Department of Urology, University of Miami, Miller School of Medicine.
Department of Urologic Oncology, Sylvester Comprehensive Cancer Center, Miami, Florida, USA.
Curr Opin Urol. 2019 May;29(3):203-209. doi: 10.1097/MOU.0000000000000605.
To provide a current comprehensive review of the available urinary biomarkers for the detection and surveillance of bladder cancer.
The limitations of urine cytology and invasive nature of cystoscopic evaluation have led to a growing search for an ideal, cost-effective biomarker with acceptable sensitivity and specificity. Current FDA approved biomarkers such as UroVysion fluorescent in situ hybridization, Immunocyt, and nuclear matrix protein 22 do not have the specificity, and thus positive predictive value to warrant their cost as a routine adjunct or replacement for cystoscopy. Several promising commercially available assays such as Cxbladder, Assure MDx, and Xpert BC may perform better than cytology in select populations. Novel genomic, epigenetic, inflammatory, and metabolomic-based assays are being analyzed as potential urinary biomarkers.
Urinary biomarkers with high sensitivity and specificity are an unmet need in bladder cancer. Several new assays may meet these criteria and future research may justify use in clinical practice.
提供当前有关膀胱癌检测和监测的可用尿生物标志物的综合综述。
尿液细胞学检查的局限性和膀胱镜检查的侵入性，促使人们越来越多地寻找一种理想的、具有成本效益的生物标志物，其具有可接受的灵敏度和特异性。目前美国食品和药物管理局（FDA）批准的生物标志物，如 UroVysion 荧光原位杂交、免疫细胞化学和核基质蛋白 22，其特异性和阳性预测值不足以证明其作为常规辅助检查或替代膀胱镜检查的成本是合理的。一些有前途的商业上可用的检测方法，如 Cxbladder、Assure MDx 和 Xpert BC，在某些人群中的表现可能优于细胞学检查。新型基于基因组、表观遗传学、炎症和代谢组学的检测方法正在被分析为潜在的尿生物标志物。
具有高灵敏度和特异性的尿生物标志物是膀胱癌未满足的需求。一些新的检测方法可能符合这些标准，未来的研究可能会证明其在临床实践中的应用是合理的。
