1
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Wang P, Wei X, Qu X, Zhu Y. Potential clinical application of microRNAs in bladder cancer. J Biomed Res 2024; 38:289-306. [PMID: 38808545 PMCID: PMC11300522 DOI: 10.7555/jbr.37.20230245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Revised: 01/05/2024] [Accepted: 01/12/2024] [Indexed: 05/30/2024] Open
Abstract
Bladder cancer (BC) is the tenth most prevalent malignancy globally, presenting significant clinical and societal challenges because of its high incidence, rapid progression, and frequent recurrence. Presently, cystoscopy and urine cytology serve as the established diagnostic methods for BC. However, their efficacy is limited by their invasive nature and low sensitivity. Therefore, the development of highly specific biomarkers and effective non-invasive detection strategies is imperative for achieving a precise and timely diagnosis of BC, as well as for facilitating an optimal tumor treatment and an improved prognosis. microRNAs (miRNAs), short noncoding RNA molecules spanning around 20-25 nucleotides, are implicated in the regulation of diverse carcinogenic pathways. Substantially altered miRNAs form robust functional regulatory networks that exert a notable influence on the tumorigenesis and progression of BC. Investigations into aberrant miRNAs derived from blood, urine, or extracellular vesicles indicate their potential roles as diagnostic biomarkers and prognostic indicators in BC, enabling miRNAs to monitor the progression and predict the recurrence of the disease. Simultaneously, the investigation centered on miRNA as a potential therapeutic agent presents a novel approach for the treatment of BC. This review comprehensively analyzes biological roles of miRNAs in tumorigenesis and progression, and systematically summarizes their potential as diagnostic and prognostic biomarkers, as well as therapeutic targets for BC. Additionally, we evaluate the progress made in laboratory techniques within this field and discuss the prospects.
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Affiliation(s)
- Pei Wang
- Laboratory Medicine Center, the Second Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210011, China
| | - Xiaowei Wei
- Laboratory Medicine Center, the Second Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210011, China
| | - Xiaojun Qu
- Laboratory Medicine Center, the Second Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210011, China
| | - Yefei Zhu
- Laboratory Medicine Center, the Second Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210011, China
- School of Biological Science and Medical Engineering, Southeast University, Nanjing, Jiangsu 210096, China
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2
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Abid R, Hussein AA, Guru KA. Artificial Intelligence in Urology: Current Status and Future Perspectives. Urol Clin North Am 2024; 51:117-130. [PMID: 37945097 DOI: 10.1016/j.ucl.2023.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2023]
Abstract
Surgical fields, especially urology, have shifted increasingly toward the use of artificial intelligence (AI). Advancements in AI have created massive improvements in diagnostics, outcome predictions, and robotic surgery. For robotic surgery to progress from assisting surgeons to eventually reaching autonomous procedures, there must be advancements in machine learning, natural language processing, and computer vision. Moreover, barriers such as data availability, interpretability of autonomous decision-making, Internet connection and security, and ethical concerns must be overcome.
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Affiliation(s)
- Rayyan Abid
- Case Western Reserve University, 10900 Euclid Avenue, Cleveland, OH 44106, USA
| | - Ahmed A Hussein
- Department of Urology, Roswell Park Comprehensive Cancer Center
| | - Khurshid A Guru
- Department of Urology, Roswell Park Comprehensive Cancer Center.
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3
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Emami Nejad A, Mostafavi Zadeh SM, Nickho H, Sadoogh Abbasian A, Forouzan A, Ahmadlou M, Nedaeinia R, Shaverdi S, Manian M. The role of microRNAs involved in the disorder of blood-brain barrier in the pathogenesis of multiple sclerosis. Front Immunol 2023; 14:1281567. [PMID: 38193092 PMCID: PMC10773759 DOI: 10.3389/fimmu.2023.1281567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 10/30/2023] [Indexed: 01/10/2024] Open
Abstract
miRNAs are involved in various vital processes, including cell growth, development, apoptosis, cellular differentiation, and pathological cellular activities. Circulating miRNAs can be detected in various body fluids including serum, plasma, saliva, and urine. It is worth mentioning that miRNAs remain stable in the circulation in biological fluids and are released from membrane-bound vesicles called exosomes, which protect them from RNase activity. It has been shown that miRNAs regulate blood-brain barrier integrity by targeting both tight junction and adherens junction molecules and can also influence the expression of inflammatory cytokines. Some recent studies have examined the impact of certain commonly used drugs in Multiple Sclerosis on miRNA levels. In this review, we will focus on the recent findings on the role of miRNAs in multiple sclerosis, including their role in the cause of MS and molecular mechanisms of the disease, utilizing miRNAs as diagnostic and clinical biomarkers, using miRNAs as a therapeutic modality or target for Multiple Sclerosis and drug responses in patients, elucidating their importance as prognosticators of disease progression, and highlighting their potential as a future treatment for MS.
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Affiliation(s)
| | - Seyed Mostafa Mostafavi Zadeh
- Department of Molecular Medicine, Faculty of Advanced Technologies in Medicine, Iran University of Medical Sciences, Tehran, Iran
- Oncopathology Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Hamid Nickho
- Department of Immunology, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Ali Sadoogh Abbasian
- Department of Internal Medicine, School of Medicine, Amiralmomenin Hospital, Arak University of Medical Sciences, Arak, Iran
| | - Azim Forouzan
- Department of Internal Medicine, School of Medicine, Amiralmomenin Hospital, Arak University of Medical Sciences, Arak, Iran
| | - Mojtaba Ahmadlou
- Department of Biostatistics, School of Medicine, Arak University of Medical Sciences, Arak, Iran
| | - Reza Nedaeinia
- Pediatric Inherited Diseases Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Saham Shaverdi
- Department of Biology, Payame Noor University (PNU), Tehran, Iran
| | - Mostafa Manian
- Department of Medical Laboratory Science, Faculty of Medicine, Islamic Azad University, Kermanshah, Iran
- Neurosciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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4
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Wu S, Li R, Jiang Y, Yu J, Zheng J, Li Z, Li M, Xin K, Wang Y, Xu Z, Li S, Chen X. Liquid biopsy in urothelial carcinoma: Detection techniques and clinical applications. Biomed Pharmacother 2023; 165:115027. [PMID: 37354812 DOI: 10.1016/j.biopha.2023.115027] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 06/13/2023] [Accepted: 06/14/2023] [Indexed: 06/26/2023] Open
Abstract
The types of urothelial carcinoma (UC) include urothelial bladder cancer and upper tract urothelial carcinoma. Current diagnostic techniques cannot meet the needs of patients. Liquid biopsy is an accurate method of determining the molecular profile of UC and is a cutting-edge and popular technique that is expected to complement existing detection techniques and benefit patients with UC. Circulating tumor cells, cell-free DNA, cell-free RNA, extracellular vesicles, proteins, and metabolites can be found in the blood, urine, or other bodily fluids and are examined during liquid biopsies. This article focuses on the components of liquid biopsies and their clinical applications in UC. Liquid biopsies have tremendous potential in multiple aspects of precision oncology, from early diagnosis and treatment monitoring to predicting prognoses. They may therefore play an important role in the management of UC and precision medicine.
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Affiliation(s)
- Siyu Wu
- Department of Urology, Shengjing Hospital of China Medical University, Shenyang, Liaoning 110004, China
| | - Rong Li
- Department of Urology, Shengjing Hospital of China Medical University, Shenyang, Liaoning 110004, China
| | - Yuanhong Jiang
- Department of Urology, Shengjing Hospital of China Medical University, Shenyang, Liaoning 110004, China
| | - Jiazheng Yu
- Department of Urology, Shengjing Hospital of China Medical University, Shenyang, Liaoning 110004, China
| | - Jianyi Zheng
- Department of Urology, Shengjing Hospital of China Medical University, Shenyang, Liaoning 110004, China
| | - Zeyu Li
- Department of Urology, Shengjing Hospital of China Medical University, Shenyang, Liaoning 110004, China
| | - Mingyang Li
- Department of Urology, Shengjing Hospital of China Medical University, Shenyang, Liaoning 110004, China
| | - Kerong Xin
- Department of Urology, Shengjing Hospital of China Medical University, Shenyang, Liaoning 110004, China
| | - Yang Wang
- Department of Gynecology, Cancer Hospital of China Medical University, Liaoning Cancer Hospital & Institute, Shenyang, Liaoning 110042, China.
| | - Zhenqun Xu
- Department of Urology, Shengjing Hospital of China Medical University, Shenyang, Liaoning 110004, China.
| | - Shijie Li
- Department of Urology, Shengjing Hospital of China Medical University, Shenyang, Liaoning 110004, China.
| | - Xiaonan Chen
- Department of Urology, Shengjing Hospital of China Medical University, Shenyang, Liaoning 110004, China.
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5
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Zhao J, Li J, Zhang R. Off the fog to find the optimal choice: Research advances in biomarkers for early diagnosis and recurrence monitoring of bladder cancer. Biochim Biophys Acta Rev Cancer 2023; 1878:188926. [PMID: 37230421 DOI: 10.1016/j.bbcan.2023.188926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 05/19/2023] [Accepted: 05/19/2023] [Indexed: 05/27/2023]
Abstract
Bladder cancer (BC) has high morbidity and mortality rates owing to challenges in clinical diagnosis and treatment. Advanced BC is prone to recurrence after surgery, necessitating early diagnosis and recurrence monitoring to improve the prognosis of patients. Traditional detection methods for BC include cystoscopy, cytology, and imaging; however, these methods have drawbacks such as invasiveness, lack of sensitivity, and high costs. Existing reviews on BC focus on treatment and management and lack a comprehensive assessment of biomarkers. Our article reviews various biomarkers for the early diagnosis and recurrence monitoring of BC and outlines the existing challenges associated with their application and possible solutions. Furthermore, this study highlights the potential application of urine biomarkers as a non-invasive, inexpensive adjunctive test for screening high-risk populations or evaluating patients with suspected BC symptoms, thereby alleviating the discomfort and financial burden associated with cystoscopy and improving patient survival.
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Affiliation(s)
- Jiaxin Zhao
- National Center for Clinical Laboratories, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital/National Center of Gerontology, PR China; National Center for Clinical Laboratories, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, PR China; Beijing Engineering Research Center of Laboratory Medicine, Beijing Hospital, Beijing, PR China
| | - Jinming Li
- National Center for Clinical Laboratories, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital/National Center of Gerontology, PR China; National Center for Clinical Laboratories, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, PR China; Beijing Engineering Research Center of Laboratory Medicine, Beijing Hospital, Beijing, PR China.
| | - Rui Zhang
- National Center for Clinical Laboratories, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital/National Center of Gerontology, PR China; National Center for Clinical Laboratories, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, PR China; Beijing Engineering Research Center of Laboratory Medicine, Beijing Hospital, Beijing, PR China.
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6
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Jafari A, Karimabadi K, Rahimi A, Rostaminasab G, Khazaei M, Rezakhani L, Ahmadi jouybari T. The Emerging Role of Exosomal miRNAs as Biomarkers for Early Cancer Detection: A Comprehensive Literature Review. Technol Cancer Res Treat 2023; 22:15330338231205999. [PMID: 37817634 PMCID: PMC10566290 DOI: 10.1177/15330338231205999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 09/10/2023] [Accepted: 09/13/2023] [Indexed: 10/12/2023] Open
Abstract
A significant number of cancer-related deaths are recorded globally each year, despite attempts to cure this illness. Medical science is working to develop new medication therapies as well as to find ways to identify this illness as early as possible, even using noninvasive techniques. Early detection of cancer can greatly aid its treatment. Studies into cancer diagnosis and therapy have recently shifted their focus to exosome (EXO) biomarkers, which comprise numerous RNA and proteins. EXOs are minuscule goblet vesicles that have a width of 30 to 140 nm and are released by a variety of cells, including immune, stem, and tumor cells, as well as bodily fluids. According to a growing body of research, EXOs, and cancer appear to be related. EXOs from tumors play a role in the genetic information transfer between tumor and basal cells, which controls angiogenesis and fosters tumor development and spread. To identify malignant activities early on, microRNAs (miRNAs) from cancers can be extracted from circulatory system EXOs. Specific markers can be used to identify cancer-derived EXOs containing miRNAs, which may be more reliable and precise for early detection. Conventional solid biopsy has become increasingly limited as precision and personalized medicine has advanced, while liquid biopsy offers a viable platform for noninvasive diagnosis and prognosis. Therefore, the use of body fluids such as serum, plasma, urine, and salivary secretions can help find cancer biomarkers using technologies related to EXOs.
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Affiliation(s)
- Ali Jafari
- Student Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Keyvan Karimabadi
- Student Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Aso Rahimi
- Student Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Gelavizh Rostaminasab
- Clinical Research Development Center, Imam Khomeini and Mohammad Kermanshahi and Farabi Hospitals, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mozafar Khazaei
- Fertility and Infertility Research Center, Health Technology Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
- Department of Tissue Engineering, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Leila Rezakhani
- Fertility and Infertility Research Center, Health Technology Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
- Department of Tissue Engineering, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Touraj Ahmadi jouybari
- Clinical Research Development Center, Imam Khomeini and Mohammad Kermanshahi and Farabi Hospitals, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Investigation of MicroRNA Biomarkers in Equine Distal Interphalangeal Joint Osteoarthritis. Int J Mol Sci 2022; 23:ijms232415526. [PMID: 36555166 PMCID: PMC9779011 DOI: 10.3390/ijms232415526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 11/30/2022] [Accepted: 12/06/2022] [Indexed: 12/13/2022] Open
Abstract
Osteoarthritis of the equine distal interphalangeal joint is a common cause of lameness. MicroRNAs from biofluids are promising biomarkers and therapeutic candidates. Synovial fluid samples from horses with mild and severe equine distal interphalangeal joint osteoarthritis were submitted for small RNA sequencing. The results demonstrated that miR-92a was downregulated in equine synovial fluid from horses with severe osteoarthritis and there was a significant increase in COMP, COL1A2, RUNX2 and SOX9 following miR-92a mimic treatment of equine chondrocytes in monolayer culture. This is the first equine study to evaluate the role of miR-92a in osteoarthritic chondrocytes in vitro.
