than controls [48.8 +/- 7.1 mg/dl, 16.9 +/- 0.6mg /dl and 11.9 +/- 5.1 ug /mg creatinine respectively]. There was no significant difference between grade 1,11 and III also between stage Ta, T1 and T2 and stage T3 and T4 bladder cancer patients regarding LSA and TSA, but there was a significant difference between these grades and stages regarding urinary TSA / Cr. ratio [20.1 +/- 16.1. 40.6 +/- 14.4 and 47.8 +/- 11.9 up / mg creatinine in grade I, II and III respectively and 32.1 +/- 12.1. 46.4 +/- 15.1 ug/mg creatinine in stage Ta. T1 and T2 and stage T3 and T4 respectively]. These findings suggest that TSA and LSA can't be used for grading and staging of bladder cancer patients. but urinary TSA / Cr. ratio can be used for grading and staging of these patients. On comparison of supeificial bladder cancer patients before and after treatment regarding the studied parameters, we found marked drop of urinary TSA/Cr. ratio in post-treatment patients [36.2 +/- 15.1 ug/mg creatinine before treatment versus 17.5 +/- 5.3 ug/mg creatinine after treatment] in contrary with serum TSA and LSA. We conclude that urine can be used as easily available physiologic fluid for evaluation of TSA / Cr. ratio by an easy, inexpensive, photometeric method as a marker for bladder cancer for grading, staging and follow-up of treatment in patients with bladder cancer