Investigating the role of HMGA2 plasma level as a diagnostic marker in bladder urothelial carcinoma patients.

Abstract

Background: Bladder Cancer (BC) is an environmental cancer caused by exposure to a globally widespread carcinogen, which is smoking, and it is characterized by high rates of recurrence and mortality. High Mobility Group A2 (HMGA2) protein is an oncofetal protein that belongs to the HMG family proteins. It is involved in various stages of carcinogenesis and cancer progression. This study investigated the presence and levels of the HMGA2 protein in bladder urothelial carcinoma patients' plasma and in healthy individuals and their association with the clinicopathological features of bladder urothelial carcinoma.

Methods: This case-control study included 80 individuals divided into two groups: a healthy group (n = 22) and a patient group with bladder urothelial carcinoma (n = 58). There were 16 patients with Muscle-Invasive Bladder Cancer (MIBC) and 42 patients with Non-Invasive Bladder Cancer (NMIBC) in the patients' cohort according to the European Association of Urology (EAU) classification. HMGA2 plasma levels were measured by Sandwich Enzyme-Linked ImmunoSorbent Assay (ELISA). The statistical analysis was performed using IBM SPSS statistics (version 25) software. The t-test and the Mann-Whitney test were used.

Results: Plasma HMGA2 protein levels were higher in the BC group than in the healthy group (P < 0.001), they also were higher in MIBC (pT2-pT3) than in NMIBC (pTa-pT1) (P < 0.001). HMGA2 plasma levels were higher in high grade BC patients than in low grade BC patients (P = 0.049).

Conclusions: This study confirmed that the plasma HMGA2 protein level was higher in bladder cancer patients than in healthy individuals and that its elevated plasma levels were correlated with advanced stage and grade of BC; thus, the plasma HMGA2 protein level represents a potential non-invasive marker that could be included in bladder cancer diagnosis approach.