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8
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Grimaldi AM, Lapucci C, Salvatore M, Incoronato M, Ferrari M. Urinary miRNAs as a Diagnostic Tool for Bladder Cancer: A Systematic Review. Biomedicines 2022; 10:2766. [PMID: 36359288 PMCID: PMC9687402 DOI: 10.3390/biomedicines10112766] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 10/26/2022] [Accepted: 10/28/2022] [Indexed: 11/03/2023] Open
Abstract
Bladder cancer is the 10th most common cancer type worldwide. Cystoscopy represents the gold standard for bladder cancer diagnosis, but this procedure is invasive and painful, hence the need to identify new biomarkers through noninvasive procedures. microRNAs (miRNAs) are considered to be promising diagnostic molecules, because they are very stable in biological fluids (including urine) and easily detectable. This systematic review analyses the power of urine miRNAs as bladder cancer diagnostic markers. We conducted this systematic review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. A total of 293 records related to miRNAs and their diagnostic significance in BC were retrieved from the PubMed and Embase databases. A systematic search of the literature was performed, and a total of 25 articles (N = 4054 participants) were identified and reviewed. Although many of the selected studies were of high scientific quality, the results proved to be quite heterogeneous, because we did not identify a univocal consensus for a specific miRNA signature but only isolated the signatures. We did not identify a univocal consensus for a specific diagnostic miRNA signature but only isolated the signatures, some of them with better diagnostic power compared to the others.
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9
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Chen H, Gu L, Zhang M, Chen H, Liao H, Cao X, Yu L, Zhang J. Interaction of miR-200a-3p with YAP regulates cell proliferation and metastasis differentially in HPV-positive and HPV-negative cervical cancer cells. BMC Cancer 2022; 22:1039. [PMID: 36195847 PMCID: PMC9533500 DOI: 10.1186/s12885-022-10118-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 09/20/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Although evidence has revealed that miR-200a-3p is involved in the malignant progression of various tumors, the regulatory mechanism of miR-200a-3p in the development of cervical cancer (CC) cells with different HPV statuses remains unknown. The present study was to investigate the differential effects of either miR-200a-3p or YAP on tumorous cells' fate in vitro in HPV-negative and HPV-positive cervical cancer cell models, and to explore if the changes in proliferation, migration, and invasion of the CC cells with different HPV statuses could be attributed to the differential interactions between miR-200a-3p and YAP. METHODS The colony formation assays, EDU assays and Transwell assays were performed for CC cell proliferation, migration and invasion capacities analysis. The prediction of downstream targets of miR-200a-3p was performed by bioinformatical databases. The dual-luciferase reporter assays were used to validate the binding sites of miR-200a-3p and YAP. The qRT-PCR assays were performed to quantify the mRNA expression of miR-200a-3p and YAP, and the protein levels of YAP were examined by Western blot analysis. RESULTS The results demonstrated that miR-200a-3p overexpression suppressed proliferation, migration, and invasion of the HPV-negative C33A cells but promoted the growth and metastasis of HPV-positive CC cells, while YAP promoted the cell growth and metastasis not only in HPV-negative but also in the HPV-positive CC cells. The suppressive role of miR-200a-3p in C33A cells appeared to be mediated partially by direct interaction with YAP, and YAP might participate in miR-200a-3p-mediated cellular changes in CC cells differing from not only the presence or absence of HPV but even also the subtypes of HPV of CC cells. Meanwhile, we preliminarily revealed that the expression level of miR-200a-3p was significantly decreased in HPV-negative, but not in HPV16-positive cervical neoplasm mucus samples. CONCLUSION miR-200a-3p-mediated functional changes of YAP exhibited regulatory effects on cells' fate differentially in HPV-negative and HPV-positive cervical cancer cells.
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Affiliation(s)
- Hong Chen
- Department of Clinical Laboratory, Shanghai Key Laboratory of Maternal Fetal Medicine, Shanghai Institute of Maternal-Fetal Medicine and Gynecologic Oncology, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, 200092, China
| | - Lingling Gu
- Key Laboratory of Brain Functional Genomics (ECNU), Ministry of Education, School of Life Sciences, East China Normal University, Shanghai, 200062, China
| | - Min Zhang
- Department of Clinical Laboratory, Shanghai Public Health Clinical Center, Fudan University, Shanghai, 201508, China
| | - Huifen Chen
- Department of Clinical Laboratory, Shanghai Key Laboratory of Maternal Fetal Medicine, Shanghai Institute of Maternal-Fetal Medicine and Gynecologic Oncology, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, 200092, China
| | - Hong Liao
- Department of Clinical Laboratory, Shanghai Key Laboratory of Maternal Fetal Medicine, Shanghai Institute of Maternal-Fetal Medicine and Gynecologic Oncology, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, 200092, China
| | - Xueping Cao
- Department of Clinical Laboratory, Shanghai Key Laboratory of Maternal Fetal Medicine, Shanghai Institute of Maternal-Fetal Medicine and Gynecologic Oncology, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, 200092, China
| | - Lu Yu
- Comprehensive Department of Traditional Chinese Medicine, Putuo Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 200062, China.
| | - Jun Zhang
- Department of Clinical Laboratory, Shanghai Key Laboratory of Maternal Fetal Medicine, Shanghai Institute of Maternal-Fetal Medicine and Gynecologic Oncology, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, 200092, China.
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10
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Pre-treatment strategies based on aqueous two-phase systems comprising ionic liquids to improve the adrenal cancer diagnosis. J Mol Liq 2022. [DOI: 10.1016/j.molliq.2022.120409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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11
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Malinaric R, Mantica G, Lo Monaco L, Mariano F, Leonardi R, Simonato A, Van der Merwe A, Terrone C. The Role of Novel Bladder Cancer Diagnostic and Surveillance Biomarkers-What Should a Urologist Really Know? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159648. [PMID: 35955004 PMCID: PMC9368399 DOI: 10.3390/ijerph19159648] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Revised: 07/29/2022] [Accepted: 07/31/2022] [Indexed: 05/20/2023]
Abstract
The aim of this review is to analyze and describe the current landscape of bladder cancer diagnostic and surveillance biomarkers. We researched the literature from 2016 to November 2021 to find the most promising new molecules and divided them into seven different subgroups based on their function and location in the cell. Although cystoscopy and cytology are still the gold standard for diagnosis and surveillance when it comes to bladder cancer (BCa), their cost is quite a burden for national health systems worldwide. Currently, the research is focused on finding a biomarker that has high negative predictive value (NPV) and can exclude with a certainty the presence of the tumor, considering missing it could be disastrous for the patient. Every subgroup has its own advantages and disadvantages; for example, protein biomarkers cost less than genomic ones, but on the other hand, they seem to be less precise. We tried to simplify this complicated topic as much as possible in order to make it comprehensible to doctors and urologists that are not as familiar with it, as well as encourage them to actively participate in ongoing research.
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Affiliation(s)
- Rafaela Malinaric
- Department of Urology, IRCCS Policlinic Hospital San Martino, 16132 Genoa, Italy
- Dipartimento di Scienze Chirurgiche e Diagnostiche Integrate (DISC), University of Genoa, 16132 Genoa, Italy
- Correspondence:
| | - Guglielmo Mantica
- Department of Urology, IRCCS Policlinic Hospital San Martino, 16132 Genoa, Italy
| | - Lorenzo Lo Monaco
- Department of Urology, IRCCS Policlinic Hospital San Martino, 16132 Genoa, Italy
- Dipartimento di Scienze Chirurgiche e Diagnostiche Integrate (DISC), University of Genoa, 16132 Genoa, Italy
| | - Federico Mariano
- Department of Urology, IRCCS Policlinic Hospital San Martino, 16132 Genoa, Italy
- Dipartimento di Scienze Chirurgiche e Diagnostiche Integrate (DISC), University of Genoa, 16132 Genoa, Italy
| | - Rosario Leonardi
- Department of Urology, Casa di Cura Musumeci GECAS, 95030 Gravina di Catania, Italy
| | - Alchiede Simonato
- Department of Surgical, Oncological and Stomatological Sciences, University of Palermo, 90133 Palermo, Italy
| | - André Van der Merwe
- Department of Urology, Tygerberg Academic Hospital, Stellenbosch University, Cape Town 7600, South Africa
| | - Carlo Terrone
- Department of Urology, IRCCS Policlinic Hospital San Martino, 16132 Genoa, Italy
- Dipartimento di Scienze Chirurgiche e Diagnostiche Integrate (DISC), University of Genoa, 16132 Genoa, Italy
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12
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The Urobiome and Its Role in Overactive Bladder. Int Neurourol J 2022; 26:190-200. [PMID: 35468617 PMCID: PMC9537439 DOI: 10.5213/inj.2244016.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 03/25/2022] [Indexed: 12/04/2022] Open
Abstract
Urine is no longer considered to be sterile. After the existence of the microbiome was revealed through metagenomic analysis using next-generation sequencing, the relationship between characteristics of the microbiome and diseases have been studied and published in various journals. A microbiome exists in the urinary tract and is associated with urinary tract infection, malignancy of the genitourinary tract, and lower urinary tract symptoms. Based on the urine sampling method, sampling site, culture method, and sex, the characteristics of the microbiome vary. Most of the Lactobacillus species are identified mainly in women, and various other species are identified in men. These microorganisms can cause or prevent various diseases. Variations in the microbiome are seen in those with and without disease, and an asymptomatic status does not indicate the absence of microbes. This microbiome has been implicated in a variety of lower urinary tract symptoms and diseases, in particular, overactive bladder. The microbiome differs between patients with urgency and urge urinary incontinence and healthy individuals. There are many aspects of the microbiome yet to be studied in relation to other lower urinary tract symptoms.
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13
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Santos V, Freitas C, Fernandes MGO, Sousa C, Reboredo C, Cruz-Martins N, Mosquera J, Hespanhol V, Campelo R. Liquid biopsy: the value of different bodily fluids. Biomark Med 2022; 16:127-145. [DOI: 10.2217/bmm-2021-0370] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Liquid biopsies have gained an increasing interest in the last years among medical and scientific communities. Indeed, the value of liquid effusions, while less invasive and more accurate techniques, has been markedly highlighted. Peripheral blood comprises the most often analyzed sample, but recent evidences have pointed out the huge importance of other bodily fluids, including pleural and peritoneal fluids, urine, saliva and cerebrospinal fluid in the detection and monitoring of different tumor types. In face to these advances, this review aims to provide an overview of the value of tumor-associated mutations, detectable in different effusions, and how they can be used in clinical practice, namely in prognosis assessment and early disease and minimal disease recurrence detection, and in predicting the treatment response or acquired-resistance development.
