Introduction
Bladder cancer is the seventh most commonly diagnosed cancer in men, in
whom it is approximately four times more common than in women. At the
time of diagnosis, approximately 75% of patients present with
non-muscle-invasive bladder cancer (NMIBC), which is confined to the
mucosa (Ta, carcinoma in situ) or submucosa (T1)(1). Many meta-analyses
have confirmed that intravesical bacillus Calmette-Guerin (BCG)
immunotherapy after transurethral resection of bladder tumor (TURBT) is
superior to TURBT alone for preventing the recurrence and/or progression
of NMIBC (2-5). Therefore, European Association of Urology (EAU)
Guidelines on NMIBC recommend intravesical BCG immunotherapy after TURBT
in patients with intermediate- or high-risk NMIBC (1).
Some studies have investigated the effect of intravesical BCG
immunotherapy on some angiogenetic factors and cytokines such as
interleukin (IL)-8 in patients with NMIBC (6,7). They suggested that
these factors and cytokines might be used for the follow up after
intravesical BCG immunotherapy in NMIBC. The antitumor features of
intravesical BCG immunotherapy primarily depend on the BCG-induced
inflammatory response (8) that is impaired in NMIBC as reflected by an
imbalanced production of immuno-modulating cytokines (9). It is
important to more fully understand the significance of these cytokines
for predicting outcome of intravesical BCG immunotherapy in NMIBC. Some
studies have showed that proinflammatory cytokines including IL -1,
IL-6, IL-8 and neopterin played an important role in the active immune
response in cancer (10-12). Therefore, these cytokines levels may
decrease after treatment of cancer (surgical resection and medical
therapy). The aim of the present study was to compare IL-1, IL-6, IL-8
and neopterin levels of the patients with NMIBC and healthy controls,
and also investigate the changes in these cytokines and neopterin levels
after TURBT and intravesical BCG immunotherapy.