Abstract
BACKGROUND AND OBJECTIVE: To clarify the clinical usefulness and diagnostic accuracy of urine chemokine (C-X-C motif) ligand 1 (CXCL1) as a biomarker for tumor detection and outcome prediction in patients with bladder cancer (BCa). METHODS: We measured urine CXCL1 levels in 175 patients with BCa and 30 healthy controls. The value of urine CXCL1 concentration normalized by urine creatinine (CXCL1/Cre) was analyzed in terms of detecting bladder tumors and predicting intravesical recurrence after transurethral resection (TUR). RESULTS: CXCL1/Cre was significantly higher (3-fold) in BCa patients than in healthy participants and the difference from control samples was greater in patients with advanced BCa. Although the urine cytology test generally lost diagnostic power in patients with low-grade superficial tumors, the sensitivity of CXCL1/Cre was not compromised in this patient population. Patients with higher CXCL1/Cre were significantly more likely to develop intravesical recurrence after TUR and multivariate analysis identified CXCL1/Cre as an independent predictor of post-TUR intravesical recurrence. Importantly, CXCL1/Cre could successfully classify the probabilities of post-TUR recurrence among patients with intermediate-risk according to EORTC risk criteria into two groups equivalent to its high- and low-risk groups. CONCLUSIONS: Urine CXCL1 is a promising, non-invasive molecular marker for tumor detection and outcome prediction in patients with BCa.