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Affiliation(s)
- Vanessa Santos
- Department of Pulmonology, Centro Hospitalar Universitário de São João, Alameda Prof. Hernâni Monteiro, Porto, 4200319, Portugal
| | - Cláudia Freitas
- Department of Pulmonology, Centro Hospitalar Universitário de São João, Alameda Prof. Hernâni Monteiro, Porto, 4200319, Portugal
- Faculty of Medicine, University of Porto, Alameda Prof. Hernâni Monteiro, Porto, 4200319, Portugal
| | - Maria GO Fernandes
- Department of Pulmonology, Centro Hospitalar Universitário de São João, Alameda Prof. Hernâni Monteiro, Porto, 4200319, Portugal
- Faculty of Medicine, University of Porto, Alameda Prof. Hernâni Monteiro, Porto, 4200319, Portugal
- Institute for Research & Innovation in Health (I3S), University of Porto, Rua Alfredo Allen, Porto, 4200135, Portugal
- Institute of Molecular Pathology & Immunology of the University of Porto (IPATIMUP), Porto, 4200135, Portugal
| | - Catarina Sousa
- Department of Pulmonology, Centro Hospitalar Universitário de São João, Alameda Prof. Hernâni Monteiro, Porto, 4200319, Portugal
| | - Cristina Reboredo
- Department of Lung Cancer & Thoracic Tumours, Complejo Hospitalario Universitario de A Coruña, As Xubias, 84, 15006, A Coruña, La Coruña, Spain
| | - Natália Cruz-Martins
- Faculty of Medicine, University of Porto, Alameda Prof. Hernâni Monteiro, Porto, 4200319, Portugal
- Institute for Research & Innovation in Health (I3S), University of Porto, Rua Alfredo Allen, Porto, 4200135, Portugal
| | - Joaquín Mosquera
- Department of Lung Cancer & Thoracic Tumours, Complejo Hospitalario Universitario de A Coruña, As Xubias, 84, 15006, A Coruña, La Coruña, Spain
| | - Venceslau Hespanhol
- Department of Pulmonology, Centro Hospitalar Universitário de São João, Alameda Prof. Hernâni Monteiro, Porto, 4200319, Portugal
- Faculty of Medicine, University of Porto, Alameda Prof. Hernâni Monteiro, Porto, 4200319, Portugal
- Institute for Research & Innovation in Health (I3S), University of Porto, Rua Alfredo Allen, Porto, 4200135, Portugal
- Institute of Molecular Pathology & Immunology of the University of Porto (IPATIMUP), Porto, 4200135, Portugal
| | - Rosário Campelo
- Department of Lung Cancer & Thoracic Tumours, Complejo Hospitalario Universitario de A Coruña, As Xubias, 84, 15006, A Coruña, La Coruña, Spain
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14
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Karanović S, Ardin M, Tang Z, Tomić K, Villar S, Renard C, Venturini E, Lorch AH, Lee DS, Stipančić Ž, Slade N, Vuković Brinar I, Dittrich D, Karlović K, Borovečki F, Dickman KG, Olivier M, Grollman AP, Jelaković B, Zavadil J. Molecular profiles and urinary biomarkers of upper tract urothelial carcinomas associated with aristolochic acid exposure. Int J Cancer 2022; 150:374-386. [PMID: 34569060 PMCID: PMC8627473 DOI: 10.1002/ijc.33827] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 07/25/2021] [Accepted: 08/31/2021] [Indexed: 12/23/2022]
Abstract
Recurrent upper tract urothelial carcinomas (UTUCs) arise in the context of nephropathy linked to exposure to the herbal carcinogen aristolochic acid (AA). Here we delineated the molecular programs underlying UTUC tumorigenesis in patients from endemic aristolochic acid nephropathy (AAN) regions in Southern Europe. We applied an integrative multiomics analysis of UTUCs, corresponding unaffected tissues and of patient urines. Quantitative microRNA (miRNA) and messenger ribonucleic acid (mRNA) expression profiling, immunohistochemical analysis by tissue microarrays and exome and transcriptome sequencing were performed in UTUC and nontumor tissues. Urinary miRNAs of cases undergoing surgery were profiled before and after tumor resection. Ribonucleic acid (RNA) and protein levels were analyzed using appropriate statistical tests and trend assessment. Dedicated bioinformatic tools were used for analysis of pathways, mutational signatures and result visualization. The results delineate UTUC-specific miRNA:mRNA networks comprising 89 miRNAs associated with 1,862 target mRNAs, involving deregulation of cell cycle, deoxyribonucleic acid (DNA) damage response, DNA repair, bladder cancer, oncogenes, tumor suppressors, chromatin structure regulators and developmental signaling pathways. Key UTUC-specific transcripts were confirmed at the protein level. Exome and transcriptome sequencing of UTUCs revealed AA-specific mutational signature SBS22, with 68% to 76% AA-specific, deleterious mutations propagated at the transcript level, a possible basis for neoantigen formation and immunotherapy targeting. We next identified a signature of UTUC-specific miRNAs consistently more abundant in the patients' urine prior to tumor resection, thereby defining biomarkers of tumor presence. The complex gene regulation programs of AAN-associated UTUC tumors involve regulatory miRNAs prospectively applicable to noninvasive urine-based screening of AAN patients for cancer presence and recurrence.
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Affiliation(s)
- Sandra Karanović
- Department of Nephrology, Arterial Hypertension, Dialysis and Transplantation, University Hospital Center ZagrebSchool of Medicine, University of ZagrebZagrebCroatia
| | - Maude Ardin
- Epigenomics and Mechanisms BranchInternational Agency for Research on Cancer, WHOLyonFrance
| | - Zuojian Tang
- Institute for Systems GeneticsNew York University Langone Medical CenterNew YorkNew YorkUSA
- Present address:
Boehringer Ingelheim Pharmaceuticals, Inc.RidgefieldCTUSA
| | - Karla Tomić
- Department of PathologyGeneral Hospital Dr. Josip BenčevićSlavonski BrodCroatia
- Present address:
Department of PathologyÅlesund Hospital, Møre and Romsdal Health TrustÅlesundNorway
| | - Stephanie Villar
- Epigenomics and Mechanisms BranchInternational Agency for Research on Cancer, WHOLyonFrance
| | - Claire Renard
- Epigenomics and Mechanisms BranchInternational Agency for Research on Cancer, WHOLyonFrance
| | - Elisa Venturini
- Office for Collaborative ScienceNew York University Langone Medical CenterNew YorkNew YorkUSA
- Present address:
Natera, Inc.San CarlosCAUSA
| | - Adam H. Lorch
- Biochemistry and Molecular GeneticsNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA
| | - Daniel S. Lee
- Office for Collaborative ScienceNew York University Langone Medical CenterNew YorkNew YorkUSA
| | - Želimir Stipančić
- Department for Dialysis OdžakCounty Hospital OrašjeOdžakBosnia and Herzegovina
| | - Neda Slade
- Division of Molecular MedicineInstitute Ruđer BoškovićZagrebCroatia
| | - Ivana Vuković Brinar
- Department of Nephrology, Arterial Hypertension, Dialysis and Transplantation, University Hospital Center ZagrebSchool of Medicine, University of ZagrebZagrebCroatia
| | - Damir Dittrich
- Department of UrologyGeneral Hospital Dr. Josip BenčevićSlavonski BrodCroatia
| | - Krešimir Karlović
- Department of UrologyGeneral Hospital Dr. Josip BenčevićSlavonski BrodCroatia
| | - Fran Borovečki
- Department for Functional Genomics, Center for Translational and Clinical ResearchUniversity Hospital Center Zagreb, School of Medicine, University of ZagrebZagrebCroatia
| | - Kathleen G. Dickman
- Department of MedicineStony Brook UniversityStony BrookNew YorkUSA
- Department of Medicine/NephrologyStony Brook UniversityStony BrookNew YorkUSA
| | - Magali Olivier
- Epigenomics and Mechanisms BranchInternational Agency for Research on Cancer, WHOLyonFrance
| | | | - Bojan Jelaković
- Department of Nephrology, Arterial Hypertension, Dialysis and Transplantation, University Hospital Center ZagrebSchool of Medicine, University of ZagrebZagrebCroatia
| | - Jiri Zavadil
- Epigenomics and Mechanisms BranchInternational Agency for Research on Cancer, WHOLyonFrance
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15
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Artificial Intelligence in Urology. Artif Intell Med 2022. [DOI: 10.1007/978-3-030-64573-1_172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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16
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Lai X, Schmitz U, Vera J. The Role of MicroRNAs in Cancer Biology and Therapy from a Systems Biology Perspective. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2022; 1385:1-22. [DOI: 10.1007/978-3-031-08356-3_1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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17
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Patuleia SIS, van der Wall E, van Gils CH, Bakker MF, Jager A, Voorhorst-Ogink MM, van Diest PJ, Moelans CB. The changing microRNA landscape by color and cloudiness: a cautionary tale for nipple aspirate fluid biomarker analysis. Cell Oncol (Dordr) 2021; 44:1339-1349. [PMID: 34655415 PMCID: PMC8648697 DOI: 10.1007/s13402-021-00641-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 10/08/2021] [Indexed: 01/15/2023] Open
Abstract
PURPOSE Investigation of nipple aspirate fluid (NAF)-based microRNAs (miRNAs) as a potential screening tool for women at increased risk of developing breast cancer is the scope of our research. While aiming to identify discriminating NAF-miRNAs between women with different mammographic densities, we were confronted with an unexpected confounder: NAF sample appearance. Here we report and alert for the impact of NAF color and cloudiness on miRNA assessment. METHODS Seven classes of NAF colors coupled with cloudiness appearance were established. Using 173 NAF samples from 154 healthy women (19 samples were bilaterally collected), the expression of 14 target and 2 candidate endogenous control (EC) miRNAs was investigated using Taqman Advanced miRNA assays to identify significant differential expression patterns between color-cloudiness classes. Inter- and intra-individual variation of miRNA expression was analyzed using the coefficient of variation (CV). RESULTS We found that between the seven NAF classes, fold change miRNA expression differences ranged between 2.4 and 19.6 depending on the interrogated miRNA. Clear NAF samples exhibited higher miRNA expression levels compared to cloudy NAF samples with fold change differences ranging between 1.1 and 6.2. Inter-individual and intra-individual miRNA expression was fairly stable (CV < 15 %), but nevertheless impacted by NAF sample appearance. Within NAF classes, inter-individual variation was largest for green samples (CV 6-15 %) and smallest for bloody samples (CV 2-6 %). CONCLUSIONS Our data indicate that NAF color and cloudiness influence miRNA expression and should, therefore, be systematically registered using an objective color classification system. Given that sample appearance is an inherent feature of NAF, these variables should be statistically controlled for in multivariate data analyses. This cautionary note and recommendations could be of value beyond the field of NAF-miRNAs, given that variability in sample color and cloudiness is likewise observed in liquid biopsies such as urine, cerebrospinal fluid and sputum, and could thereby influence the levels of miRNAs and other biomarkers.
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Affiliation(s)
- Susana I S Patuleia
- Department of Pathology, University Medical Center Utrecht, Utrecht University, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
- Department of Medical Oncology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Elsken van der Wall
- Department of Medical Oncology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Carla H van Gils
- Department of Epidemiology of the Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Marije F Bakker
- Department of Epidemiology of the Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Agnes Jager
- Department of Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - Marleen M Voorhorst-Ogink
- Department of Pathology, University Medical Center Utrecht, Utrecht University, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - Paul J van Diest
- Department of Pathology, University Medical Center Utrecht, Utrecht University, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - Cathy B Moelans
- Department of Pathology, University Medical Center Utrecht, Utrecht University, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands.
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18
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MicroRNA as a Biomarker for Diagnostic, Prognostic, and Therapeutic Purpose in Urinary Tract Cancer. Processes (Basel) 2021. [DOI: 10.3390/pr9122136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The incidence of urologic cancers, including kidney, upper tract urothelial, and bladder malignancies, is increasing globally, with a high percentage of cases showing metastasis upon diagnosis and low five-year survival rates. MicroRNA (miRNA), a small non-coding RNA, was found to regulate the expression of oncogenes and tumor suppressor genes in several tumors, including cancers of the urinary system. In the current review, we comprehensively discuss the recently reported up-or down-regulated miRNAs as well as their possible targets and regulated pathways involved in the development, progression, and metastasis of urinary tract cancers. These miRNAs represent potential therapeutic targets and diagnostic/prognostic biomarkers that may help in efficient and early diagnosis in addition to better treatment outcomes.
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19
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Cavallari I, Ciccarese F, Sharova E, Urso L, Raimondi V, Silic-Benussi M, D’Agostino DM, Ciminale V. The miR-200 Family of microRNAs: Fine Tuners of Epithelial-Mesenchymal Transition and Circulating Cancer Biomarkers. Cancers (Basel) 2021; 13:5874. [PMID: 34884985 PMCID: PMC8656820 DOI: 10.3390/cancers13235874] [Citation(s) in RCA: 61] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 11/17/2021] [Accepted: 11/18/2021] [Indexed: 12/13/2022] Open
Abstract
The miR-200 family of microRNAs (miRNAs) includes miR-200a, miR-200b, miR-200c, miR-141 and miR-429, five evolutionarily conserved miRNAs that are encoded in two clusters of hairpin precursors located on human chromosome 1 (miR-200b, miR-200a and miR-429) and chromosome 12 (miR-200c and miR-141). The mature -3p products of the precursors are abundantly expressed in epithelial cells, where they contribute to maintaining the epithelial phenotype by repressing expression of factors that favor the process of epithelial-to-mesenchymal transition (EMT), a key hallmark of oncogenic transformation. Extensive studies of the expression and interactions of these miRNAs with cell signaling pathways indicate that they can exert both tumor suppressor- and pro-metastatic functions, and may serve as biomarkers of epithelial cancers. This review provides a summary of the role of miR-200 family members in EMT, factors that regulate their expression, and important targets for miR-200-mediated repression that are involved in EMT. The second part of the review discusses the potential utility of circulating miR-200 family members as diagnostic/prognostic biomarkers for breast, colorectal, lung, ovarian, prostate and bladder cancers.
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Affiliation(s)
- Ilaria Cavallari
- Veneto Institute of Oncology IOV–IRCCS, 35128 Padova, Italy; (I.C.); (F.C.); (E.S.); (L.U.); (V.R.); (M.S.-B.)
| | - Francesco Ciccarese
- Veneto Institute of Oncology IOV–IRCCS, 35128 Padova, Italy; (I.C.); (F.C.); (E.S.); (L.U.); (V.R.); (M.S.-B.)
| | - Evgeniya Sharova
- Veneto Institute of Oncology IOV–IRCCS, 35128 Padova, Italy; (I.C.); (F.C.); (E.S.); (L.U.); (V.R.); (M.S.-B.)
| | - Loredana Urso
- Veneto Institute of Oncology IOV–IRCCS, 35128 Padova, Italy; (I.C.); (F.C.); (E.S.); (L.U.); (V.R.); (M.S.-B.)
- Department of Surgery, Oncology and Gastroenterology, University of Padua, 35128 Padova, Italy
| | - Vittoria Raimondi
- Veneto Institute of Oncology IOV–IRCCS, 35128 Padova, Italy; (I.C.); (F.C.); (E.S.); (L.U.); (V.R.); (M.S.-B.)
| | - Micol Silic-Benussi
- Veneto Institute of Oncology IOV–IRCCS, 35128 Padova, Italy; (I.C.); (F.C.); (E.S.); (L.U.); (V.R.); (M.S.-B.)
| | - Donna M. D’Agostino
- Veneto Institute of Oncology IOV–IRCCS, 35128 Padova, Italy; (I.C.); (F.C.); (E.S.); (L.U.); (V.R.); (M.S.-B.)
