A study of lipid- and protein- bound sialic acids for the diagnosis of bladder cancer and their relationships with the severity of malignancy

Background: The gold standard for detection of bladder cancer is cystoscopy, which is an invasive and complicated procedure. Our study was conducted to find a tumor marker with high specificity, sensitivity, and accuracy for the diagnosis of bladder cancer. Methods: Serum samples were collected from 58 bladder cancer patients and 60 healthy control subjects. Levels of lipid-bound sialic acid (LBSA), and protein-bound sialic acid (PBSA) were measured spectrophotometrically by Aminoff’s method. Results: Mean levels of both markers were found to be significantly higher in the patients than the healthy controls. Positive correlations were observed between serum levels of lipid- (r=0.283, p < 0.05) and protein- bound (r=0.56, p < 0.05) sialic acids and the grade of malignancy. To differentiate patients with bladder tumors from healthy controls, cut-offpoints were determined for each of the two parameters based on Receiver Operating Characteristic (ROC) curve analysis (LBSA=21.25 mg/dL, PBSA=6.15 mg/dL). The data showed good sensitivities (LBSA=89%, PBSA=79%), specificities (LBSA=70%, PBSA=70%) and accuracies (LBSA=83%, PBSA=81%) for both markers. Conclusion: Measuring serum LBSA and PBSA by this simple, reproducible, noninvasive, and inexpensive method can accurately discriminate cancer patients from healthy individuals.