Introduction
Bladder cancer is the seventh most commonly diagnosed cancer in men, in whom it is approximately four times more common than in women. At the time of diagnosis, approximately 75% of patients present with non-muscle-invasive bladder cancer (NMIBC), which is confined to the mucosa (Ta, carcinoma in situ) or submucosa (T1)(1). Many meta-analyses have confirmed that intravesical bacillus Calmette-Guerin (BCG) immunotherapy after transurethral resection of bladder tumor (TURBT) is superior to TURBT alone for preventing the recurrence and/or progression of NMIBC (2-5). Therefore, European Association of Urology (EAU) Guidelines on NMIBC recommend intravesical BCG immunotherapy after TURBT in patients with intermediate- or high-risk NMIBC (1).
Some studies have investigated the effect of intravesical BCG immunotherapy on some angiogenetic factors and cytokines such as interleukin (IL)-8 in patients with NMIBC (6,7). They suggested that these factors and cytokines might be used for the follow up after intravesical BCG immunotherapy in NMIBC. The antitumor features of intravesical BCG immunotherapy primarily depend on the BCG-induced inflammatory response (8) that is impaired in NMIBC as reflected by an imbalanced production of immuno-modulating cytokines (9). It is important to more fully understand the significance of these cytokines for predicting outcome of intravesical BCG immunotherapy in NMIBC. Some studies have showed that proinflammatory cytokines including IL -1, IL-6, IL-8 and neopterin played an important role in the active immune response in cancer (10-12). Therefore, these cytokines levels may decrease after treatment of cancer (surgical resection and medical therapy). The aim of the present study was to compare IL-1, IL-6, IL-8 and neopterin levels of the patients with NMIBC and healthy controls, and also investigate the changes in these cytokines and neopterin levels after TURBT and intravesical BCG immunotherapy.