- Department of Biomedical Sciences, University of Padua, 35131 Padova, Italy
| | - Vincenzo Ciminale
- Veneto Institute of Oncology IOV–IRCCS, 35128 Padova, Italy; (I.C.); (F.C.); (E.S.); (L.U.); (V.R.); (M.S.-B.)
- Department of Surgery, Oncology and Gastroenterology, University of Padua, 35128 Padova, Italy
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20
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Piao XM, Kang H, Kim WJ, Yun SJ. Prominence of urinary biomarkers for bladder cancer in the COVID-19 era: From the commercially available to new prospective candidates. Investig Clin Urol 2021; 62:500-519. [PMID: 34488250 PMCID: PMC8421991 DOI: 10.4111/icu.20210194] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 05/24/2021] [Accepted: 06/07/2021] [Indexed: 12/21/2022] Open
Abstract
Molecular markers detected in urine may improve our understanding of the evolution of bladder cancer (BCa) and its micro- and macroenvironment. Detection of such markers will identify disease earlier, allow stratification of patients according to risk, and improve prognostication and prediction of outcomes, thereby facilitating targeted therapy. However, current guidelines have yet to embrace such markers for routine management of BCa, and most research studies have focused on urine-based tumor markers. In this review, we summarize known urinary biomarkers for BCa and highlight newly identified molecules. We then discuss the challenges that must be overcome to incorporate these markers into clinical care.
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Affiliation(s)
- Xuan-Mei Piao
- Department of Urology, College of Medicine, Chungbuk National University, Cheongju, Korea
| | - Howon Kang
- Department of Urology, College of Medicine, Chungbuk National University, Cheongju, Korea
- Department of Urology, Chungbuk National University Hospital, Cheongju, Korea
| | - Wun-Jae Kim
- Department of Urology, College of Medicine, Chungbuk National University, Cheongju, Korea
- Institute of Urotech, Cheongju, Korea
| | - Seok Joong Yun
- Department of Urology, College of Medicine, Chungbuk National University, Cheongju, Korea
- Department of Urology, Chungbuk National University Hospital, Cheongju, Korea.
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21
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Humayun-Zakaria N, Ward DG, Arnold R, Bryan RT. Trends in urine biomarker discovery for urothelial bladder cancer: DNA, RNA, or protein? Transl Androl Urol 2021; 10:2787-2808. [PMID: 34295762 PMCID: PMC8261432 DOI: 10.21037/tau-20-1327] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Accepted: 04/23/2021] [Indexed: 02/01/2023] Open
Abstract
Urothelial bladder cancer is a complex disease displaying a landscape of heterogenous molecular subtypes, mutation profiles and clinical presentations. Diagnosis and surveillance rely on flexible cystoscopy which has high accuracy, albeit accompanied by a high-cost burden for healthcare providers and discomfort for patients. Advances in "omic" technologies and computational biology have provided insights into the molecular pathogenesis of bladder cancer and provided powerful tools to identify markers for disease detection, risk stratification, and predicting responses to therapy. To date, numerous attempts have been made to discover and validate diagnostic biomarkers that could be deployed as an adjunct to the cystoscopic diagnosis and long-term surveillance of bladder cancer. We report a comprehensive literature analysis using PubMed to assess the changing trends in investigating DNA, RNA, or proteins as diagnostic urinary biomarkers over a period of 5 decades: 1970-2020. A gradual shift has been observed in research away from protein biomarkers to nucleic acids including different classes of RNA, and DNA methylation and mutation markers. Until 2000, publications involving protein biomarker discovery constituted 87% of the total number of research articles with DNA comprising 6% and RNA 7%. Since 2000 the proportion of protein biomarker articles has fallen to 40%, and DNA and RNA studies increased to 32% and 28%, respectively. Clearly research focus, perhaps driven by technological innovation, has shifted from proteins to nucleic acids. We optimistically hypothesise that, following thorough validation, a clinically useful detection test for bladder cancer based on a panel of DNA or RNA markers could become reality within 5-10 years.
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Affiliation(s)
- Nada Humayun-Zakaria
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK
| | - Douglas G Ward
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK
| | - Roland Arnold
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK
| | - Richard T Bryan
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK
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22
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Artificial Intelligence and Its Impact on Urological Diseases and Management: A Comprehensive Review of the Literature. J Clin Med 2021; 10:jcm10091864. [PMID: 33925767 PMCID: PMC8123407 DOI: 10.3390/jcm10091864] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 04/04/2021] [Accepted: 04/08/2021] [Indexed: 12/22/2022] Open
Abstract
Recent advances in artificial intelligence (AI) have certainly had a significant impact on the healthcare industry. In urology, AI has been widely adopted to deal with numerous disorders, irrespective of their severity, extending from conditions such as benign prostate hyperplasia to critical illnesses such as urothelial and prostate cancer. In this article, we aim to discuss how algorithms and techniques of artificial intelligence are equipped in the field of urology to detect, treat, and estimate the outcomes of urological diseases. Furthermore, we explain the advantages that come from using AI over any existing traditional methods.
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23
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Tan J, Qin F, Yuan J. Current applications of artificial intelligence combined with urine detection in disease diagnosis and treatment. Transl Androl Urol 2021; 10:1769-1779. [PMID: 33968664 PMCID: PMC8100834 DOI: 10.21037/tau-20-1405] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
In recent years, the advantages of artificial intelligence (AI) in data processing and model analysis have emerged in the medical field, enabled by computer technology developments and the integration of multiple disciplines. The application of AI in the medical field has gradually deepened and broadened. Among them, the development of clinical medicine intelligent decision-making is the fastest. The advantage of clinical medicine intelligent decision-making is to make the diagnosis faster and more accurate on the basis of certain information. Urine detection technologies, such as urine proteomics, urine metabolomics, and urine RNomics, have developed rapidly with the advancements in omics and medical tests. Advances in urine testing have made it possible to obtain a wealth of information from easily accessible urine. However, it has always been a problem to extract effective information from this information and use it. AI technology provides the possibility to process and use the information in urine. AI, combined with urine detection, not only provides new possibilities for precise and individual diagnosis and disease treatment, but also helps promote non-invasive diagnosis and treatment. This article reviews the research and applications of AI combined with urine detection for disease diagnosis and treatment and discusses its existing problems and future development.
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Affiliation(s)
- Jun Tan
- Andrology Laboratory, West China Hospital, Sichuan University, Chengdu, China.,Department of Urology, West China Hospital, Sichuan University, Chengdu, China
| | - Feng Qin
- Andrology Laboratory, West China Hospital, Sichuan University, Chengdu, China
| | - Jiuhong Yuan
- Andrology Laboratory, West China Hospital, Sichuan University, Chengdu, China.,Department of Urology, West China Hospital, Sichuan University, Chengdu, China
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24
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Henning GM, Barashi NS, Smith ZL. Advances in Biomarkers for Detection, Surveillance, and Prognosis of Bladder Cancer. Clin Genitourin Cancer 2021; 19:194-198. [PMID: 33781702 DOI: 10.1016/j.clgc.2020.12.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 11/24/2020] [Accepted: 12/26/2020] [Indexed: 02/07/2023]
Abstract
Bladder cancer may present management challenges, as it frequently recurs and can progress when not expeditiously diagnosed and carefully monitored following initial therapy for noninvasive disease. Cystoscopy and cytology have long been the primary tools for the urologist treating bladder cancer. However, as a host of potential biomarkers have been developed, new avenues for noninvasive testing have become available in the detection, surveillance, and prognostic setting. Analysis of urine for mutational signatures at the genetic and epigenetic levels appears promising, but such testing has yet to become widely adopted into clinical practice. Here, we review recent advances in bladder cancer biomarker assays, with particular attention to clinical relevance and potential application.
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Affiliation(s)
- Grant M Henning
- Division of Urology, Washington University School of Medicine, St Louis, MO
| | - Nimrod S Barashi
- Division of Urology, Washington University School of Medicine, St Louis, MO
| | - Zachary L Smith
- Division of Urology, Washington University School of Medicine, St Louis, MO.
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25
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Role of Exosomal miRNA in Bladder Cancer: A Promising Liquid Biopsy Biomarker. Int J Mol Sci 2021; 22:ijms22041713. [PMID: 33567779 PMCID: PMC7915637 DOI: 10.3390/ijms22041713] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 02/04/2021] [Accepted: 02/04/2021] [Indexed: 12/11/2022] Open
Abstract
Bladder cancer (BCa) is the most prevalent neoplasia of the urinary tract. Unfortunately, limited improvements in effective BCa management have meant that it remains a challenging disease. Cystoscopy has been the gold standard for BCa diagnosis and surveillance for over two centuries but is an invasive and expensive approach. Recently, liquid biopsy has been identified as a promising field of cancer research, due to its noninvasiveness and ease of sampling. Liquid biopsy samples could provide comprehensive information regarding the genetic landscape of cancer and could track genomic evolution of the disease over time. Exosomes, which contain RNAs, DNAs, and proteins, are a potential source of tumor biomarkers in liquid biopsy samples. In particular, exosomal miRNAs (exomiRs) hold great promise as biomarkers for tumor development and progression. In this review, we provide an overview of liquid biopsy biomarkers, with a particular focus on the use of exomiRs as biomarkers of cancer, and summarize their clinical implications for BCa. Finally, we discuss the future perspectives of these biomarkers in cancer research.
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26
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Chu KY, Tradewell MB. Artificial Intelligence in Urology. Artif Intell Med 2021. [DOI: 10.1007/978-3-030-58080-3_172-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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27
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Prognostic Stratification of Bladder Cancer Patients with a MicroRNA-based Approach. Cancers (Basel) 2020; 12:cancers12113133. [PMID: 33114775 PMCID: PMC7692037 DOI: 10.3390/cancers12113133] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 10/20/2020] [Accepted: 10/21/2020] [Indexed: 12/12/2022] Open
Abstract
Robust non-invasive tests for prognostic stratification of bladder cancer (BCa) patients are in high demand. Following a comprehensive analysis of studies on BCa, we selected a panel of 29 microRNAs (miRNAs) and analyzed their levels in urine and plasma samples in a prospective cohort of 63 BCa patients (32 at high risk of recurrence and 31 low-risk cases) and 37 healthy controls using RT-qPCR. To design an assay suitable for large-scale testing, we applied a hierarchical pipeline to select the miRNAs that were not affected by confounding factors such as haematuria and urine specific gravity, and exceeded stringent cut-off criteria (fold change >2.5 and p-value < 0.005). Using a two-step decision tree based on the urine levels of miR-34a-5p, miR-200a-3p and miR-193a-5p, normalized against miR-125b-5p, patients could be classified as high- or low-risk with a sensitivity of 0.844, specificity of 0.806 and accuracy of 0.825. Furthermore, univariate Cox proportional hazards regression analyses indicated that increased urine levels of miR-29a-3p, miR-34a-5p, miR-193a-5p, miR-200c-3p, miR-205-5p and miR-532-5p were associated with a shorter event-free survival (hazard ratios > 3.1, p-value < 0.05). Taken together, our findings suggest that measuring the urine levels of these miRNAs could provide a novel cost-effective, noninvasive test for risk assessment of BCa patients.
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28
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Sharma PC, Gupta A. MicroRNAs: potential biomarkers for diagnosis and prognosis of different cancers. Transl Cancer Res 2020; 9:5798-5818. [PMID: 35117940 PMCID: PMC8798648 DOI: 10.21037/tcr-20-1294] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Accepted: 06/12/2020] [Indexed: 12/14/2022]
Abstract
A thorough understanding of the tumor environment and underlying genetic factors helps in the better formulation of cancer management strategies. Availability of efficient diagnostic and prognostic biomarkers facilitates early detection and progression of the disease. MicroRNAs affect different biological processes participating in tumorigenesis through regulation of their target genes. An expanding list of unique RNAs and understanding of their regulatory role has opened up a new field in cancer research. Based on a comprehensive literature search, we identified 728 miRNAs dysregulated in sixteen cancer types namely bladder cancer (BC), breast cancer (BrC), cervical cancer (CC), colorectal cancer (CRC), esophageal cancer (EC), endometrial cancer (EnC), gastric cancer (GC), hepatocellular cancer (HCC), head and neck squamous cell cancer (HNSCC), lung cancer (LC), ovarian cancer (OC), pancreatic cancer (PC), prostate cancer (PrC), renal cell cancer (RCC), skin cancer (SC), and thyroid cancer (TC). Expression of 43 miRNAs was either upregulated or downregulated in six or more of these cancers. Finally, seven miRNAs namely mir-18a, mir-21, mir-143/145, mir-210, mir-218, mir-221, showing maximum dysregulation, either up- or down-regulation in the majority of cancers, were selected for a detailed presentation of their expression and evaluation of their potential as biomarkers in the diagnosis and prognosis of different cancers.
