Urinary modified nucleosides as novel biomarkers for diagnosis and prognostic monitoring of urothelial bladder cancer.

PMID 25688500


To ascertain the value of the detection of urinary modified nucleosides in the early diagnosis and prognostic monitoring of urothelial bladder cancer. One hundred seventeen patients with urothelial bladder carcinoma and 66 healthy volunteers were included in the study. High-performance liquid chromatography/electrospray ionization quadrupole time-of-flight mass spectrometry (HPLC/ESI-Q-TOF-MS) was used to measure the levels of urinary modified nucleosides in the bladder cancer and control groups. Postoperative monitoring was done every 3 months in patients with noninvasive carcinoma; 85 patients attended the 1-year follow-up visit. The levels of m1A, ac4C, O6-MeG and 1-MeI were significantly higher in cases than controls (P < 0.05). The highest sensitivity (92.45%) and specificity (87.50%) were obtained when 1-MeI detection was combined with m1A detection. The m1A and 1-MeI levels 3 months after operation in both patient groups were significantly lower than the preoperative levels (P < 0.01). The no-recurrence group subsequently maintained low levels, but in the recurrence group the levels rose again almost to preoperative values. At 6, 9 and 12 months after operation, the m1A and 1-MeI levels of the recurrence group were higher than those of the no-recurrence group and the control group (P < 0.01). Urinary modified nucleosides might become novel tumor markers that will facilitate the clinical management and will be helpful in the diagnosis and follow-up of urothelial bladder cancer. m1A and 1-MeI appear to be most promising for clinical use and be worthy of further study in the near future.