Evaluation of Serum Fibronectin Levels and Fibronectin Gene Polymorphism in Patients Receiving Intravesical BCG Therapy for NonMuscle Invasive Bladder Cancer

Abstract Background: Bladder cancer remains a significant health concern, prompting research into novel biomarkers and treatment strategies. In this study, we aimed to investigate the serum fibronectin levels and gene polymorphisms between patients with NMIBC receiving intravesical BCG treatment and the control group. Methods: Between June 2022 and December 2022, data of 73 patients who applied to the Mersin University Urology Clinic due to NMIBC and were followed and treated in our clinic, receiving intravesical BCG treatment, when necessary, as well as 56 individuals without any malignancy, were prospectively examined. Serum fibronectin levels were measured using the ELISA method. PCR testing was applied for the fibronectin gene RS10202709 and RS 35343655 gene polymorphisms by using Real-Time PCR. Results: The mean serum fibronectin level in the patient group was 76.794±66.998ng/ml. Simultaneously, it was 50.486±25.156ng/ml in the control group, and these differences in serum fibronectin levels were statistically significant(p=0.003). Out of the 73 patients included in the study, recurrence of bladder cancer was observed in 53 of them. They were divided into two groups based on the recurrence times: early recurrence and late recurrence. When examined in terms of fibronectin levels, it was calculated that the mean fibronectin level in the early recurrence group was 102±86.1ng/ml.At the same time,it was 44.7±11.8ng/ml in the late recurrence group (p<0.001). Conclusions: The statistically higher concentrations of serum fibronectin levels in patients with bladder cancer observed in our study are a noteworthy finding.However, we do not anticipate it to be predictive of the response to intravesical BCG treatment.Additionally,the statistically significant findings in our study regarding serum fibronectin level measurements in predicting early and late recurrences suggest that it will provide guiding information about the prognosis of the disease. Trial registration: Ethical approval for the research was obtained from the Mersin University Faculty of Medicine Local Ethics Committee with the decision dated 23.03.2022, numbered 2022/200.