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Lin HJ, Hu RM, Chen HC, Lin CC, Lee CY, Chou CY. CA125 for the Diagnosis of Advanced Urothelial Carcinoma of the Bladder: A Systematic Review and Meta-Analysis. Cancers (Basel) 2023; 15:cancers15030813. [PMID: 36765770 PMCID: PMC9913454 DOI: 10.3390/cancers15030813] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 01/23/2023] [Accepted: 01/26/2023] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Urothelial carcinoma of the bladder (UCB) is the second most common genitourinary cancer. This study aims to assess the diagnostic accuracy of CA125 in advanced UCB. METHODS We searched prevalent studies in PubMed, the Cochrane Library, Scopus, Embase, the Web of Science China National Knowledge Infrastructure database, and Wanfang data before October 2022. Pooled sensitivity, specificity, and summary receiver operating characteristics were used to assess the diagnostic value of CA125. RESULTS One thousand six hundred forty-one patients from 14 studies were analyzed. UCB stage T3-4N1 was defined as advanced UCB in ten studies; T2-4 was used in three studies; and N1M1 in one study. Patients' age was between 21 to 92, and 21% to 48.6% of patients were female. The pooled sensitivity was 0.695 (95% confidence interval (CI): 0.426-0.875). The pooled specificity was 0.846 (95% CI: 0.713-0.924). The diagnostic odds ratio was 8.138 (95% CI: 4.559-14.526). The AUC was 0.797. CONCLUSION CA125 may provide significant diagnostic accuracy in identifying muscle-invasive, lymph node-involved, and distant metastatic tumors in patients with urothelial carcinoma of the bladder. Limited studies have been conducted on the prognostic role of CA125. More studies are needed for a meta-analysis on the prognostic role of CA125 in UCB.
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Affiliation(s)
- Hsuan-Jen Lin
- Division of Nephrology, Asia University Hospital, Taichung 41354, Taiwan
- Department of Bioinformatics and Medical Engineering, Asia University, Taichung 41354, Taiwan
| | - Rouh-Mei Hu
- Department of Bioinformatics and Medical Engineering, Asia University, Taichung 41354, Taiwan
| | - Hung-Chih Chen
- Division of Nephrology, Asia University Hospital, Taichung 41354, Taiwan
| | - Chung-Chih Lin
- Division of Nephrology, Asia University Hospital, Taichung 41354, Taiwan
| | - Chi-Yu Lee
- Division of Nephrology, Asia University Hospital, Taichung 41354, Taiwan
| | - Che-Yi Chou
- Division of Nephrology, Asia University Hospital, Taichung 41354, Taiwan
- College of Medicine, China Medical University, Taichung 404332, Taiwan
- Division of Nephrology and Kidney Institute, China Medical University Hospital, Taichung 404332, Taiwan
- Department of Post-baccalaureate Veterinary Medicine, Asia University, Taichung 41354, Taiwan
- Correspondence: ; Tel.: +886-4-3706-1668-1878; Fax: +886-4-3706-1668-1338
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Li AL, Chou CY, Chen CL, Wu KL, Lin SC, Chen HC, Wang MC, Chang CC, Hsu BG, Wu MS, Ma N, Huang CC. The MicroRNA Prediction Models as Ancillary Diagnosis Biomarkers for Urothelial Carcinoma in Patients With Chronic Kidney Disease. Front Med (Lausanne) 2021; 8:726214. [PMID: 34660637 PMCID: PMC8517232 DOI: 10.3389/fmed.2021.726214] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 09/07/2021] [Indexed: 12/24/2022] Open
Abstract
Urothelial carcinoma is a common urological cancer in chronic kidney disease patients. Cystoscopy and urine cytology are the clinical diagnostic tools for UC. However, cystoscopy is an invasive procedure, while urine cytology showed low sensitivity for low-grade urothelial tumors. High accuracy with non-invasive tools for UC is needed for CKD patients. Our study collected a total of 272 urine and 138 plasma samples to detect the miRNA expression levels for establishing UC signatures from CKD patients. Seventeen candidate miRNAs of biofluids were selected and confirmed by qRT-PCR. Our results showed that urinary miR-1274a and miR-30a-5p expression levels were significantly lower but miR-19a-5p expression levels were higher in UC when compared with CKD. In plasma samples, miR-155-5p, miR-19b-1-5p, miR-378, and miR-636 showed significantly lower expression in UC compared to those with CKD. The Kaplan-Meier curve showed that lower expression of miR-19a, miR-19b, miR-636 and miR-378, and higher expression of miR-708-5p were associated with poor prognosis in patients with bladder cancer. In addition, we produced classifiers for predicting UC by multiple logistic regression. The urine signature was developed with four miRNAs, and the AUC was 0.8211. Eight miRNA expression levels from both urine and plasma samples were examined, and the AUC was 0.8595. Two miRNA classifiers and the nomograms could improve the drawbacks of current UC biomarker screenings for patients with CKD.
