Role of serum and urine transforming growth factor beta 1, matrix metallopeptidase 9, tissue inhibitor of metalloproteinase 2, and nerve growth factor beta levels and serum neutrophil-to-lymphocyte ratio in predicting recurrence and progression risks in patients with primary non-muscle invasive bladder cancer

Abstract

Objective: The current study aimed to examine the correlation between serum and urine transforming growth factor beta 1 (TGF-beta 1), matrix metallopeptidase 9 ( MMP-9), tissue inhibitor of metalloproteinase 2 (TIMP-2), and nerve growth factor beta (NGF-beta) levels and serum neutrophil-to-lymphocyte ratio (NLR) as well as the recurrence and progression risks of non-muscle invasive bladder cancer (NMIBC). Material and methods: The current study included 89 individuals: n=47, patients with primary NMIBC (patient group) and n=42, healthy controls (control group). The TGF-beta 1, MMP-9, TIMP-2, and NGF-beta levels in the blood and urine samples were assessed using an enzyme-linked immunosorbent assay. Moreover, the serum NLR was evaluated. For the statistical analysis, a generalized linear model was used to compare the groups. In the analysis, gender and use of cigarettes were used as the secondary factors, and age was included as the covariate in the generalized linear model set for the intergroup evaluations. Meanwhile, a logistic regression model was utilized to evaluate the impact of the biomarkers on the risk of recurrence and progression. Results: The serum NLR was higher in the patient group than in the control group (p=0.033). The patients with disease recurrence had higher body mass index and MMP-9 levels, but the results were not statistically significant. Moreover, the patients with a high NLR had a high risk of disease progression (odds ratio [OR]=13.046, 95% confidence interval [CI]=1.057-161.18, p=0.045), whereas the patients with a high serum TGF-beta 1 level (OR=0.972, 95% CI=0.945-0.999, p=0.047) had a low risk of disease progression. Conclusion: High NLR and low TGF-beta 1 values were associated with an increased risk of disease progression in patients with NMIBC. However, no relationships were found between TGF-beta 1, MMP-9, TIMP-2, and NGF-beta values and the recurrence of NMIBC.