An exploratory study of BLCA-4 expression, STR analysis, and urothelial cytology in smokers versus non-smokers with bladder cancer.

Background: Numerous studies have established that smoking is associated with a threefold increase in the risk of developing bladder cancer. However, the precise relationship between smoking and the underlying genetic and morphological alterations remains an active area of investigation. Therefore, this study was designed to explore BLCA-4 expression and perform short tandem repeat (STR) genotyping using blood and urine samples from both smokers and non-smokers patients with bladder cancer, as well as from healthy controls. Additionally, cytological examination of urinary epithelial cells was conducted. Methods: A total of 273 participants were enrolled and stratified into three distinct groups: healthy controls with no smoking history (HPG, n = 70); patients diagnosed with bladder cancer with no smoking history (BC-S, n = 101); and patients diagnosed with bladder cancer with a positive smoking history (BC+S, n = 102). Results: This study demonstrates that the mean BLCA-4 concentration was significantly (P < 0.01) elevated in BC-S and BC+S groups relative to the HPG group across both blood and urine analysis. In the BC-S samples, a low-grade urothelial tumor was detected. In contrast, a high-grade urothelial tumor characterized by multiple large, isolated malignant cell structures was found in the BC+S samples. The results indicated changes at four loci (CSF1PO, D21S11, D7S820, and D2S1338); in contrast, the other five loci (Amelogenin, D13S317, D16S539, D18S51, and FGA) remained unchanged in LOH and MSI analysis across STR loci in urine samples from the BC-S and BC+S groups. Conclusions: Urine samples may be practically employed for diagnosing and predicting BC could be practically employed for STR genotyping to estimate the impact of smoking in patients with BC.