Snell, K, Ward, DG, Gordon, NS, Goldsmith, JC, Sutton, AJ, Patel, P, James, ND, Zeegers, MP, Cheng, KK and Bryan, RT (2018) Exploring the roles of urinary HAI-1, EpCAM and EGFR in bladder cancer prognosis and risk stratification. Oncotarget.

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Abstract

Objectives:
To investigate whether elevated urinary HAI-1, EpCAM and EGFR are independent prognostic biomarkers within non-muscle-invasive bladder cancer (NMIBC) patients, and have utility for risk stratification to facilitate treatment decisions.

Results:
After accounting for EAU risk group in NMIBC patients, the risk of BC-specific death was 2.14 times higher (95% CI: 1.08 to 4.24) if HAI-1 was elevated and 2.04 times higher (95% CI: 1.02 to 4.07) if EpCAM was elevated. The majority of events occurred in the high-risk NMIBC group and this is where the biggest difference is seen in the survival curves when plotted for EAU risk groups separately. In MIBC patients, being elevated for any of the three biomarkers was significantly associated with BC-specific mortality after accounting for other risk factors, HR = 4.30 (95% CI: 1.85 to 10.03).

Patients and Methods:
Urinary levels of HAI-1, EpCAM and EGFR were measured by ELISA in 683 and 175 patients with newly-diagnosed NMIBC and MIBC, respectively, recruited to the Bladder Cancer Prognosis Programme. Associations between biomarkers and progression, BC-specific mortality and all-cause mortality were evaluated using univariable and multivariable Cox regression models, adjusted for European Association of Urology (EAU) NMIBC risk groups. The upper 25% of values for each biomarker within NMIBC patients were considered as elevated. Exploratory analyses in urine from MIBC patients were also undertaken.

Conclusion:
Urinary HAI-1 and EpCAM are prognostic biomarkers for NMIBC patients. These biomarkers have potential to guide treatment decisions for high-risk NMIBC patients. Further analyses are required to define the roles of HAI-1, EpCAM and EGFR in MIBC patients.

Item Type: Article
Additional Information: This is the final published version of the article (version of record). It first appeared online via Impact Journals at https://doi.org/10.18632/oncotarget.25397 - please refer to any applicable terms of use of the publisher.
Uncontrolled Keywords: HAI-1, EpCAM, EGFR, bladder cancer, prognosis
Subjects: R Medicine > R Medicine (General)
R Medicine > RC Internal medicine > RC0254 Neoplasms. Tumors. Oncology (including Cancer)
Divisions: Faculty of Medicine and Health Sciences > Primary Care Health Sciences
Depositing User: Symplectic
Date Deposited: 01 May 2018 09:21
Last Modified: 27 Sep 2018 14:51
URI: http://eprints.keele.ac.uk/id/eprint/4803

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