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Affiliation(s)
- Prakash Chand Sharma
- University School of Biotechnology, Guru Gobind Singh Indraprastha University, New Delhi, India
| | - Alisha Gupta
- University School of Biotechnology, Guru Gobind Singh Indraprastha University, New Delhi, India
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Lozano F, Raventos CX, Carrion A, Trilla E, Morote J. Current status of genetic urinary biomarkers for surveillance of non-muscle invasive bladder cancer: a systematic review. BMC Urol 2020; 20:99. [PMID: 32664878 PMCID: PMC7362437 DOI: 10.1186/s12894-020-00670-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Accepted: 07/08/2020] [Indexed: 01/22/2023] Open
Abstract
Background Genetic biomarkers are a promising and growing field in the management of bladder cancer in all stages. The aim of this paper is to understand the role of genetic urinary biomarkers in the follow up of patients with non muscle invasive bladder cancer where there is increasing evidence that they can play a role in avoiding invasive techniques. Methods Following PRISMA criteria, we have performed a systematic review. The search yielded 164 unique articles, of which 21 articles were included involving a total of 7261 patients. Sixteen of the articles were DNA based biomarkers, analyzing different methylations, microsatellite aberrations and gene mutations. Five articles studied the role of RNA based biomarkers, based on measuring levels of different combinations of mRNA. QUADAS2 critical evaluation of each paper has been reported. Results There are not randomized control trials comparing any biomarker with the gold standard follow-up, and the level of evidence is 2B in almost all the studies. Negative predictive value varies between 55 and 98.5%, being superior in RNA based biomarkers. Conclusions Although cystoscopy and cytology are the gold standard for non muscle invasive bladder cancer surveillance, genetic urinary biomarkers are a promising tool to avoid invasive explorations to the patients with a safe profile of similar sensitivity and negative predictive value. The accuracy that genetic biomarkers can offer should be taken into account to modify the paradigm of surveillance in non muscle invasive bladder cancer patients, especially in high-risk ones where many invasive explorations are recommended and biomarkers experiment better results.
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Affiliation(s)
- F Lozano
- Urology Department, Vall d'Hebron University Hospital, Pg. Vall d'Hebron 119-129, 08035, Barcelona, Spain. .,Universitat Autònoma de Barcelona, Barcelona, Spain.
| | - C X Raventos
- Urology Department, Vall d'Hebron University Hospital, Pg. Vall d'Hebron 119-129, 08035, Barcelona, Spain
| | - A Carrion
- Urology Department, Vall d'Hebron University Hospital, Pg. Vall d'Hebron 119-129, 08035, Barcelona, Spain
| | - E Trilla
- Urology Department, Vall d'Hebron University Hospital, Pg. Vall d'Hebron 119-129, 08035, Barcelona, Spain
| | - J Morote
- Urology Department, Vall d'Hebron University Hospital, Pg. Vall d'Hebron 119-129, 08035, Barcelona, Spain.,Universitat Autònoma de Barcelona, Barcelona, Spain
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Erdmann K, Salomo K, Klimova A, Heberling U, Lohse-Fischer A, Fuehrer R, Thomas C, Roeder I, Froehner M, Wirth MP, Fuessel S. Urinary MicroRNAs as Potential Markers for Non-Invasive Diagnosis of Bladder Cancer. Int J Mol Sci 2020; 21:ijms21113814. [PMID: 32471285 PMCID: PMC7312501 DOI: 10.3390/ijms21113814] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 05/20/2020] [Accepted: 05/26/2020] [Indexed: 12/21/2022] Open
Abstract
Currently, voided urine cytology (VUC) serves as the gold standard for the detection of bladder cancer (BCa) in urine. Despite its high specificity, VUC has shortcomings in terms of sensitivity. Therefore, alternative biomarkers are being searched, which might overcome these disadvantages as a useful adjunct to VUC. The aim of this study was to evaluate the diagnostic potential of the urinary levels of selected microRNAs (miRs), which might represent such alternative biomarkers due to their BCa-specific expression. Expression levels of nine BCa-associated microRNAs (miR-21, -96, -125b, -126, -145, -183, -205, -210, -221) were assessed by quantitative PCR in urine sediments from 104 patients with primary BCa and 46 control subjects. Receiver operating characteristic (ROC) curve analyses revealed a diagnostic potential for miR-96, -125b, -126, -145, -183, and -221 with area under the curve (AUC) values between 0.605 and 0.772. The combination of the four best candidates resulted in sensitivity, specificity, positive and negative predictive values (NPV), and accuracy of 73.1%, 95.7%, 97.4%, 61.1%, and 80.0%, respectively. Combined with VUC, sensitivity and NPV could be increased by nearly 8%, each surpassing the performance of VUC alone. The present findings suggested a diagnostic potential of miR-125b, -145, -183, and -221 in combination with VUC for non-invasive detection of BCa in urine.
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Affiliation(s)
- Kati Erdmann
- Department of Urology, Technische Universität Dresden, 01307 Dresden, Germany; (K.E.); (K.S.); (U.H.); (A.L.-F.); (R.F.); (C.T.); (M.F.); (M.P.W.)
- National Center for Tumor Diseases (NCT), 01307 Dresden, Germany; (A.K.); (I.R.)
| | - Karsten Salomo
- Department of Urology, Technische Universität Dresden, 01307 Dresden, Germany; (K.E.); (K.S.); (U.H.); (A.L.-F.); (R.F.); (C.T.); (M.F.); (M.P.W.)
| | - Anna Klimova
- National Center for Tumor Diseases (NCT), 01307 Dresden, Germany; (A.K.); (I.R.)
- Institute for Medical Informatics and Biometrics, Technische Universität Dresden, 01307 Dresden, Germany
| | - Ulrike Heberling
- Department of Urology, Technische Universität Dresden, 01307 Dresden, Germany; (K.E.); (K.S.); (U.H.); (A.L.-F.); (R.F.); (C.T.); (M.F.); (M.P.W.)
| | - Andrea Lohse-Fischer
- Department of Urology, Technische Universität Dresden, 01307 Dresden, Germany; (K.E.); (K.S.); (U.H.); (A.L.-F.); (R.F.); (C.T.); (M.F.); (M.P.W.)
| | - Romy Fuehrer
- Department of Urology, Technische Universität Dresden, 01307 Dresden, Germany; (K.E.); (K.S.); (U.H.); (A.L.-F.); (R.F.); (C.T.); (M.F.); (M.P.W.)
| | - Christian Thomas
- Department of Urology, Technische Universität Dresden, 01307 Dresden, Germany; (K.E.); (K.S.); (U.H.); (A.L.-F.); (R.F.); (C.T.); (M.F.); (M.P.W.)
| | - Ingo Roeder
- National Center for Tumor Diseases (NCT), 01307 Dresden, Germany; (A.K.); (I.R.)
- Institute for Medical Informatics and Biometrics, Technische Universität Dresden, 01307 Dresden, Germany
| | - Michael Froehner
- Department of Urology, Technische Universität Dresden, 01307 Dresden, Germany; (K.E.); (K.S.); (U.H.); (A.L.-F.); (R.F.); (C.T.); (M.F.); (M.P.W.)
| | - Manfred P. Wirth
- Department of Urology, Technische Universität Dresden, 01307 Dresden, Germany; (K.E.); (K.S.); (U.H.); (A.L.-F.); (R.F.); (C.T.); (M.F.); (M.P.W.)
| | - Susanne Fuessel
- Department of Urology, Technische Universität Dresden, 01307 Dresden, Germany; (K.E.); (K.S.); (U.H.); (A.L.-F.); (R.F.); (C.T.); (M.F.); (M.P.W.)
- Correspondence: ; Tel.: +49-351-45814544
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Abstract
MicroRNAs (miRNAs) are endogenous noncoding RNAs, which regulate gene expression on the post-transcriptional level. Since miRNAs are involved in the regulation of apoptosis, cellular proliferation, differentiation, and other important cellular processes, their deregulation is important for the development of a wide range of diseases including cancer. Apart from tissue, specific disease-related miRNA signatures can be found in body fluids as well. Especially for urologic diseases or injuries, urine miRNAs represent a promising group of biomarkers. Despite a large number of studies describing the importance of urinary miRNAs, there is a lack of recommendations for urine management and subsequent miRNA analysis. Thus, in this chapter, we aim to describe the origin and functions of urinary miRNAs and discuss the technical aspects of their detection including the pre-analytical phase principles and new directions in quantification, which could forward urine miRNA into clinical practice.
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Affiliation(s)
- Jaroslav Juracek
- Central European Institute of Technology, Masaryk University, Brno, Czech Republic
| | - Ondrej Slaby
- Central European Institute of Technology, Masaryk University, Brno, Czech Republic.
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Checcucci E, Autorino R, Cacciamani GE, Amparore D, De Cillis S, Piana A, Piazzolla P, Vezzetti E, Fiori C, Veneziano D, Tewari A, Dasgupta P, Hung A, Gill I, Porpiglia F. Artificial intelligence and neural networks in urology: current clinical applications. MINERVA UROL NEFROL 2019; 72:49-57. [PMID: 31833725 DOI: 10.23736/s0393-2249.19.03613-0] [Citation(s) in RCA: 84] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
INTRODUCTION As we enter the era of "big data," an increasing amount of complex health-care data will become available. These data are often redundant, "noisy," and characterized by wide variability. In order to offer a precise and transversal view of a clinical scenario the artificial intelligence (AI) with machine learning (ML) algorithms and Artificial neuron networks (ANNs) process were adopted, with a promising wide diffusion in the near future. The present work aims to provide a comprehensive and critical overview of the current and potential applications of AI and ANNs in urology. EVIDENCE ACQUISITION A non-systematic review of the literature was performed by screening Medline, PubMed, the Cochrane Database, and Embase to detect pertinent studies regarding the application of AI and ANN in Urology. EVIDENCE SYNTHESIS The main application of AI in urology is the field of genitourinary cancers. Focusing on prostate cancer, AI was applied for the prediction of prostate biopsy results. For bladder cancer, the prediction of recurrence-free probability and diagnostic evaluation were analysed with ML algorithms. For kidney and testis cancer, anecdotal experiences were reported for staging and prediction of diseases recurrence. More recently, AI has been applied in non-oncological diseases like stones and functional urology. CONCLUSIONS AI technologies are growing their role in health care; but, up to now, their "real-life" implementation remains limited. However, in the near future, the potential of AI-driven era could change the clinical practice in Urology, improving overall patient outcomes.
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Affiliation(s)
- Enrico Checcucci
- Department of Urology, San Luigi Gonzaga Hospital, University of Turin, Orbassano, Turin, Italy -
| | | | | | - Daniele Amparore
- Department of Urology, San Luigi Gonzaga Hospital, University of Turin, Orbassano, Turin, Italy
| | - Sabrina De Cillis
- Department of Urology, San Luigi Gonzaga Hospital, University of Turin, Orbassano, Turin, Italy
| | - Alberto Piana
- Department of Urology, San Luigi Gonzaga Hospital, University of Turin, Orbassano, Turin, Italy
| | - Pietro Piazzolla
- Department of Management and Production Engineer, Politechnic University of Turin, Turin, Italy
| | - Enrico Vezzetti
- Department of Management and Production Engineer, Politechnic University of Turin, Turin, Italy
| | - Cristian Fiori
- Department of Urology, San Luigi Gonzaga Hospital, University of Turin, Orbassano, Turin, Italy
| | - Domenico Veneziano
- Department of Urology and Renal Transplantation, Bianchi-Melacrino-Morelli Hospital, Reggio Calabria, Italy
| | - Ash Tewari
- Icahn School of Medicine of Mount Sinai, New York, NY, USA
| | | | - Andrew Hung
- USC Institute of Urology, University of Southern California, Los Angeles, CA, USA
| | - Inderbir Gill
- USC Institute of Urology, University of Southern California, Los Angeles, CA, USA
| | - Francesco Porpiglia
- Department of Urology, San Luigi Gonzaga Hospital, University of Turin, Orbassano, Turin, Italy
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Lopez-Beltran A, Cheng L, Gevaert T, Blanca A, Cimadamore A, Santoni M, Massari F, Scarpelli M, Raspollini MR, Montironi R. Current and emerging bladder cancer biomarkers with an emphasis on urine biomarkers. Expert Rev Mol Diagn 2019; 20:231-243. [DOI: 10.1080/14737159.2020.1699791] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- Antonio Lopez-Beltran
- Department of Pathology and Surgery, Faculty of Medicine, Cordoba University, Cordoba, Spain
| | - Liang Cheng
- Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Thomas Gevaert
- Laboratory of Experimental Urology, Organ Systems, KU Leuven, Leuven, Belgium
- Department of Pathology, AZ Klina, Brasschaat, Belgium
| | - Ana Blanca
- Unit of Experimental Urology, Instituto Maimonides de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, Spain
| | - Alessia Cimadamore
- Section of Pathological Anatomy, United Hospital, School of Medicine, Polytechnic University of the Marche Region, Ancona, Italy
| | | | | | - Marina Scarpelli
- Section of Pathological Anatomy, United Hospital, School of Medicine, Polytechnic University of the Marche Region, Ancona, Italy
| | - Maria R. Raspollini
- Histopathology and Molecular Diagnostics, University Hospital Careggi, Florence, Italy
| | - Rodolfo Montironi
- Section of Pathological Anatomy, United Hospital, School of Medicine, Polytechnic University of the Marche Region, Ancona, Italy
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Güllü Amuran G, Tinay I, Filinte D, Ilgin C, Peker Eyüboğlu I, Akkiprik M. Urinary micro-RNA expressions and protein concentrations may differentiate bladder cancer patients from healthy controls. Int Urol Nephrol 2019; 52:461-468. [PMID: 31679136 DOI: 10.1007/s11255-019-02328-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2019] [Accepted: 10/28/2019] [Indexed: 12/24/2022]
Abstract
PURPOSE To determine expression differences of urine exosomal miR-19b1-5p, 21-5p, 136-3p, 139-5p, 210-3p and concentration differences of urinary BLCA-4, NMP22, APE1/Ref1, CRK, VIM between bladder cancer, follow-up patients, and control samples, to evaluate diagnostic importance of these differences and establish a diagnostic panel for bladder cancer. METHODS Urine samples of 59 bladder cancer patients, 34 healthy controls, and 12 follow-up patients without recurrence were enrolled to this study. Real-time PCR and ELISA were performed to determine urine exosomal miR-19b1-5p, 21-5p, 136-3p, 139-5p, 210-3p expressions and urinary BLCA-4, NMP22, APE1/Ref1, CRK, VIM, creatinine concentrations. Logistic regression analyses were performed to determine the diagnostic panel, the sensitivity, and specificity of the panel assessed by the ROC curve analysis. p values < 0.05 were considered statistically significant. RESULTS In bladder cancer risk groups, mir-139, -136, -19 and 210 expressions or positivity were found to be different and concentrations of urinary Ape1/Ref1, BLCA4, CRK, and VIM increased by twofold on average compared to healthy controls. Logistic regression and ROC analyses revealed that panel could differentiate bladder cancer patients from healthy controls with 80% sensitivity and 88% specificity (AUC = 0.899), low-risk patients from controls with 93% sensitivity and 95.5% specificity (AUC = 0.976). Despite the low number of samples, our findings suggest that urine exosomal miR-19b1-5p, 136-3p, 139-5p expression, and urinary APE1/Ref1, BLCA-4, CRK concentrations are promising candidates in terms of bladder cancer diagnosis. CONCLUSIONS Although our panel has great sensitivity for early detection of BC, it needs to be validated in larger populations.
