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Int J Mol Sci. 2023 Sep 21;24(18):14374. doi: 10.3390/ijms241814374.
Bladder cancer is one of the most financially burdensome cancers globally, from its diagnostic to its terminal stages. The impact it imposes on patients and the medical community is substantial, exacerbated by the absence of disease-specific characteristics and limited disease-free spans. Frequent recurrences, impacting nearly half of the diagnosed population, require frequent and invasive monitoring. Given the advancing comprehension of its etiology and attributes, bladder cancer is an appealing candidate for screening strategies. Cystoscopy is the current gold standard for bladder cancer detection, but it is invasive and has the potential for undesired complications and elevated costs. Although urine cytology is a supplementary tool in select instances, its efficacy is limited due to its restricted sensitivity, mainly when targeting low-grade tumors. Although most of these assays exhibit higher sensitivity than urine cytology, clinical guidelines do not currently incorporate them. Consequently, it is necessary to explore novel screening assays to identify distinctive alterations exclusive to bladder cancer. Thus, integrating potential molecular assays requires further investigation through more extensive validation studies. Within this article, we offer a comprehensive overview of the critical features of bladder cancer while conducting a thorough analysis of the FDA-approved assays designed to diagnose and monitor its recurrences.
膀胱癌是全球医疗费用负担最重的癌症之一,从诊断到晚期都需要大量的费用。它对患者和医疗界造成的影响是巨大的,而且由于缺乏疾病特异性特征和有限的无病生存期,这种影响还在加剧。近一半被诊断出患有膀胱癌的患者会频繁复发,需要频繁且有创的监测。鉴于对膀胱癌病因和特征的认识不断提高,它是筛查策略的一个有吸引力的候选对象。膀胱镜检查是目前膀胱癌检测的金标准,但它具有侵入性,并且有潜在的不良并发症和高昂的成本。虽然尿细胞学检查在某些情况下是一种辅助工具,但由于其敏感性有限,主要是针对低级别肿瘤,因此其效果有限。虽然这些检测方法中的大多数比尿细胞学检查具有更高的敏感性,但临床指南目前并没有将它们纳入其中。因此,有必要探索新的筛查检测方法来识别膀胱癌特有的改变。因此,需要通过更广泛的验证研究进一步研究整合潜在的分子检测方法。在本文中,我们全面概述了膀胱癌的关键特征,并对 FDA 批准的用于诊断和监测膀胱癌复发的检测方法进行了深入分析。