The role of SHMT2 and NDUFA4L2 gene expression and UCA1 levels in Egyptian patients with bladder cancer.

Bladder Cancer (BC) has a significant burden, with poor survival rates in advanced cases. This case-controlled study aimed to identify genes having diagnostic and prognostic value. Seventy patients with BC and 70 healthy individuals were included. Real-time PCR was used to quantify the expression of the SHMT2 and NDUFA4L2 genes, and UCA1 levels. Results showed that SHMT2, NDUFA4L2, and UCA1 were significantly upregulated in patients compared to the control group (p < 0.001). The area under the receiver operating characteristic curve (ROC) analysis showed that AUC was 0.995 (95% CI = 0.989-1, p < 0.001), 0.994 (95% CI = 0.987-1, p < 0.001) and 0.977 (95% CI = 0.958-0.996, p < 0.001) for UCA1, SHMT2, and NDUFA4L2, respectively with high diagnostic sensitivity and specificity. Additionally, the high expression of SHMT2 and the high level of UCA1 were correlated with histological grade (p < 0.001and 0.001, respectively) and with CT tumor size (p = 0.005 and 0.001, respectively). In univariate COX regression analysis, SHMT2 and UCA1 were poor prognostic (p = 0.003 and 0.001, respectively). Furthermore, in the multivariate analysis, UCA1 was independent poor prognostic factor (p =0.037). Thus, SHMT2, NDUFA4L2, and UCA1 could be promising diagnostic and prognostic biomarkers and a novel therapeutic target.