الفهرس 
Introduction & Aim of the workOnly 14 pages are availabe for public view
 |  | from | 153 |  |  |
| | | from | 153 | | |
Abstract
The most common symptom of bladder cancer (BC) is hematuria. For evaluation of hematuria, cross-sectional imaging and cystoscopy are used but with high negative results, and expensive costs. The aim of the study was to validate novel urine-based tests; miR-155, miR-200b, hTERT, and E2F3 for BC detection in patients with hematuria. In addition investigating whether low serum 25-hydroxyvitamin D (25(OH)D) at diagnosis predicts early recurrence. Between August 2018 and May 2019, Patients who presented with hematuria were evaluated with a CT urogram and office white light cystoscopy with subsequent inpatient biopsy for positive findings. 115 patients (84 BC patients and 31 control) were included in the analysis. Control patients were with a normal urologic workup. Of the 84 patients with BC, 64 patients had NMIBC, and 20 were MIBC. Regarding pathology grading, 21 patients had low-grade (LG) and 43 patients had high-grade (HG) tumors. Voided precystoscopy urine samples were collected. Gene expression of miR-155, miR-200b, hTERT, and E2F3 by quantitative real-time polymerase chain reaction (qRT-PCR) technique and cytology were performed. 25(OH)D was determined in serum by electrochemiluminescence binding assay. Tests characteristics were calculated based on the ability to identify BC noninvasively. All tested biomarkers were superior to cytology for BC diagnosis. Only hTERT and E2F3 could differentiate between NMIBC and MIBC patients. Compared to cytology, hTERT and E2F3 had the highest ability for discrimination of NMIBC grades with a sensitivity of 86% for both of them. Compared to control, BC patients had lower serum levels of 25(OH)D with the lowest level in muscle invasion subgroup. Future work is required to test whether vitamin D deficiency is associated with NMIBC recurrence and correction of its deficiency may improve quality of life and extend survival in these patients.