الفهرس 
REVIEW OF LITERATUREOnly 14 pages are availabe for public view
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Abstract
Aim: To optimize the use of different urinary tumor markers in diagnosis and prediction of recurrence in non-muscle invasive bladder cancer (NMIBC). Subjects and methods: The study included 3 groups: group 1 (study group) comprised 100 patients who were histologically confirmed as TCC with no evidence of muscle invasion after TURBT. group 2 (control non-healthy group) included 100 patients with other pathology rather than NMIBC and group 3 (control normal) included 100 healthy persons. group 1 was subdivided according to recurrence state and its frequency into patients with and without recurrence. Among patients with recurrence, we further classified them into those with single or multiple recurrences. Urine samples were obtained during TURBT before tissue biopsy for patients in group 1. Voided urine morning samples were obtained from patients of both control groups. Urinary markers: telomerase reverse transcriptase TERT, Carnitine palmitoyl transferase 1C CPT1C, indoleamine 2,3- dioxygenase IDO-1 and MicroRNAs miR-34a were evaluated for diagnosis and prediction of recurrence.
Results: Higher urinary TERT > 3.2, CPT1c > 0.74, IDO-1> 0.77 and
lower urinary miR34a < 0.85 were detected significantly in bladder
cancer group compared to controls (P < 0.0001). Urinary TERT and
IDO-1 achieved higher overall diagnostic accuracy for NMIBC. Out
of 100 patients in group 1, 65% experienced tumor recurrence. Higher
grade of tumor, urinary TERT > 8.6, CPT1c > 4 and IDO-1 > 1.6 with
miR34a < 0.6 were found to be independent risk factors for NMIBC
recurrence (P= 0.004, 0.03, 0.001, <0.0001 and 0.01, respectively).
Urinary TERT and miR34a followed by IDO-1 achieved higher
overall diagnostic accuracy for t umor recurrences. Urinary CPT1c >
9.05 was detected to be the only independent risk factor associated
with increasing the incidence of multiple tumor recurrences.
Conclusion: Urinary molecular tumor markers are non-invasive tools
for diagnosis and recurrence prediction. Urinary TERT > 3.2 and
IDO-1> 0.77 had the highest overall diagnostic values among other
urinary biomarkers for bladder cancer detection. In addition, urinary
TERT > 8.6, IDO-1 > 1.6 and miR34a < 0.6 were linked with
increased the risk for tumor recurrence urinary CPT1c > 9.05. Higher
CPT1c was associated with multiple tumor recurrence.