Survivin protein as a predictor of disease course in non-muscle invasive bladder cancer

Aim. To evaluate the diagnostic prospects of determining urine survivin level for monitoring the course of the disease in patients with non-muscle invasive bladder cancer (NMIBC).

Materials and methods. In total, 66 urine samples from patients with NMIBC were analyzed. The survivin concentration in the urinary supernatant was determined by bioluminescent immunoassay. All patients with bladder cancer were examined and treated at the Krasnoyarsk Regional Clinical Oncological Dispensary named after A.I. Kryzhanovsky taking into account current clinical guidelines. The main clinical and morphological parameters were evaluated: histological variant of the tumor, invasion depth, differentiation grade, size and number of lesions in the bladder, and risk group for disease recurrence. As part of the follow-up, times to tumor recurrence, development of muscle-invasive cancer, and metastasis were determined. Statistical data processing was performed using Microsoft Excel software for Windows 10, StatTech v.4.11.2 (developed by Stattech LLC, Russia).

Results. Urine survivin level of NMIBC patients before transurethral resection directly correlates with the risk group for disease recurrence. Decrease in the degree of tumor differentiation (p < 0.001) and an increase in the size of the tumor (p = 0.021) increase concentration of the cancer marker. Survivin level of more than 10 pg/mL significantly reduces disease-free survival, and level of more than 50 pg/mL also reduces event-free survival and progression-free survival.

Conclusion. The survivin cancer marker allows stratification of patients per unfavorable prognostic factors, which can be used to determine patient treatment tactics and subsequent follow-up.