Prognostic Value of Oxidative Stress Markers in Bladder Cancer: A Study of Ceruloplasmin, ADMA, MPO, XO, TAS, and TOS

Objective: This study aimed to evaluate the oxidant and antioxidant balance in patients with bladder cancer and to investigate the association between oxidative stress markers ceruloplasmin, asymmetric dimethylarginine (ADMA), myeloperoxidase (MPO), xanthine oxidase (XO), total antioxidant status (TAS), and total oxidant status (TOS) with tumor grade and invasion. Methods: This prospective study included 49 patients with histopathologically confirmed bladder cancer and 49 age- and sex-matched healthy controls. Serum levels of ceruloplasmin, ADMA, MPO, XO, TAS, and TOS were measured using standard biochemical methods. Results: Compared with the control group, patients with bladder cancer had significantly higher levels of ceruloplasmin, ADMA, MPO, XO, and TOS (p = 0.001 for all), while TAS levels were significantly lower (p = 0.001). As tumor stage and grade increased, ceruloplasmin, ADMA, and MPO levels significantly increased (p < 0.05), whereas XO, TAS, and TOS levels showed no significant differences. Conclusion: Our findings demonstrate that oxidative stress is markedly increased, while antioxidant defense is impaired in patients with bladder cancer. The disturbed oxidant-antioxidant equilibrium is prominently associated with tumor presence. Furthermore, progressive alterations in ceruloplasmin, ADMA, and MPO may reflect tumor progression and biological aggressiveness, suggesting their potential utility as supportive indicators alongside standard clinical parameters.