OCT 12, 2020 6:18 AM PDT

Urine analysis is better at detecting bladder cancer than urine cytology

In a study published recently in the American Association for Cancer Research journal Clinical Cancer Research, scientists from China suggest that a new type of urine analysis is better at detecting urothelial carcinoma than urine cytology.

"Urine cytology, which is widely used to screen for bladder cancer, has high specificity but lacks sensitivity, especially for low-grade cancers," said study author Chuan-Liang Xu, MD, PhD, who is a urologist at Changhai Hospital in Shanghai. "Cystoscopy, while more accurate than cytology, is an invasive procedure with added costs and potential complications for the patient," he added. "Therefore, an inexpensive, non-invasive test for the detection and monitoring of bladder cancer is an unmet clinical need."

Xu and study co-author Jia-Tao Ji, MD, PhD, a urologist at Shanghai Hudong Hospital, decided to try to address that unmet need by designing a way to detect DNA copy number variants (CNVs) in urine. CNVs are a type of structural variation in DNA occurring from a duplication or deletion event that affects a considerable number of base pairs. CNVs are present in many cancers.

"The DNA isolated from urine exfoliated cells, a complex cell mixture that potentially includes tumor cells shed from the lining of the bladder, can provide clues to the presence of bladder cancer," said Ji. "Because CNVs are a hallmark of many cancers, we developed an assay to detect CNV burden in the DNA from urine exfoliated cells."

The assay the team created is called UroCAD. UroCAD uses a cost-effective low-coverage whole-genome sequencing to analyze a urine sample in order to detect the presence of CNV. In their trials, the researchers used UroCAD on 190 patients (126 with urothelial carcinoma, 64 without cancer) participated and no significant CNV burden in participants without cancer. They later determined that UroCAD was capable of detecting urothelial carcinoma with a sensitivity and specificity of 82.5% and 96.9%, respectively.

In comparison to the conventional bladder cancer detection method of urine cytology, UroCAD had significantly higher sensitivity (80.4% vs 33.9%) and comparable specificity (94.9% vs 100%) for the detection of urothelial carcinoma. The team also showed that for seven patients whose low-grade tumors were only in the epithelial layer of the bladder, UroCAD had a sensitivity of 71.4%, while urine cytology had a sensitivity of 0%.

Photo: Pexels

"Ultimately, we believe that our assay could help to reduce the frequency of cystoscopy examination, but not to replace it" says Xu. "For patients with hematuria or who have suspected urothelial carcinoma, UroCAD is a promising way to replace cytology and to reduce repeated cystoscopy examinations," Ji added, saying that they are currently conducting clinical trials to determine the sensitivity of UroCAD for the surveillance of urothelial carcinoma.

Sources: Clinical Cancer Research, Eureka Alert

About the Author
  • Kathryn is a curious world-traveller interested in the intersection between nature, culture, history, and people. She has worked for environmental education non-profits and is a Spanish/English interpreter.
You May Also Like
SEP 16, 2020
Cancer
I'm addicted to the sun, are you?
SEP 16, 2020
I'm addicted to the sun, are you?
New research published in the Journal of Investigative Dermatology reports evidence that some people are geneticall ...
OCT 05, 2020
Cancer
Does Having an Appendectomy Increase Your Risk for Cancer?
OCT 05, 2020
Does Having an Appendectomy Increase Your Risk for Cancer?
Cancer research is more than just the study of diagnostics and novel therapies. Researchers also investigate the causes ...
OCT 05, 2020
Cancer
Fighting mitochondrial terminal exhaustion
OCT 05, 2020
Fighting mitochondrial terminal exhaustion
New findings reported in Nature Immunology highlight how the tumor microenvironment attacks the mitochondria of T l ...
OCT 18, 2020
Cancer
Virus-mimicking drug attacks melanoma tumors
OCT 18, 2020
Virus-mimicking drug attacks melanoma tumors
Research published recently in the journal Science Translational Medicine from scientists at the UCLA Jonsson Compr ...
OCT 27, 2020
Cancer
Increased muscle mass improves outcomes for colorectal cancer surgery
OCT 27, 2020
Increased muscle mass improves outcomes for colorectal cancer surgery
New research published in JAMA Surgery reports a new way to prepare for surgery: sit-ups. According to the findings ...
NOV 11, 2020
Cell & Molecular Biology
Visualizing a Tumor Suppressor in Action
NOV 11, 2020
Visualizing a Tumor Suppressor in Action
Many types of cells in our bodies are short-lived and need to be replenished. Cell division has to be carefully controll ...
Loading Comments...