title: Interleukin-6/10 ratio as a prognostic marker of recurrence in patients with intermediate risk urothelial bladder carcinoma.
abstract: OBJECTIVE
  Several potential markers have been investigated to improve the noninvasive diagnosis of recurrent superficial bladder carcinoma. We evaluated the role of the interleukin-6/10 ratio as a prognostic marker of recurrence in patients with intermediate risk superficial bladder carcinoma.
  
  
  METHODS
  A total of 65 consecutive urological patients seen in the office, including 41 with intermediate risk superficial bladder carcinoma and 24 controls, were selected for this prospective study. Five urine samples for urinary cytology and interleukin analyses were collected from each subject at baseline, and 3, 6, 9 and 12 months after surgery, respectively. Interleukin-6 and 10 were determined in urine by the Quantikine solid phase interleukin-6 and 10 enzyme-linked immunosorbent assay, respectively. Sensitivity, specificity, and positive and negative predictive values of the method were calculated.
  
  
  RESULTS
  At baseline sample collection the interleukin-6/10 ratio was not statistically different between patients and controls (p = 0.58). Interleukin-6/10 was statistically different between patients with vs without recurrence 3 (0.009 vs 0.408), 6 (0.011 vs 0.268), 9 (0.012 vs 0.288) and 12 months (0.009 vs 0.302) after pre-transurethral bladder tumor resection (each p <0.001). Multivariate analysis indicated that interleukin-6/10 was an independent prognostic factor of recurrence (HR 3.62, 95% CI 2.80-4.92, p <0.001). Test sensitivity and specificity were 0.83% (95% CI 0.57-0.95) and 0.76% (95% CI 0.45-0.93), respectively.
  
  
  CONCLUSIONS
  The current study highlights the feasible role of the interleukin-6/10 ratio for predicting intermediate risk superficial bladder carcinoma recurrence. However, clinical trials with a greater number of patients are needed to consider its use in clinical urological practice.
authors.affiliation: Department of Urology, University of Florence, Florence, Italy. ktommy@libero.it
authors.forename: Tommaso
authors.initials: T
authors.lastname: Cai
authors.forename: Sandra
authors.initials: S
authors.lastname: Mazzoli
authors.forename: Francesca
authors.initials: F
authors.lastname: Meacci
authors.forename: Galliano
authors.initials: G
authors.lastname: Tinacci
authors.forename: Gabriella
authors.initials: G
authors.lastname: Nesi
authors.forename: Enzo
authors.initials: E
authors.lastname: Zini
authors.forename: Riccardo
authors.initials: R
authors.lastname: Bartoletti
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000652:urine*; D002295:Carcinoma, Transitional Cell / Q000473:pathology / Q000652:urine*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016753:Interleukin-10 / Q000652:urine*; D015850:Interleukin-6 / Q000652:urine*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology / Q000652:urine*; D009367:Neoplasm Staging; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D012680:Sensitivity and Specificity; D001749:Urinary Bladder Neoplasms / Q000473:pathology / Q000652:urine*; D014556:Urine / Q000166:cytology
chemical_list: D014408:Biomarkers, Tumor; D015850:Interleukin-6; D016753:Interleukin-10