Correlation between Tissue and Released VEGF Levels in Urine of Bladder Cancer Patients

Purpose. Angiogenesis is a complex multistep process essential for tumor growth. Vascular endothelial growth factor (VEGF) is a potent endothelial cell mitogen and vascular permeability-inducing agent. The aim of this study was to analyze whether tissue and urinary VEGF levels of bladder cancer patients are correlated and study their correlation with classical clinicopathological parameters and bilharizial bladder cancer patients. The study group was consisted of consecutive series of 120 bladder cancer patients. VEGF levels were measured by an enzyme immunoassay method (EIA). We evaluated EIA method for quantifying tissue and urinary VEGF levels with intra-assay CVs of 7.3-9.2% and 6.7-9.5%; and inter-assay CVs of 8.3-9.1% and 6.7-9% respectively. The recovery of tissue VEGF level was 96-99% and urinary VEGF was 97-101%. A high significant association was observed between tissue and urinary VEGF levels (p<0.001). The present analysis reveals significant positive association between VEGF levels and late stage, high grad, SCC type and bilharzial bladder cancer patients. Moreover, 71.2 % of SCC patients infected with bilhariziasis showed significant high VEGF levels (p<0.001) compared to their counterparts with non-bilharzial bladder cancer or TCC type infected with bilhariziasis. Association between increased VEGF levels in tumor tissue and urine of bladder cancer patients may be useful as urinary VEGF may act as a surrogate for VEGF levels within the tumor and be a valuable non-invasive tumor marker. Also, the observations of increased VEGF were more frequent in SCC patients infected with bilhariziasis may suggest a potential role of VEGF in bilharzial bladder cancer vasculogenesis, these results if confirmed, could suggest possible differences in the angiogenic process to evaluate for appropriate antiangiogenic therapy.