Prognostic value of a T helper 1 urinary cytokine response after intravesical bacillus Calmette-Guerin treatment for superficial bladder cancer.
OBJECTIVE
Interleukin (IL)-2 and interferon-gamma are released during T helper 1 lymphocyte responses, while IL-10 is released during T helper 2 responses. We evaluated the prognostic value of urinary IL-2, interferon-gamma and IL-10 levels in patients with superficial bladder cancer treated with bacillus Calmette-Guerin (BCG) instillation.


METHODS
Urinary IL-2, interferon-gamma and IL-10 were measured by enzyme-linked immunosorbent assay in 37 patients receiving BCG for stages Ta/T1 superficial bladder cancer, and carcinoma in situ. Measurements were made after instillations 5 and 6 during a course of 6 weekly instillations of 150 mg. BCG, Pasteur strain. Correlations of cytokine levels with the clinical outcome were evaluated using the log rank test.


RESULTS
Median followup was 29 months. Patients with urinary IL-2 less than 27 pg./micromol. creatinine were significantly more likely to have recurrences than those with higher values (log rank test p = 0.0009). Urinary IL-10 and interferon-gamma levels had no apparent impact on the risk of recurrence or progression.


CONCLUSIONS
Urinary IL-2 levels may serve to identify patients at risk for bladder cancer recurrence after a single course of BCG and, thus, to tailor individual treatment.
Saint
Fabien
F
Department of Urology, Groupe d'Etude des Tumeurs Urologiques, EMI-INSERM 99/09, Hôpital Henri Mondor, Créteil, France.
Patard
Jean J
JJ
Maille
Pascale
P
Soyeux
Pascale
P
Hoznek
André
A
Salomon
Laurent
L
Abbou
Claude C
CC
Chopin
Dominique K
DK
D000368:Aged; D001500:BCG Vaccine / Q000008:administration & dosage / Q000627:therapeutic use*; D002295:Carcinoma, Transitional Cell / Q000188:drug therapy*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D007371:Interferon-gamma / Q000652:urine*; D016753:Interleukin-10 / Q000652:urine; D007376:Interleukin-2 / Q000652:urine*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D011379:Prognosis; D006377:T-Lymphocytes, Helper-Inducer / Q000378:metabolism; D001749:Urinary Bladder Neoplasms / Q000188:drug therapy*
D001500:BCG Vaccine; D007376:Interleukin-2; D016753:Interleukin-10; D007371:Interferon-gamma