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Affiliation(s)
- An-Lun Li
- Department of Biomedical Sciences and Engineering, National Central University, Taoyuan, Taiwan
| | - Che-Yi Chou
- Division of Nephrology, Department of Internal Medicine, Asia University Hospital, Taichung, Taiwan
| | - Chien-Lung Chen
- Department of Nephrology, Landseed International Hospital, Taoyuan, Taiwan
| | - Kun-Lin Wu
- Department of Biomedical Sciences and Engineering, National Central University, Taoyuan, Taiwan.,Division of Nephrology, Department of Internal Medicine, Taoyuan Armed Forces General Hospital, Taoyuan, Taiwan
| | - Shih-Chieh Lin
- Institute of Basic Medical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Hung-Chun Chen
- Division of Nephrology, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Ming-Cheng Wang
- Division of Nephrology, Cheng Kung University Hospital, Tainan, Taiwan
| | - Chia-Chu Chang
- Division of Nephrology, Department of Internal Medicine, Kuang Tien General Hospital, Taichung, Taiwan.,Department of Nutrition, Hungkuang University, Taichung, Taiwan
| | - Bang-Gee Hsu
- Division of Nephrology, Buddhist Tzu Chi General Hospital, Hualien, Taiwan
| | - Mai-Szu Wu
- Division of Nephrology, Taipei Medical University and Hospitals, Taipei, Taiwan
| | - Nianhan Ma
- Department of Biomedical Sciences and Engineering, National Central University, Taoyuan, Taiwan
| | - Chiu-Ching Huang
- Division of Nephrology and The Kidney Institute, China Medical University and Hospitals, Taichung, Taiwan
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Chou CY, Shu KH, Chen HC, Wang MC, Chang CC, Hsu BG, Chen TW, Chen CL, Huang CC. Urine phthalate metabolites are associated with urothelial cancer in chronic kidney disease patients. CHEMOSPHERE 2021; 273:127834. [PMID: 33077191 DOI: 10.1016/j.chemosphere.2020.127834] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 07/22/2020] [Accepted: 07/26/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Di(2-ethylhexyl) phthalate (DEHP) is one of the most widely used phthalates and is associated with breast cancer. Ths association between DEHP and other types of cancer is not clear. DEHP may increase matrix metalloproteinase-9 that is critical for the development of urothelial cancer (UC). We examined the association between urinary phthalate metabolites and UC. CKD patients were selected as a control group because CKD patients are more at risk of UC than the general population. METHODS In this cross-sectional study, we measured seven urinary phthalate metabolites that are abundant and can be measured using HPLC-MS/MS in Taiwan CKD patients between Jul 2013 and Dec 2015. MiBP (a urinary metabolite of Dibutyl phthalates[DBP]) and MEHHP (a urinary metabolite of DEHP) were described because they are the most abundant phthalate metabolites. The association of phthalate (log-transformed) and UC were analyzed using logistic regression with adjustments for age, gender, renal function, use of traditional Chinese medicine, toxins (dye, organic solvent), and non-steroidal anti-inflammatory drugs. RESULTS We measured the urinary MEHHP and MiBP of 496 patients (224 UC and 272 CKD patients). The urinary MEHHP was associated with UC but MiBP was not. Medical history including the use of non-steroid anti-inflammatory drugs, exposure to environmental toxins (dye, paint, and organic solvent), and the use of traditional Chinese medicine was independently associated with UC. The adjusted odds ratio of MEHHP was 1.42 (95% confidence interval: 1.21-1.68). CONCLUSION Phthalate urinary metabolite(MEHHP) may be associated with UC in CKD patients and the association is independent of well-known risk factors of UC.
