Abstract
BACKGROUND: Bladder cancer (BLCA) remains a prevalent and complex malignancy characterized by significant heterogeneity. Treatment strategies are diverse, based on patient characteristics and cancer stage. Early identification of biomarkers is crucial for improving diagnosis, staging, and treatment planning. These biomarkers offer valuable insights into lesion features, tumor differentiation, and disease progression, thereby playing a pivotal role in the personalized management of BLCA. OBJECTIVE: This study investigated the expression of cancer-testis antigens SPEF1 and SPEF2 in BLCA using comprehensive bioinformatic analyses to assess their potential as biomarkers. METHODS: The UALCAN database, based on The Cancer Genome Atlas datasets, was employed to compare SPEF1 and SPEF2 expression levels in normal bladder tissues and BLCA samples. In addition, the Kaplan-Meier Plotter, OncoDB, and TIMER 2.0 platforms were utilized to evaluate the prognostic and immunotherapeutic relevance of these antigens. RESULTS: The findings suggest that SPEF1 and SPEF2 are integral to various biological processes driving BLCA onset and progression. Both genes appear to facilitate BLCA cell progression and migration, contributing to poor prognosis through specific pathways and by altering tumor microenvironment. Notably, SPEF1 expression was significantly upregulated in BLCA tissues compared to normal tissues. Conversely, higher SPEF2 expression was associated with longer overall survival and positively correlated with immunotherapeutic targets. CONCLUSION: Although these results were derived from in silico analyses, they offer insights into the potential roles of SPEF1 and SPEF2 as biomarkers. Further studies are warranted to validate these biomarkers in retrospective patient cohorts to establish their clinical utility.