Bladder cancer detection by urinary extracellular vesicle mRNA analysis

Area of Science:

• Uro-oncology
• Molecular diagnostics
• Biomarker discovery

Background:

• Urinary extracellular vesicles (EVs) are emerging as potential biomarkers for urological diseases.
• Early detection of bladder cancer is crucial for improving patient outcomes.

Purpose of the Study:

• To screen for potential mRNA biomarkers in urinary EVs for early-stage bladder cancer detection.
• To evaluate the diagnostic performance of identified EV mRNA markers in a larger patient cohort.

Main Methods:

• RNA sequencing (RNA-seq) was used to identify candidate EV mRNA biomarkers from urinary samples.
• Reverse transcription quantitative polymerase chain reaction (RT-qPCR) was employed to validate diagnostic performance in a larger patient group.

Main Results:

• Urinary EVs SLC2A1, GPRC5A, and KRT17 mRNA were significantly overexpressed in bladder cancer, with fold changes of 20.6, 18.2, and 29.5, respectively.
• These markers demonstrated diagnostic potential for non-muscle invasive bladder cancer (pTa, pTis, pT1) and muscle-invasive bladder cancer (pT2+), with AUCs ranging from 0.56 to 0.90.
• Subgroup analysis suggested utility in detecting cytology-negative/suspicious and recurrent bladder cancers.

Conclusions:

• Three urinary EV mRNA biomarkers (SLC2A1, GPRC5A, KRT17) were identified as elevated in bladder cancer.
• Urinary EV mRNA analysis represents a promising approach for urothelial cancer biomarker discovery.
• Further investigation into these urinary EV mRNA biomarkers is warranted.