Serum levels of endostatin and matrix metalloproteinase-9 associated with high stage and grade primary transitional cell carcinoma of the bladder.

Objectives: To analyze the preoperative serum levels of endostatin and matrix metalloproteinase-9 (MMP-9) in patients with primary transitional cell carcinoma of the bladder according to tumor stage and grade and to evaluate their clinical diagnostic application.

Methods: Preoperative serum levels of endostatin and MMP-9 were determined in 52 patients with transitional cell carcinoma of the bladder (13 with superficial carcinoma and 39 with advanced carcinoma) and 32 healthy controls by enzyme-linked immunosorbent assay.

Results: The serum levels of endostatin and MMP-9 were significantly greater in the 52 patients with bladder cancer than in the healthy controls (endostatin 46.8 ng/mL versus 30.6 ng/mL, P <0.001; MMP-9 786 ng/mL versus 417 ng/mL, P <0.001). The endostatin level correlated positively with the MMP-9 level (R = 0.55, P <0.01). Furthermore, the levels of endostatin and MMP-9 were associated with the tumor stage and grade. Patients with distant metastasis (n = 7) had significantly greater levels of endostatin and MMP-9 than patients without metastasis (n = 45) (endostatin 69.8 ng/mL versus 43.3 ng/mL, P <0.001; MMP-9 1529 ng/mL versus 674 ng/mL, P <0.001).

Conclusions: Elevated endostatin and MMP-9 levels are associated with a greater stage and grade of primary transitional cell carcinoma of the bladder.