Association Between Positive iNOS mRNA Expression and Recurrence-free Survival Among Patients with Non-muscle-invasive Bladder Cancer

Abstract 

Objective

Nitric oxide synthase is the key enzyme of the conversion of L-arginine to L-citrulline and nitric oxide. We conducted a study to investigate the association between positive inducible nitric oxide synthase (iNOS) mRNA expression and recurrence of bladder cancer.

Materials and Methods

Seventy-one patients with primary non-muscleinvasive bladder cancer were enrolled in this study. Tumor tissues were harvested during transurethral resection of bladder tumors. All operations were performed at the same hospital. Recurrence-free patients were followed up for at least 1 year unless tumors recurred during that time. The median intervals of follow-up were 34 months in the recurrence-free group and 12 months in the recurrence group. iNOS mRNA was detected using the RT-PCR-based method.

Results

Bladder cancer patients with positive iNOS mRNA expression had a higher recurrence risk (18.7% vs. 2.6%; p = 0.04). After adjusting for other risk factors, a statistical significance remained (p = 0.04; hazards ratio = 13.27; 95% CI = 1.07–164.36). The patients also had reduced recurrence-free survival (p = 0.019).

Conclusion

The positive expression of iNOS mRNA may be a useful prognostic indicator of bladder cancer.

Keywords:  Bladder cancer , Inducible nitric oxide synthase , Messenger RNA , Recurrence , Reverse transcriptase polymerase chain reaction

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