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Affiliation(s)
- Gökçe Güllü Amuran
- Department of Medical Biology, School of Medicine, Marmara University, Başıbüyük Campus, Başıbüyük Mah. Maltepe Başıbüyük Yolu Sok. No:9/2, Maltepe, 34854, Istanbul, Turkey
| | - Ilker Tinay
- Department of Urology, School of Medicine, Marmara University, 34854, Istanbul, Turkey
| | - Deniz Filinte
- Department of Pathology, School of Medicine, Marmara University, 34854, Istanbul, Turkey
| | - Can Ilgin
- Department of Public Health, School of Medicine, Marmara University, 34899, Istanbul, Turkey
| | - Irem Peker Eyüboğlu
- Department of Medical Biology, School of Medicine, Marmara University, Başıbüyük Campus, Başıbüyük Mah. Maltepe Başıbüyük Yolu Sok. No:9/2, Maltepe, 34854, Istanbul, Turkey
| | - Mustafa Akkiprik
- Department of Medical Biology, School of Medicine, Marmara University, Başıbüyük Campus, Başıbüyük Mah. Maltepe Başıbüyük Yolu Sok. No:9/2, Maltepe, 34854, Istanbul, Turkey.
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Zhu R, Yang X, Guo W, Xu XJ, Zhu L. An eight-mRNA signature predicts the prognosis of patients with bladder urothelial carcinoma. PeerJ 2019; 7:e7836. [PMID: 31660264 PMCID: PMC6814068 DOI: 10.7717/peerj.7836] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Accepted: 09/05/2019] [Indexed: 12/27/2022] Open
Abstract
Background Bladder cancer is one of the most common cancers, and its histopathological type is mainly bladder urothelial carcinoma, accounting for about 90%. The prognostic biomarkers of bladder cancer are classified into clinical features biomarkers and molecular biomarkers. Nevertheless, due to the existence of individual specificity, patients with similar pathological characteristics still have great differences in the risk of disease recurrence. Therefore, it is often inaccurate to predict the survival status of patients based on clinical characteristic biomarkers, and a prognostic molecular biomarker that can grade the risk of bladder cancer patients is needed. Methods A total of three bladder urothelial carcinoma datasets were used in this study from the Cancer Genome Atlas database and Gene Expression Omnibus database. In order to avoid overfitting, all samples were randomly divided into one training set and three validation sets, which were used to construct and test the prognostic biomarker model of bladder urothelial carcinoma. Univariate and multivariate Cox regression were used to screen candidate mRNAs and construct prognostic biomarkers model. Kaplan-Meier survival analysis and the receiver operating characteristic (ROC) curve were used to evaluate the predictive performance of the model. Results A prognostic biomarker model of bladder urothelial carcinoma combining with eight mRNA was constructed. Kaplan-Meier analyses indicated that a significant difference in the survival time of patients between the high-risk and the low-risk group. The area under the ROC curve were 0.632 (95% confidence interval (CI) [0.541-0.723]), 0.693 (95% CI [0.601-0.784]) and 0.686 (95% CI [0.540-0.831]) when the model was used to predict the patient's survival time in three validation datasets. The model showed high accuracy and applicability.
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Affiliation(s)
- Rui Zhu
- Department of Mathematics, Shanghai University, Shanghai, China.,School of Life Sciences, Shanghai University, Shanghai, China
| | - Xin Yang
- School of Life Sciences, Shanghai University, Shanghai, China
| | - Wenna Guo
- School of Life Sciences, Zhengzhou University, Zhengzhou, Henan, China
| | - Xin-Jian Xu
- Department of Mathematics, Shanghai University, Shanghai, China
| | - Liucun Zhu
- School of Life Sciences, Shanghai University, Shanghai, China
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Agreda Castañeda F, Raventós Busquets C, Morote Robles J. Urinary markers in the surveillance of non-muscle invasive bladder cancer. A literature review. Actas Urol Esp 2019; 43:404-413. [PMID: 31097210 DOI: 10.1016/j.acuro.2019.03.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Revised: 02/13/2019] [Accepted: 03/04/2019] [Indexed: 12/31/2022]
Abstract
BACKGROUND The surveillance of non-muscle-invasive bladder cancer (NMIBC) is usually performed by cystoscopy and cytology. Until today, no effective urinary biomarker has been used to reduce the morbidity and cost associated with these procedures. OBJECTIVE To describe the performance of urinary biomarkers in the surveillance of NMIBC. EVIDENCE ACQUISITION on August 1, 2018, a bibliographic search was carried out in Pubmed, Embase and Cochrane Library, limited to the last 10 years, with the terms: bladder cancer, recurrence, detection and urine marker.973 registers were obtained, and 27 publications were selected following the PRISMA recommendations. EVIDENCE SYNTHESIS The negative predictive values (NPV) of several assays could reduce the number of cystoscopies in NMIBC surveillance. Six transcription-factor trials had an NPV rate greater than 90%, and one of them can be performed at the control point. Six transcription-factors evaluations describe anticipated diagnosis between 68% and 83% of their "false positives". Two transcription factors and one protein assays proved reduction between 23% and 35% of surveillance cystoscopies. Nowadays, cell-based assays are restricted to reflex test after doubtful cytologies. CONCLUSION There are few studies analysing the improvement of the NMIBC surveillance protocols. Several transcription factor assays are more precise and allow anticipatory diagnosis. Currently, there are no comparative studies between alternative surveillance protocols and classic ones.
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Chen J, Remulla D, Nguyen JH, Dua A, Liu Y, Dasgupta P, Hung AJ. Current status of artificial intelligence applications in urology and their potential to influence clinical practice. BJU Int 2019; 124:567-577. [PMID: 31219658 DOI: 10.1111/bju.14852] [Citation(s) in RCA: 65] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To investigate the applications of artificial intelligence (AI) in diagnosis, treatment and outcome predictionin urologic diseases and evaluate its advantages over traditional models and methods. MATERIALS AND METHODS A literature search was performed after PROSPERO registration (CRD42018103701) and in compliance with Preferred Reported Items for Systematic Reviews and Meta-Analyses (PRISMA) methods. Articles between 1994 and 2018 using the search terms "urology", "artificial intelligence", "machine learning" were included and categorized by the application of AI in urology. Review articles, editorial comments, articles with no full-text access, and nonurologic studies were excluded. RESULTS Initial search yielded 231 articles, but after excluding duplicates and following full-text review and examination of article references, only 111 articles were included in the final analysis. AI applications in urology include: utilizing radiomic imaging or ultrasonic echo data to improve or automate cancer detection or outcome prediction, utilizing digitized tissue specimen images to automate detection of cancer on pathology slides, and combining patient clinical data, biomarkers, or gene expression to assist disease diagnosis or outcome prediction. Some studies employed AI to plan brachytherapy and radiation treatments while others used video based or robotic automated performance metrics to objectively evaluate surgical skill. Compared to conventional statistical analysis, 71.8% of studies concluded that AI is superior in diagnosis and outcome prediction. CONCLUSION AI has been widely adopted in urology. Compared to conventional statistics AI approaches are more accurate in prediction and more explorative for analyzing large data cohorts. With an increasing library of patient data accessible to clinicians, AI may help facilitate evidence-based and individualized patient care.
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Affiliation(s)
- Jian Chen
- Catherine & Joseph Aresty Department of Urology, Center for Robotic Simulation & Education, University of Southern California Institute of Urology, Los Angeles, CA, USA
| | - Daphne Remulla
- Catherine & Joseph Aresty Department of Urology, Center for Robotic Simulation & Education, University of Southern California Institute of Urology, Los Angeles, CA, USA
| | - Jessica H Nguyen
- Catherine & Joseph Aresty Department of Urology, Center for Robotic Simulation & Education, University of Southern California Institute of Urology, Los Angeles, CA, USA
| | - Aastha Dua
- Computer Science Department, Viterbi School of Engineering, University of Southern California, Los Angeles, CA, USA
| | - Yan Liu
- Computer Science Department, Viterbi School of Engineering, University of Southern California, Los Angeles, CA, USA
| | - Prokar Dasgupta
- Division of Transplantation Immunology and Mucosal Biology, Faculty of Life Sciences and Medicine, Kings College London, London, UK
| | - Andrew J Hung
- Catherine & Joseph Aresty Department of Urology, Center for Robotic Simulation & Education, University of Southern California Institute of Urology, Los Angeles, CA, USA
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Pan J, Xie X, Li H, Li Z, Ren C, Ming L. Detection of serum long non-coding RNA UCA1 and circular RNAs for the diagnosis of bladder cancer and prediction of recurrence. INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL PATHOLOGY 2019; 12:2951-2958. [PMID: 31934131 PMCID: PMC6949697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Accepted: 06/24/2019] [Indexed: 06/10/2023]
Abstract
Accumulating evidence indicates that long noncoding RNAs (lncRNAs) and circular RNAs (circRNAs) may be biomarkers for the diagnosis and prediction of recurrence in tumor patients because they play an important role in tumorigenesis and progression. In this study, the expression of lncRNA urothelial carcinoma-associated 1 (UCA1) and associated circFARSA, circSHKBP1, and circBANP was investigated in serum specimens from bladder cancer (BC) patients and healthy controls using real-time PCR. When comparing patients with BC to healthy controls, the expression of lncRNA UCA1, circFARSA, and circSHKBP1 was significantly increased. The area under the curve (AUC) of the lncRNA UCA1 and circSHKBP1 signature to distinguish BC patients from controls was 0.804. The diagnostic performance of this signature was more optimal for low volume tumors (AUC = 0.870). Moreover, we determined that the expression of circFARSA, circSHKBP1, and circBANP was higher for recurrent BC than for patients without recurrence. Receiver operating characteristic (ROC) analysis revealed that a combination of circFARSA and circBANP levels was able to discriminate the patients with tumor recurrence from those without, with an area under the ROC curve of 0.737. In conclusion, our results identified an lncRNA UCA1: circSHKBP1 panel and a circFARSA: circBANP panel for BC diagnosis and prognosis, respectively.
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Affiliation(s)
- Jingjing Pan
- Department of Laboratory Medicine, The First Affiliated Hospital of Zhengzhou UniversityZhengzhou, CN
| | - Xiaojuan Xie
- Shaanxi Center for Clinical Laboratory, Shaanxi Provincial People’s HospitalXi’an, CN
| | - Huijin Li
- Institute of Basic and Translational Medicine, Xi’an Medical UniversityXi’an, CN
| | - Zhengkun Li
- Department of Medical Technology, Xi’an Medical UniversityXi’an, CN
| | - Chunfeng Ren
- Department of Laboratory Medicine, The First Affiliated Hospital of Zhengzhou UniversityZhengzhou, CN
| | - Liang Ming
- Department of Laboratory Medicine, The First Affiliated Hospital of Zhengzhou UniversityZhengzhou, CN
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Mussack V, Wittmann G, Pfaffl MW. Comparing small urinary extracellular vesicle purification methods with a view to RNA sequencing-Enabling robust and non-invasive biomarker research. BIOMOLECULAR DETECTION AND QUANTIFICATION 2019; 17:100089. [PMID: 31194192 PMCID: PMC6554496 DOI: 10.1016/j.bdq.2019.100089] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Revised: 02/27/2019] [Accepted: 04/10/2019] [Indexed: 01/10/2023]
Abstract
Small extracellular vesicles (EVs) are 50–200 nm sized mediators in intercellular communication that reflect both physiological and pathophysiological changes of their parental cells. Thus, EVs hold great potential for biomarker detection. However, reliable purification methods for the downstream screening of the microRNA (miRNA) cargo carried within urinary EVs by small RNA sequencing have yet to be established. To address this knowledge gap, RNA extracted from human urinary EVs obtained by five different urinary EV purification methods (spin column chromatography, immunoaffinity, membrane affinity, precipitation and ultracentrifugation combined with density gradient) was analyzed by small RNA sequencing. Urinary EVs were further characterized by nanoparticle tracking analysis, Western blot analysis and transmission electron microscopy. Comprehensive EV characterization established significant method-dependent differences in size and concentration as well as variances in protein composition of isolated vesicles. Even though all purification methods captured enough total RNA to allow small RNA sequencing, method-dependent differences were also observed with respect to library sizes, mapping distributions, number of miRNA reads and diversity of transcripts. Whereas EVs obtained by immunoaffinity yielded the purest subset of small EVs, highly comparable with results attained by ultracentrifugation combined with density gradient, precipitation and membrane affinity, sample purification by spin column chromatography indicated a tendency to isolate different subtypes of small EVs, which might also carry a distinct subset of miRNAs. Based on our results, different EV purification methods seem to preferentially isolate different subtypes of EVs with varying efficiencies. As a consequence, sequencing experiments and resulting miRNA profiles were also affected. Hence, the selection of a specific EV isolation method has to satisfy the respective research question and should be well considered. In strict adherence with the MISEV (minimal information for studies of extracellular vesicles) guidelines, the importance of a combined evaluation of biophysical and proteomic EV characteristics alongside transcriptomic results was clearly demonstrated in this present study.
