Type 2 diabetes mellitus and non-muscle invasive bladder cancer: characteristics of the epidermal growth factor system components content in blood, urine, and tumor

Background. The incidence of bladder cancer (BC) and type 2 diabetes mellitus (T2DM) are rising consistently worldwide. It is not uncommon for these two pathologies to be found in combination. T2DM is a contributing factor in many cancer types. It is currently understood that the development of non-muscle invasive BC (NMIBC) occurs primarily through the activation of oncogenes that involve the epidermal growth factor (EGF) system. However, the effect of T2DM on the EGF system in the context of NMIBC remains unclear.

Aim. To investigate the specific content of the EGF system components in the blood, urine, and tumor tissue of patients with NMIBC with concomitant T2DM.

Materials and methods. The participants were divided into the main group – patients with NMIBC and T2DM (n = 11), and the control group – patients with NMIBC without T2DM (n = 11). The comparison group comprised of patients with T2DM only (n = 8). All parameters were evaluated in comparison to those of healthy donors (n = 12). The levels of EGF (Ray Bio, Germany) and its soluble receptor (sEGFR) (RAD Systems, USA) were quantified in blood, urine and 10 % tumor tissue homogenates using standard EIA kits on an automatic analyzer, the Infinite F50 (Tecan Austria GmbH, Austria).

Results. In 80 % of control group patients, blood EGF levels increased 2.8-fold compared to donors, while in 20 % they remained unchanged. Blood EGF content in patients with comorbid pathology and the comparison group (T2DM only) was comparable and at the same time 2.1–2.7 times lower than in most patients from the control group. In all BC patients, blood sEGFR concentration was 1.4 times lower than in donors and T2DM patients, but increased in urine: 2.9-fold in BC patients without T2DM and 3.5-fold in BC patients with T2DM. Patients with NMIBC and T2DM had 1.5 times less EGF and 2.0 times less sEGFR than NMIBC patients without T2DM.

Conclusion. The patients with NMIBC and T2DM were deficient in EGF (in blood, urine, and tumor tissue) and sEGFR (in blood and tumor tissue), compared to the patients with NMIBC without T2DM who demonstrated increased levels of EGF (in blood, urine, and tumor tissue). The development of NMIBC was associated with an increase in urinary sEGFR concentrations, irrespective of T2DM status.

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