| Objective To investigate the role of preoperative serum and urine chemokine ligand 27 (CCL27) in predicting the risk of recurrence and progression in patients with non-muscle invasive bladder cancer (NMIBC). Methods From September 10, 2017 to April 1, 2019, a total of 15 NMIBC patients with transurethral resection of bladder tumor (TURBT) were recruited from the Department of Urology of the hospital as the discovery group, and 91 NMIBC patients with successful TURBT were recruited as the validation group, and preoperative serum and urine samples were collected. Discovery group cytokines/chemokines were detected by flexible Multi-Analyte Profiling. Serum and urine CCL27 levels in the validation group were detected by enzyme-linked immunosorbent assay. Results In the discovery group, there were significant differences between patients with recurrence and those without recurrence, or between patients with progression and those without progression only at the level of CCL27 (P<0.05). In the verification group, the preoperative serum and urine CCL27 levels in the relapsing/progressing group were significantly higher than those in the non-relapsing/progressing group (P<0.05). The area under ROC curve (AUC) of serum and urine CCL27 for predicting NMIBC recurrence were 0.780 (95%CI: 0.678～0.881) and 0.869 (95%CI: 0.796～0.942), which predicting the progression of NMIBC were 0.803 (95%CI: 0.708～0.897) and 0.862 (95%CI: 0.788～0.936), respectively. Logistic regression analysis showed that preoperative high urinary CCL27 level was an independent predictor of recurrence or progression of NMIBC (P<0.05). According to the cut-off value determined by the ROC curve, NMIBC patients were divided into groups with high serum or urine CCL27 level and groups with low serum or urine CCL27 level. During 5-year follow-up, median relapse-free survival (RFS) and median progression-free survival (PFS) were significantly shorter in patients with high serum and urine CCL27 levels (P<0.001). Conclusion Upregulation of CCL27 level is closely related to the recurrence and progression of NMIBC. Preoperative serum or urine CCL27 is promising as an early predictor for identifying patients at high risk of recurrence and progression of NMIBC, while the predictive value of urine CCL27 is better. |