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Key Words
- A, spin column chromatography
- ANOVA, analysis of variance
- Ago2, argonaute-2 protein
- B, immunoaffinity
- Biomarker
- C, membrane affinity
- D, precipitation
- DGE, differential gene expression
- DTT, dithiothreitol
- E, ultracentrifugation combined with density gradient
- EV(s), extracellular vesicle(s)
- Extracellular vesicles
- FM, fluorescent mode
- Human
- MISEV, minimal information for studies of extracellular vesicles
- NTA, nanoparticle tracking analysis
- PC, principal component
- RIN, RNA integrity number
- RNA-Seq, RNA sequencing
- SM, scattering mode
- Small RNA sequencing
- TEM, transmission electron microscopy
- UCrea, urinary creatinine
- Urine
- mIgG, murine immunoglobulin G
- mRNA, messenger RNA
- miRNA, microRNA
- microRNA
- nm, nanometer(s)
- nt, nucleotide(s)
- rRNA, ribosomal RNA
- snRNA, small nuclear RNA
- snoRNA, small nucleolar RNA
- tRNA, transfer RNA
- uEVs, urinary extracellular vesicles
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Affiliation(s)
- Veronika Mussack
- Animal Physiology and Immunology, School of Life Sciences Weihenstephan, Technical University of Munich, Weihenstephaner Berg 3, 85354, Freising, Germany
| | - Georg Wittmann
- Department for Transfusion Medicine, Cell therapeutics and Haemostaseology, University Hospital LMU, Marchioninistraße 15, 81377, Munich, Germany
| | - Michael W Pfaffl
- Animal Physiology and Immunology, School of Life Sciences Weihenstephan, Technical University of Munich, Weihenstephaner Berg 3, 85354, Freising, Germany
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Ghorbanmehr N, Gharbi S, Korsching E, Tavallaei M, Einollahi B, Mowla SJ. miR-21-5p, miR-141-3p, and miR-205-5p levels in urine-promising biomarkers for the identification of prostate and bladder cancer. Prostate 2019; 79:88-95. [PMID: 30194772 DOI: 10.1002/pros.23714] [Citation(s) in RCA: 70] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Accepted: 08/09/2018] [Indexed: 01/24/2023]
Abstract
BACKGROUND Early detection of cancers improves patients' survival and decreases the treatment cost. Unfortunately, the current methods for diagnosis of bladder and prostate cancers, two most common urothelial malignancies, suffer from a low sensitivity and specificity. MicroRNAs, as a group of endogenously produced non-coding RNAs, regulate gene expression and their expression is observed to be altered in many cancers and cancer progression phenomena. The remarkable stability of microRNAs in biofluids and their unique expression pattern in different pathological conditions make them an appealing, noninvasive diagnostic method in cancer diagnosis. Our objective is to identify microRNAs as biomarkers in urine samples of bladder and prostate cancers to improve the existing diagnostic methods in this field. MATERIALS AND METHODS In this study, urine samples from 110 men with either bladder (n = 45) or prostate (n = 23) cancer, benign prostatic hyperplasia (n = 22) and healthy controls (n = 20) were collected. qPCR was used to evaluate the expression level of miR-21-5p, miR-141-3p, and miR-205-5p in these samples. The sensitivity and specificity of these microRNAs were determined using ROC curve analysis. RESULTS The analysis of the data revealed that miR-21-5p, miR-141-3p, and miR-205-5p are differentially expressed in urine of bladder and prostate cancer patients. All these three microRNAs were upregulated in these samples and they were also able to differentiate benign prostatic hyperplasia from malignant cases. The statistical analyses revealed a good specificity for each individual microRNA. CONCLUSION The results show that these three urine-based microRNAs might be a good choice to implement a specific and non-invasive diagnostic tool for bladder and prostate cancer. The expression pattern of all three microRNAs was particularly useful to distinguish benign and invasive tumors in prostate cases. From the patients' perspective the improvement of the diagnostic situation is awaited eagerly.
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Affiliation(s)
- Nassim Ghorbanmehr
- Department of Biotechnology, Faculty of Biological Sciences, Alzahra University, Tehran, Iran
| | - Sedigheh Gharbi
- Department of Biology, Faculty of Basic Sciences, Shahid Bahonar University of Kerman, Kerman, Iran
| | - Eberhard Korsching
- Institute of Bioinformatics, University Hospital of Münster, University of Münster, Münster, Germany
| | - Mahmood Tavallaei
- Genetic Research Center, Baqiyatallah Medical Sciences University, Tehran, Iran
| | - Behzad Einollahi
- Nephrology and Urology Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Seyed Javad Mowla
- Department of Molecular Genetics, Faculty of Biological Sciences, Tarbiat Modares University, Tehran, Iran
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Liu Y, Li B, Yang X, Zhang C. MiR-99a-5p inhibits bladder cancer cell proliferation by directly targeting mammalian target of rapamycin and predicts patient survival. J Cell Biochem 2018; 120:19330-19337. [PMID: 30560585 DOI: 10.1002/jcb.27318] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Accepted: 06/27/2018] [Indexed: 12/14/2022]
Abstract
Bladder cancer is a common malignancy and miR-99a-5p has been reported to be downregulated in bladder cancer, but its function and the underlying mechanism in bladder cancer development remains largely unclear. Here, we report that miR-99a-5p expression was decreased in bladder cancer compared with the adjacent normal tissues. Receiver operating characteristic curve revealed that miR-99a-5p expression signature had area under curve value of 0.7989 in differing bladder cancer from the adjacent normal tissues. Bladder cancer patients with low expression of miR-99a-5p had a poor survival rate. Gain-of-function and loss-of-function approaches demonstrated that miR-99a-5p inhibited bladder cell proliferation and cell cycle. Furthermore, we identified that mammalian target of rapamycin (mTOR) was a direct target of miR-99a-5p and mTOR restore could rescue the proliferative ability of bladder cancer cells. Moreover, miR-99a-5p/mTOR axis regulated S6K1 phosphorylation. These suggested that miR-99a-5p/mTOR axis might be a therapeutic target for bladder cancer.
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Affiliation(s)
- Yan Liu
- Department of Urinary Surgery, The First Affiliated Hospital of Jinzhou Medical University, Jinzhou, China
| | - Bingxun Li
- Department of Urinary Surgery, The First Affiliated Hospital of Jinzhou Medical University, Jinzhou, China
| | - Xianxu Yang
- Department of Urinary Surgery, The First Affiliated Hospital of Jinzhou Medical University, Jinzhou, China
| | - Chenglong Zhang
- Department of Urinary Surgery, The First Affiliated Hospital of Jinzhou Medical University, Jinzhou, China
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42
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New Insights in Bladder Cancer Diagnosis: Urinary miRNAs and Proteins. Med Sci (Basel) 2018; 6:medsci6040113. [PMID: 30544619 PMCID: PMC6318758 DOI: 10.3390/medsci6040113] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Revised: 11/13/2018] [Accepted: 12/03/2018] [Indexed: 12/24/2022] Open
Abstract
Bladder cancer is the 10th-most common cancer worldwide. The diagnosis and follow-up of patients require costly invasive methods and due to these expenses, bladder cancer continues to be one of the expensive malignancies. Early diagnosis is crucial in bladder cancer as it is in other cancers; therefore, non-invasive biomarkers for early diagnosis are very important. In this review, we aimed to focus on the most recent investigations on potential urinary micro RNA (miRNA) and protein biomarkers for bladder cancer diagnosis and their associated pathways. Studies performed by different groups were compiled and the biomarker properties of various proteins and miRNAs in the urine of bladder cancer patients were evaluated. Key studies were obtained by searching keywords “bladder cancer, urinary miRNA, urinary protein, urinary biomarker”. Targets and the pathways of the miRNAs and proteins were analyzed according to mirBase Catalogue and Panther Database. The major pathways that are targeted by aberrantly expressed miRNAs are Cholecystokinin receptor (CCKR), p53, Wnt signaling pathway, and feedback loops. We hereby conclude that urinary micro RNAs and proteins are promising candidates for bladder cancer diagnosis. It should be noted that urine collection, storage conditions, choice of fraction, and normalization strategies should be standardized.
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Hofbauer SL, de Martino M, Lucca I, Haitel A, Susani M, Shariat SF, Klatte T. A urinary microRNA (miR) signature for diagnosis of bladder cancer. Urol Oncol 2018; 36:531.e1-531.e8. [PMID: 30322728 DOI: 10.1016/j.urolonc.2018.09.006] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Revised: 08/30/2018] [Accepted: 09/07/2018] [Indexed: 02/06/2023]
Abstract
INTRODUCTION Bladder cancer (BC) is diagnosed by cystoscopy, which is invasive, costly and causes considerable patient discomfort. MicroRNAs (miR) are dysregulated in BC and may serve as non-invasive urine markers for primary diagnostics and monitoring. The purpose of this study was to identify a urinary miR signature that predicts the presence of BC. METHODS For the detection of potential urinary miR markers, expression of 384 different miRs was analyzed in 16 urine samples from BC patients and controls using a Taqman™ Human MicroRNA Array (training set). The identified candidate gene signature was subsequently validated in an independent cohort of 202 urine samples of patients with BC and controls with microscopic hematuria. The final miR signature was developed from a multivariable logistic regression model. RESULTS Analysis of the training set identified 14 candidate miRs for further analysis within the validation set. Using backward stepwise elimination, we identified a subset of 6 miRs (let-7c, miR-135a, miR-135b, miR-148a, miR-204, miR-345) that distinguished BC from controls with an area under the curve of 88.3%. The signature was most accurate in diagnosing high-grade non-muscle invasive BC (area under the curve = 92.9%), but was capable to identify both low-grade and high-grade disease as well as non-muscle and muscle-invasive BC with high accuracies. CONCLUSIONS We identified a 6-gene miR signature that can accurately predict the presence of BC from urine samples, independent of stage and grade. This signature represents a simple urine assay that may help reducing costs and morbidity associated with invasive diagnostics.
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Affiliation(s)
- Sebastian L Hofbauer
- Department of Urology, Medical University of Vienna, Währinger Gürtel 18-20, A-1090 Vienna, Austria
| | - Michela de Martino
- Department of Urology, Medical University of Vienna, Währinger Gürtel 18-20, A-1090 Vienna, Austria
| | - Ilaria Lucca
- Department of Urology, Medical University of Vienna, Währinger Gürtel 18-20, A-1090 Vienna, Austria
| | - Andrea Haitel
- Institute of Clinical Pathology, Medical University of Vienna, Vienna, Austria
| | - Martin Susani
- Institute of Clinical Pathology, Medical University of Vienna, Vienna, Austria
| | - Shahrokh F Shariat
- Department of Urology, Medical University of Vienna, Währinger Gürtel 18-20, A-1090 Vienna, Austria
| | - Tobias Klatte
- Department of Urology, Medical University of Vienna, Währinger Gürtel 18-20, A-1090 Vienna, Austria.
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44
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Santoni G, Morelli MB, Amantini C, Battelli N. Urinary Markers in Bladder Cancer: An Update. Front Oncol 2018; 8:362. [PMID: 30245975 PMCID: PMC6137202 DOI: 10.3389/fonc.2018.00362] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Accepted: 08/16/2018] [Indexed: 12/12/2022] Open
Abstract
Bladder cancer (BC) is ones of the most common cancer worldwide. It is classified in muscle invasive (MIBC) and muscle non-invasive (NMIBC) BC. NMIBCs frequently recur and progress to MIBCs with a reduced survival rate and frequent distant metastasis. BC detection require unpleasant and expensive cystoscopy and biopsy, which are often accompanied by several adverse effects. Thus, there is an urgent need to develop novel diagnostic methods for initial detection and surveillance in both MIBCs and NMIBCs. Multiple urine-based tests approved by FDA for BC detection and surveillance are commercially available. However, at present, sensitivity, specificity and diagnostic accuracy of these urine-based assays are still suboptimal and, in the attend to improve them, novel molecular markers as well as multiple-assays must to be translated in clinic. Now there are growing evidence toward the use of minimally invasive “liquid biopsy” to identify biomarkers in urologic malignancy. DNA- and RNA-based markers in body fluids such as blood and urine are promising potential markers in diagnostic, prognostic, predictive and monitoring urological malignancies. Thus, circulating cell-free DNA, DNA methylation and mutations, circulating tumor cells, miRNA, IncRNA and mRNAs, cell-free proteins and peptides, and exosomes have been assessed in urine specimens. However, proteomic and genomic data must to be validated in well-designed multicenter clinical studies, before to be employed in clinic oncology.
