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The urinary bladder is a hollow, muscular sac that temporarily stores urine before it is expelled from the body. It can hold approximately 600 mL of urine prior to micturition. The bladder is retroperitoneal and located behind the pubic symphysis in the pelvic floor.
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Residual stresses reside in a structure even after removing the original stress inducer. This phenomenon often arises from varied plastic deformations across different parts of a structure. Consider a rod stretched beyond its yield point. It will not regain its original length due to permanent deformation. Even after load removal, the rod does not entirely lose stress because of uneven plastic deformations, resulting in residual stresses. The computation of these stresses in structures is...
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In materials that exhibit elastic and plastic behavior, known as elastoplastic materials, residual stresses can accumulate when these materials experience plastic deformation. This deformation arises from either high levels of shearing stress or significant strains. Residual stresses are internal stresses that persist within a material after removing the external force causing deformation. This phenomenon is demonstrated when observing the behavior of a shaft under torque; notably, the...
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Urinary Biomarkers Objectively Measure Minimal Residual Disease in Non-Muscle-Invasive Bladder Cancer.

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Carcinoma in situ (CIS) is not a sufficient measure of minimal residual disease (MRD) in non-muscle-invasive bladder cancer (NMIBC). Pretreatment urinary cytology and urinary tumor DNA (utDNA) offer more objective MRD assessment for NMIBC risk stratification.

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Area of Science:

  • Urology
  • Oncology
  • Molecular Diagnostics

Background:

  • Non-muscle-invasive bladder cancer (NMIBC) management relies on accurate assessment of minimal residual disease (MRD).
  • Carcinoma in situ (CIS) is a non-invasive form of bladder cancer, and its eradication is a key treatment goal.
  • Current methods for assessing MRD in NMIBC may have limitations.

Purpose of the Study:

  • To evaluate if CIS is a sufficient measure of MRD in NMIBC.
  • To identify and assess alternative biomarkers for MRD in NMIBC.
  • To improve risk stratification and treatment assessment for NMIBC patients.

Main Methods:

  • Concordance analysis of CIS on transurethral resection of bladder tumor (TURBT) and radical cystectomy (RC) specimens.
  • Prospective evaluation of pretreatment urinary cytology and urinary tumor DNA (utDNA) as biomarkers in BCG-naive high-grade NMIBC.
  • Assessment of high-grade recurrence-free survival (HG-RFS) in relation to biomarkers.

Main Results:

  • Only 20% of clinical CIS (cCIS) cases were eradicated by TURBT alone.
  • Abnormal pretreatment urinary cytology, unlike cCIS, was associated with occult pathologic CIS (pCIS).
  • Pretreatment urinary cytology and utDNA demonstrated superior predictive value for HG-RFS compared to cCIS (AUCs: 0.68/0.74 vs. 0.52).

Conclusions:

  • CIS assessment via TURBT is an inadequate measure of MRD in NMIBC.
  • Pretreatment urinary cytology and utDNA are more objective and reliable biomarkers for MRD assessment in NMIBC.
  • These urine-based biomarkers can enhance risk stratification and treatment response evaluation for NMIBC.