Enhanced oxidative stress and the glycolytic switch in superficial urothelial carcinoma of urinary bladder

Objective: To examine whether oxidative stress and the glycolytic switch are correlated to tumor grading, tumor recurrence, and disease progression in urothelial carcinoma (UC) of the urinary bladder (UB). Methods: All surgical specimens obtained from 27 patients (each containing their UC and normal tissues of UB) were subjected to a pathological examination by computerized tomography, and a portion of each specimen was used for the analysis of molecular biomarkers. The mRNA expression levels of pyruvate dehydrogenase kinase-1 (PDK1), hypoxia-inducible factor 1 alpha (HIF-1α), lactate dehydrogenase A (LDHA), pyruvate dehydrogenase, and glucose transporter protein 1 (Glut-1) were measured using TaqMan-based real-time quantitative polymerase chain reaction. In addition, 8-hydroxy-2-deoxyguanosine (8-OHdG) and the mitochondrial DNA (mtDNA) copy number were also determined. Results: The 8-OHdG content and glycolytic genes expression were higher in UC of the UB than those in the normal tissues of UB, whereas the mtDNA copy number was depleted. According to the multivariate analysis, patients with Grade 3 tumors had higher expression levels of HIF-1α, LDHA, and Glut-1 than those with Grades 1 and 2 tumors. In addition, patients with locally recurrent tumors had a higher expression of HIF-1α and LDHA than those with nonrecurrent tumors. Furthermore, patients under disease progression had higher levels of HIF-1α and PDK1 than those not under disease progression. Conclusions: UC of the UB manifested that the glycolytic phenotype would reflect the Warburg effect. We suggest that the molecular mechanism in the regulation of glycolytic switch in UC of the UB might provide a specific biomarker for the future development of cancer diagnosis.