Association of Thrombomodulin Expression with Bladder Cancer Grade, Stage, and Recurrence: A Single-Center Prospective Pilot Study.

Abstract

Background & objective: Bladder cancer is the fourth most prevalent malignancy and lacks reliable biomarkers for predicting tumor stage, grade, and clinical outcomes. This study aimed to evaluate the association between thrombomodulin (TM)-positive cell rate (PR) and tumor grade, stage, and recurrence in patients with bladder cancer.

Methods: This prospective observational pilot study was conducted at the Urology Clinic of Sina Hospital, Tehran, between March and December 2022. A total of 51 patients diagnosed with bladder cancer following cystoscopy and transurethral resection of bladder tumor (TURBT) were enrolled. Of these, 11 patients with stage T2 disease underwent radical cystectomy. TM expression was assessed by immunohistochemical staining, and the PR score was calculated. The remaining 40 patients underwent follow-up cystoscopy 3 months post-TURBT to assess for recurrence or progression. Statistical analyses were performed using SPSS version 26, with comparisons of quantitative variables conducted using ANOVA and t tests.

Results: The mean age of participants was 66.73 ± 11.00 years, and 46 were male. The mean TM PR value was 25.51 ± 6.24. No significant differences in TM PR values were observed among different tumor grades (p = 0.144) or stages (p = 0.815). Additionally, there were no significant differences in TM PR values or PR scores between patients with and without recurrence at 3-month follow-up cystoscopy (p = 0.144 and p = 0.085, respectively).

Conclusion: TM PR values did not correlate with tumor grade, stage, or recurrence in this cohort of bladder cancer patients. Further studies with larger sample sizes and longer follow-up periods are warranted.