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Affiliation(s)
- Che-Yi Chou
- Division of Nephrology and Kidney Institute, Department of Internal Medicine, China Medical University and Hospitals, Taichung, Taiwan; College of Medicine, China Medical University, Taichung, Taiwan; Division of Nephrology, Asia University Hospital, Taichung, Taiwan; Department of Post-baccalaureate Veterinary Medicine, Asia University, Taichung, Taiwan
| | - Kuo-Hsiung Shu
- Division of Nephrology, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Hung-Chun Chen
- Division of Nephrology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Ming-Cheng Wang
- Division of Nephrology, Cheng Kung University Hospital, Tainan, Taiwan
| | - Chia-Chu Chang
- Division of Nephrology, Changhua Christian Hospital, Chang Hua, Taiwan
| | - Bang-Gee Hsu
- Division of Nephrology, Buddhist Tzu Chi General Hospital, Hualien, Taiwan
| | - Tzen-Wen Chen
- Division of Nephrology, Taipei Medical University, Taipei, Taiwan
| | | | - Chiu-Ching Huang
- Division of Nephrology and Kidney Institute, Department of Internal Medicine, China Medical University and Hospitals, Taichung, Taiwan; College of Medicine, China Medical University, Taichung, Taiwan.
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Zhu F, Zhou C, Wen Z, Wang DW. DDAH1 promoter -396 4N insertion variant is associated with increased risk of type 2 diabetes in a gender-dependent manner. Mol Genet Genomic Med 2019; 8:e1011. [PMID: 31733101 PMCID: PMC6978400 DOI: 10.1002/mgg3.1011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Revised: 09/17/2019] [Accepted: 09/26/2019] [Indexed: 12/16/2022] Open
Abstract
Background Asymmetrical dimethylarginine (ADMA) is an endogenous inhibitor of nitric oxide synthases, making it a contributing factor for diabetes. Endogenous ADMA is hydrolyzed by dimethylarginine dimethylaminohydrolase 1 (DDAH1), and a DDAH1 promoter ‐396 4N deletion/insertion polymorphism (DDAH1: ‐396_‐395insGCGT) regulates its transcriptional activity. This study aimed to explore the association between this polymorphism and type 2 diabetes (T2DM). Methods In a case–control study, all participants were genotyped for this polymorphism within two sets of populations (discovery: 1,227 T2DM patients and 1,339 controls; replication: 1,190 patients and 1,651 controls). The disease association was assessed by a unconditional logistic regression model. Homeostasis model assessment calculations were conducted among different genotypes. Results We identified that DDAH1: ‐396_‐395insGCGT insertion allele was significantly associated with increased risk of T2DM (discovery: adjusted odds ratio [OR] = 1.380, 95% CI = 1.128–1.687, p = .002; replication: OR = 1.231, 95% CI = 1.007–1.504, p = .043). The homeostasis model assessment of insulin resistance was increased in participants carrying Ins/Ins alleles (p = .0452). Interestingly, the insertion allele increased the risk of T2DM in males but not in females (male discovery: OR = 1.528, 95% CI = 1.141–2.047, p = .004; replication: OR = 1.439, 95% CI = 1.083–1.911, p = .012; female discovery: OR = 1.218, 95% CI = 0.913–1.626, p = .18; replication: OR = 1.161, 95% CI = 0.871–1.548, p = .308). Conclusion The DDAH1: ‐396_‐395insGCGT insertion allele is associated with increased risk of T2DM in a gender‐dependent manner, affects males but not females.
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Affiliation(s)
- Fasheng Zhu
- Division of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Hubei Key Laboratory of Genetics and Molecular Mechanisms of Cardiological Disorders, Wuhan, China.,Department of Cardiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, and Peking Union Medical College, Beijing, China
| | - Chi Zhou
- Division of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Hubei Key Laboratory of Genetics and Molecular Mechanisms of Cardiological Disorders, Wuhan, China
| | - Zheng Wen
- Division of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Hubei Key Laboratory of Genetics and Molecular Mechanisms of Cardiological Disorders, Wuhan, China
| | - Dao Wen Wang
- Division of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Hubei Key Laboratory of Genetics and Molecular Mechanisms of Cardiological Disorders, Wuhan, China
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