Urinary vascular endothelial growth factor is high in patients with a bladder cancer and correlates with recurrence rates

Introduction: Vascular endothelial growth factor (VEGF) is an important angiogenesis factor expressed at high levels in bladder cancer. A cross-sectional study was performed to measure urinary VEGF levels in patients with bladder cancer. Patients and methods: VEGF was measured in urine samples from 153 patients undergoing bladder tumour cystosurveillance; 97 patients had bladder tumours whilst 56 had clear cystoscopies. VEGF was also measured in the urine from 38 patients with renal cancer. 18 with benign urological conditions and 39 with other ueoplastic conditions, and in protein preparations from macroscopically normal bladder wall from five cadaveric controls and 10 patients with bladder tumours. Results: Urinary VEGF was higher in patients undergoing bladder tumour cystosurveillance than in the other groups (P < 0.011. The mean level in the patients with bladder tumours (205 ng/g creatinine) was 2.7-fold greater than that in those with a clear cystoscopy (75 ng/g creatinine;P < 0.001 ). Higher urinary VEGF levels correlated with higher recurrence rates (P < 0.01). There was no difference in the urinary VEGF levels between pre- and post-TURBT specimens (P =0.66). different tumour stages (P =0.51) or tumour grade (P= 0.59). The median VEGF protein levels in the macroscopically normal bladder from 10 patients with bladder tumours (85 ng/g total protein) was 14-fold higher than in bladder from the five cadaveric controls (6 ng/g total protein; P =0.006). Conclusion: VEGF levels are high in urine from patients with bladder cancer. The correlation with recurrence rate supports a possible role in planning follow-up and indicates the potential benefit from intravesical therapy targeted against VEGF. Higher VEGF protein levels in macroscopically normal urothelium from patients with bladder tumour indicates a source of the VEGF other than the tumour. © 1997 British Journal of Urology.