Bladder cancer risk stratification using a urinary mRNA biomarker panel - A path towards cystoscopy triaging

Area of Science:

• Urology
• Oncology
• Biomarker Discovery

Background:

• Cystoscopy is essential for bladder cancer (BCa) diagnosis and recurrence monitoring.
• Improved risk stratification can personalize patient triage and surveillance strategies.
• Current methods for BCa risk assessment can be invasive and burdensome.

Purpose of the Study:

• To develop a urinary mRNA biomarker panel for risk stratification in patients undergoing BCa screening and surveillance.
• To create a non-invasive tool for identifying patients with increased-risk BCa.
• To evaluate the potential of this panel to reduce the need for cystoscopies.

Main Methods:

• Urine samples were collected from 177 patients undergoing cystoscopy.
• mRNA expression of ROBO1, WNT5A, CDC42BPB, ABL1, CRH, IGF2, ANXA10, and UPK1B was analyzed.
• A diagnostic model was developed using logistic regression and validated with cross-validation to detect "increased-risk" BCa.

Main Results:

• A 3-marker panel (ROBO1, CRH, IGF2) achieved 92.5% sensitivity and 73.5% specificity for detecting "increased-risk" BCa.
• The model demonstrated a standardized net benefit of 0.81.
• Expression of ROBO1, CRH, and IGF2 correlated with "increased-risk" disease.

Conclusions:

• A 3-marker urinary mRNA panel offers a non-invasive method for identifying "increased-risk" bladder cancer.
• Further validation could establish this panel as a tool to decrease cystoscopy frequency in low-risk patients.
• This approach may enhance personalized surveillance and triage strategies for bladder cancer.