Ahangar Melika, Mahjoubi Frouzandeh, Mowla Seyed Javad
Department of Clinical Genetics, National Institute of Genetic Engineering and Biotechnology (NIGEB), Tehran, Iran.
Department of Molecular Genetics, Faculty of Biological Sciences, Tarbiat Modares University, Tehran, Iran.
Front Oncol. 2024 Nov 29;14:1453278. doi: 10.3389/fonc.2024.1453278. eCollection 2024.
Bladder cancer is a significant health concern worldwide, necessitating effective diagnostic and monitoring strategies. Biomarkers play a crucial role in the early detection, prognosis, and treatment of this disease. This review explores the current landscape of bladder cancer biomarkers, including FDA-approved molecular biomarkers and emerging ones. FDA-approved molecular biomarkers, such as BTA stat, BTA TRAK, and NMP22, have been instrumental in diagnosing and monitoring bladder cancer. These biomarkers are derived from urinary samples and are particularly useful due to their sensitivity and specificity. As we move forward, we should continue to seek ways to optimize our processes and outcomes, these markers remain seriously challenged in the detection of early bladder cancer due to their limited sensitivity and specificity. For instance, sensitivities of BTA stat in bladder tumor detection have varied between 40-72%, while its specificities vary from 29-96%. In the same way, 70% sensitivity and 80% specificity have been recorded for BTA TRAK, while 11-85.7% sensitivity and 77-100% specificity have been documented for NMP22 BladderChek. The given variations, especially the low sensitivity in the diagnosis of bladder cancer at an early stage call for the invention of better diagnostic systems. Moreover, different sample collection and handling procedures applied in different laboratories further contribute to inconsistent results obtained. Extracellular vesicles (EVs) and exosomes, which carry a vast number of proteins, are being considered as potential biomarkers. Although these markers show promise, challenges remain due to non-standardized isolation techniques and lack of reproducibility across studies. Moreover, the discovery of new potential biomarkers is ongoing. For instance, the UBC Rapid test and UBC ELISA kit, the XPERT BC Monitor, BC UroMark, TaqMan Arrays, Soluble FAS (sFAS), Bladder tumor fibronectin (BTF), and IGF2 and MAGE-A3 are among the newest biomarkers under investigation. In conclusion, while bladder cancer biomarkers have shown great promise, more research is needed to standardize the testing procedures and validate these biomarkers in a clinical setting. This will pave the way for more accurate and efficient diagnosis and monitoring of bladder cancer, ultimately improving patient outcomes.
膀胱癌是全球范围内一个重大的健康问题，需要有效的诊断和监测策略。生物标志物在该疾病的早期检测、预后评估及治疗中发挥着关键作用。本综述探讨了膀胱癌生物标志物的现状，包括美国食品药品监督管理局（FDA）批准的分子生物标志物和新兴的生物标志物。FDA批准的分子生物标志物，如BTA stat、BTA TRAK和NMP22，在膀胱癌的诊断和监测中发挥了重要作用。这些生物标志物来源于尿液样本，因其敏感性和特异性而特别有用。随着我们不断前进，我们应继续寻求优化流程和结果的方法，由于其有限的敏感性和特异性，这些标志物在早期膀胱癌检测中仍面临严峻挑战。例如，BTA stat在膀胱肿瘤检测中的敏感性在40%-72%之间变化，而其特异性在29%-96%之间变化。同样，BTA TRAK的敏感性记录为70%，特异性为80%，而NMP22 BladderChek的敏感性为11%-85.7%，特异性为77%-100%。所给出的这些变化，尤其是在早期膀胱癌诊断中敏感性较低的情况，需要发明更好的诊断系统。此外，不同实验室采用的不同样本采集和处理程序进一步导致了结果的不一致。携带大量蛋白质的细胞外囊泡（EVs）和外泌体正被视为潜在的生物标志物。尽管这些标志物显示出了前景，但由于分离技术不规范以及研究间缺乏可重复性，挑战依然存在。此外，新的潜在生物标志物的发现工作正在进行。例如，UBC快速检测法和UBC ELISA试剂盒、XPERT BC监测仪、BC UroMark、TaqMan芯片、可溶性FAS（sFAS）、膀胱肿瘤纤连蛋白（BTF）以及IGF2和MAGE - A3是正在研究的最新生物标志物。总之，虽然膀胱癌生物标志物已显示出巨大前景，但仍需要更多研究来规范检测程序并在临床环境中验证这些生物标志物。这将为更准确、高效地诊断和监测膀胱癌铺平道路，最终改善患者的治疗效果。
