Serum values and prognostic significance of SMAD-2 and MMP-9 molecules in the examination of lamina propria transition in the staging of bladder cancer patients

Introduction: In the prognosis of bladder tumors, the tumor stage upgrades when the lamina propria passes through the tumor. The tumors passing the lamina propria is understood after transurethral resection. In our study, mRNA expression and protein levels of the molecule SMAD-2 which is involved in the adhesion of the cells and molecule MMP-9 involved in the destruction of lamina propria in the basal membrane were investigated in order to determine the molecular damage of the tumor as it passed through the lamina propria. Patients and Methods: Blood samples of 57 patients with diagnosis of a changing epithelial cell bladder tumor before transurethral tumor resection were defined as the study group. 20 healthy control groups were included in the study. After blood collection from patients they were centrifuged at 4000 rpm for 10 minutes (Hettich Universal 32), the separated serum were stored at -80 ° C until the number of tests was completed. Pathologic T stages of the patients were determined. Accordingly, Ta and T1 stages are non-muscle invasive bladder cancer; T2 and advanced stage were grouped as muscle invasive bladder cancer. MRNA expression and protein levels of MMP-9 and SMAD-2 molecules were analyzed by Real time PCR and ELISA methods, respectively. Results: No significant difference was found between the control and study groups in terms of age, gender and smoking status. MMP-9 and SMAD-2 protein levels were found to be significantly increased in patients with bladder tumors compared to the control group. (p = 0.0001 for MMP-9, p = 0.0001 for SMAD-2). We found that the difference between the levels of mRNA, which is a gene expression product, is not statistically significant. (p = 0.89 for MMP-9, p = 0.99 for SMAD-2) MMP-9 protein level was found to be significantly increased in pT1 patients compared to pTa and pT2 patients. (p = 0.018, p = 0.02 respectively) Difference between SMAD-2 protein levels were not statistically significant. There was no significant difference between mRNA levels for MMP-9 and SMAD-2. Conclusion: MMP-9 and SMAD-2 protein levels increase in patients with bladder tumors compared to the control group. The level of MMP-9 protein would be useful in detecting the pT1 phase, showing the invasion of lamina propria.