# Low Cubilin/Myeloperoxidase ratio as a promising biomarker for prognosis of high-grade T1 bladder cancer

## TL;DR

A low ratio of two proteins in urine may help predict which early-stage bladder cancers are more likely to return or worsen.

## Contribution

The study introduces the CUBN/MPO ratio as a novel urinary biomarker for high-grade T1 bladder cancer prognosis.

## Key findings

- A low CUBN/MPO ratio was linked to higher recurrence and progression rates in patients.
- Patients with low CUBN/MPO ratios had a greater risk of disease recurrence and death.
- The study suggests the CUBN/MPO ratio could guide early interventions for aggressive bladder cancers.

## Abstract

T1 bladder cancer is known for its high progression and recurrence rates. Identifying aggressive tumours at the non-muscle-invasive stage is crucial to allow early interventions and subsequently increase patient survival. This study aimed to investigate the potential of the cubilin/myeloperoxidase (CUBN/MPO) ratio as a high-grade T1 bladder cancer biomarker.

Urine samples were collected from 30 patients who underwent transurethral resection of the tumour with high-grade T1 bladder cancer (June 2015 to December 2019) before surgery. The urinary proteome was analysed using high-resolution mass spectrometry and the CUBN/MPO ratio was calculated. The primary outcome was the recurrence during the follow-up (around 31.5 months after resection). Univariate Cox regression and Kaplan–Meier curves were used for data analysis.

Patients with a low CUBN/MPO ratio exhibited upregulated MPO and/or downregulated CUBN. This group of patients had a higher incidence of disease recurrence and progression. Low CUBN/MPO ratio was significantly associated with a higher likelihood of recurrence, progression, and death. It is worth noting that this study was exploratory and conducted on a small sample size, so further research is needed to validate these findings in larger cohorts.

This study highlights the potential of the CUBN/MPO ratio as a prognostic biomarker for high-grade T1 bladder cancer.

The online version contains supplementary material available at 10.1007/s11255-024-03971-4.