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Affiliation(s)
- Giorgio Santoni
- Immunopathology Laboratory, School of Pharmacy, University of Camerino, Camerino, Italy
| | - Maria B Morelli
- Immunopathology Laboratory, School of Pharmacy, University of Camerino, Camerino, Italy.,Immunopathology Laboratory, School of Biosciences, Biotechnology and Veterinary Medicine, University of Camerino, Camerino, Italy
| | - Consuelo Amantini
- Immunopathology Laboratory, School of Biosciences, Biotechnology and Veterinary Medicine, University of Camerino, Camerino, Italy
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Lodewijk I, Dueñas M, Rubio C, Munera-Maravilla E, Segovia C, Bernardini A, Teijeira A, Paramio JM, Suárez-Cabrera C. Liquid Biopsy Biomarkers in Bladder Cancer: A Current Need for Patient Diagnosis and Monitoring. Int J Mol Sci 2018; 19:E2514. [PMID: 30149597 PMCID: PMC6163729 DOI: 10.3390/ijms19092514] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2018] [Revised: 08/16/2018] [Accepted: 08/21/2018] [Indexed: 02/08/2023] Open
Abstract
Bladder Cancer (BC) represents a clinical and social challenge due to its high incidence and recurrence rates, as well as the limited advances in effective disease management. Currently, a combination of cytology and cystoscopy is the routinely used methodology for diagnosis, prognosis and disease surveillance. However, both the poor sensitivity of cytology tests as well as the high invasiveness and big variation in tumour stage and grade interpretation using cystoscopy, emphasizes the urgent need for improvements in BC clinical guidance. Liquid biopsy represents a new non-invasive approach that has been extensively studied over the last decade and holds great promise. Even though its clinical use is still compromised, multiple studies have recently focused on the potential application of biomarkers in liquid biopsies for BC, including circulating tumour cells and DNA, RNAs, proteins and peptides, metabolites and extracellular vesicles. In this review, we summarize the present knowledge on the different types of biomarkers, their potential use in liquid biopsy and clinical applications in BC.
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Affiliation(s)
- Iris Lodewijk
- Molecular Oncology Unit, CIEMAT (Centro de Investigaciones Energéticas, Medioambientales y Tecnológicas), Avenida Complutense nº 40, 28040 Madrid, Spain.
- Biomedical Research Institute I+12, University Hospital "12 de Octubre", Av Córdoba s/n, 28041 Madrid, Spain.
| | - Marta Dueñas
- Molecular Oncology Unit, CIEMAT (Centro de Investigaciones Energéticas, Medioambientales y Tecnológicas), Avenida Complutense nº 40, 28040 Madrid, Spain.
- Biomedical Research Institute I+12, University Hospital "12 de Octubre", Av Córdoba s/n, 28041 Madrid, Spain.
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), 28029 Madrid, Spain.
| | - Carolina Rubio
- Molecular Oncology Unit, CIEMAT (Centro de Investigaciones Energéticas, Medioambientales y Tecnológicas), Avenida Complutense nº 40, 28040 Madrid, Spain.
- Biomedical Research Institute I+12, University Hospital "12 de Octubre", Av Córdoba s/n, 28041 Madrid, Spain.
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), 28029 Madrid, Spain.
| | - Ester Munera-Maravilla
- Molecular Oncology Unit, CIEMAT (Centro de Investigaciones Energéticas, Medioambientales y Tecnológicas), Avenida Complutense nº 40, 28040 Madrid, Spain.
- Biomedical Research Institute I+12, University Hospital "12 de Octubre", Av Córdoba s/n, 28041 Madrid, Spain.
| | - Cristina Segovia
- Molecular Oncology Unit, CIEMAT (Centro de Investigaciones Energéticas, Medioambientales y Tecnológicas), Avenida Complutense nº 40, 28040 Madrid, Spain.
- Biomedical Research Institute I+12, University Hospital "12 de Octubre", Av Córdoba s/n, 28041 Madrid, Spain.
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), 28029 Madrid, Spain.
| | - Alejandra Bernardini
- Molecular Oncology Unit, CIEMAT (Centro de Investigaciones Energéticas, Medioambientales y Tecnológicas), Avenida Complutense nº 40, 28040 Madrid, Spain.
- Biomedical Research Institute I+12, University Hospital "12 de Octubre", Av Córdoba s/n, 28041 Madrid, Spain.
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), 28029 Madrid, Spain.
| | - Alicia Teijeira
- Molecular Oncology Unit, CIEMAT (Centro de Investigaciones Energéticas, Medioambientales y Tecnológicas), Avenida Complutense nº 40, 28040 Madrid, Spain.
| | - Jesús M Paramio
- Molecular Oncology Unit, CIEMAT (Centro de Investigaciones Energéticas, Medioambientales y Tecnológicas), Avenida Complutense nº 40, 28040 Madrid, Spain.
- Biomedical Research Institute I+12, University Hospital "12 de Octubre", Av Córdoba s/n, 28041 Madrid, Spain.
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), 28029 Madrid, Spain.
| | - Cristian Suárez-Cabrera
- Molecular Oncology Unit, CIEMAT (Centro de Investigaciones Energéticas, Medioambientales y Tecnológicas), Avenida Complutense nº 40, 28040 Madrid, Spain.
- Biomedical Research Institute I+12, University Hospital "12 de Octubre", Av Córdoba s/n, 28041 Madrid, Spain.
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miR-27a in serum acts as biomarker for prostate cancer detection and promotes cell proliferation by targeting Sprouty2. Oncol Lett 2018; 16:5291-5298. [PMID: 30250598 DOI: 10.3892/ol.2018.9274] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Accepted: 09/01/2017] [Indexed: 12/23/2022] Open
Abstract
Prostate cancer (PCa) exhibits a high incidence among men, but there is no effective and non-invasive biomarker for the diagnosis of PCa, and the pathogenesis of PCa remains unclear. The present study identified that miR-27a was significantly overexpressed in the tumor tissues and sera of patients with PCa. In addition, high serum levels of miR-27a were correlated with poor survival in patients with PCa. Receiver-operating characteristic curves analysis demonstrated that the serum levels of miR-27a exhibited a high area under the curve value. Furthermore, miR-27a mimics or inhibitors significantly promoted or repressed the proliferation of PCa cells, respectively. In addition, it was identified that the expression of Sprouty2 (SPRY2) was inversely correlated with the expression of miR-27a in PCa tissues. The knockdown or overexpression of SPRY2 promoted or suppressed the proliferation of PCa cells, respectively, and the overexpression of SPRY2 inhibited the increased proliferation and cell cycle distribution of PCa cells mediated by miR-27a mimics. Taken together, these data indicated that the serum levels of miR-27a may be a novel and non-invasive biomarker for the diagnosis and prognosis of patients with PCa, and miR-27a/SPRY2 may be a therapeutic target for the treatment of PCa.
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Han C, Mengual L, Kang B, Lozano JJ, Yang X, Zhang C, Alcaraz A, Liang J, Ye D. Validation of Urine-based Gene Classifiers for Detecting Bladder Cancer in a Chinese Study. J Cancer 2018; 9:3208-3215. [PMID: 30210644 PMCID: PMC6134826 DOI: 10.7150/jca.24506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Accepted: 04/15/2018] [Indexed: 11/07/2022] Open
Abstract
Background: Current standard methods used to detect and monitor bladder cancer (BC) are invasive or have low sensitivity. We have previously reported in an international European study four non-invasive tests for BC diagnosis based on the gene expression patterns of urine. Objective: to validate the tests in an independent Asian cohort. Design, setting and participants: Prospective blinded study in which consecutive voided urine samples from BC patients and controls (n=520) were collected in the Fudan University Shanghai Cancer Center from 2014-2016. Gene expression values were quantified using TaqMan Arrays. The same cut-off as previously reported for discrimination between tumours and controls was used in this validation study. Results and limitations: Finally, a total of 257 tumour and 132 control urine samples were analysed. We found a high accuracy for the four gene classifiers in this independent Asian set, the classifiers composed of 5 and 10 genes achieved the best sensitivity (80.54% and 81.32%, respectively) maintaining a high specificity (91.67% and 85.61%, respectively). Sensitivity of 5-gene (GS_D5) and 10-gene (GS_D10) expression classifiers in recurrent BC cases (78 and 79%, respectively) is comparable to that of primary BC cases (82%). Cytology and NMP22 identified 67% and 40%, respectively, of tumours that have been diagnosed with our tests. In addition, influence of each studied gene was analyzed and showed similar gene rank between Chinese and Caucasian population. Conclusions: Our study proves that our non-invasive diagnostic BC tests can be reproduced in independent cohorts and in an external laboratory. All the four gene classifiers have shown equal or superior performance to the current gold standard in the present and previously reported validation studies. Consequently, they may be taken for consideration as molecular tests applicable to clinical practice in the management of BC. Patient summary: Our gene classifiers achieve sensitivities up to 90% in HR NMIBC and MIBC patients, while this achievement is comparatively lower in LR NMIBC ones.
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Affiliation(s)
- Chengtao Han
- Department of Urology, Fudan University Shanghai Cancer Center, Shanghai, P.R. China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, P.R. China
| | - Lourdes Mengual
- Department and Laboratory of Urology, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi iSunyer, Universitat de Barcelona, Barcelona, Spain
| | - Bin Kang
- Fudan University Shanghai Cancer Center - Institut Merieux Laboratory, Cancer Institute,Fudan University Shanghai Cancer Center, Shanghai, P.R. China.,bioMerieux (Shanghai) Company Limited, Shanghai, P.R. China
| | | | - Xiaoqun Yang
- Department of Pathology, Rui Jin Hospital, School of Medicine, Shanghai Jiao-Tong University, Shanghai, P.R. China
| | - Cuizhu Zhang
- Department of Urology, Fudan University Shanghai Cancer Center, Shanghai, P.R. China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, P.R. China
| | - Antonio Alcaraz
- Department and Laboratory of Urology, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi iSunyer, Universitat de Barcelona, Barcelona, Spain
| | - Ji Liang
- Fudan University Shanghai Cancer Center - Institut Merieux Laboratory, Cancer Institute,Fudan University Shanghai Cancer Center, Shanghai, P.R. China.,bioMerieux (Shanghai) Company Limited, Shanghai, P.R. China
| | - Dingwei Ye
- Department of Urology, Fudan University Shanghai Cancer Center, Shanghai, P.R. China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, P.R. China
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Tölle A, Blobel CC, Jung K. Circulating miRNAs in blood and urine as diagnostic and prognostic biomarkers for bladder cancer: an update in 2017. Biomark Med 2018; 12:667-676. [PMID: 29896971 DOI: 10.2217/bmm-2017-0392] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
This study presents a critical appraisal of previously published study data of miRNAs in blood, urine and exosomes as biomarkers of bladder cancer (BC). The evaluation included 39 articles published from the beginning of 2010 until September 2017 and searched in PubMed. The heterogeneity of studies, due to their clinicopathological variability, including insufficient consideration of diagnostic and prognostic biomarker guidelines and missing internal and external validation of data, do not currently allow the recommending of a useful miRNA marker as diagnostic or prognostic tool in BC. Future multi-institutional studies are necessary to overcome the deficiencies in these studies in order to prove the usefulness of circulating miRNAs as robust biomarkers for BC.
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Affiliation(s)
- Angelika Tölle
- Department of Urology, Charité - Universitätsmedizin Berlin, 10117 Berlin, Germany.,CONGEN Biotechnology GmbH, 13125 Berlin, Germany
| | - Conrad C Blobel
- Department of Urology, Charité - Universitätsmedizin Berlin, 10117 Berlin, Germany
| | - Klaus Jung
- Berlin Institute for Urologic Research, 10117 Berlin, Germany
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49
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Identification of miRNAs in cervical mucus as a novel diagnostic marker for cervical neoplasia. Sci Rep 2018; 8:7070. [PMID: 29728572 PMCID: PMC5935744 DOI: 10.1038/s41598-018-25310-1] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2017] [Accepted: 04/18/2018] [Indexed: 01/17/2023] Open
Abstract
microRNAs (miRNAs) play important roles in regulation of gene expression during cervical carcinogenesis. We investigated expression profiles of miRNAs in cervical cancer and its precursor lesions by utilizing cervical mucus. Cervical mucus was collected from 230 patients with a normal cervix, cervical intraepithelial neoplasia (CIN), squamous cell carcinoma (SCC), or adenocarcinoma (AD). The levels of miRNA in the mucus were quantified by miRNA array and real-time reverse-transcriptase polymerase chain reaction (RT-PCR). The performance for detecting diseases was statistically analysed. The expression of miRNAs was further validated in the surgical tissues of enrolled patients. Four miRNAs (miR-126-3p, -20b-5p, -451a, and -144-3p) were significantly up-regulated in SCC and AD compared with normal, and their expression levels correlated with disease severity and high-risk human papillomavirus infection. Receiver operating characteristic curve analyses revealed that the area under the curve values for miR-126-3p, -20b-5p, -451a, and -144-3p were 0.89, 0.90, 0.94, and 0.93, respectively, for SCC plus AD compared with normal, showing high accuracy of cancer detection. Real-time RT-PCR analyses confirmed the expression of these four miRNAs in frozen tissues from cervical cancer. miR-126-3p, -20b-5p, -451a, and -144-3p in cervical mucus are promising biomarkers for cervical cancer and high-grade CINs.
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50
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Pardini B, Cordero F, Naccarati A, Viberti C, Birolo G, Oderda M, Di Gaetano C, Arigoni M, Martina F, Calogero RA, Sacerdote C, Gontero P, Vineis P, Matullo G. microRNA profiles in urine by next-generation sequencing can stratify bladder cancer subtypes. Oncotarget 2018; 9:20658-20669. [PMID: 29755679 PMCID: PMC5945522 DOI: 10.18632/oncotarget.25057] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Accepted: 03/18/2018] [Indexed: 12/31/2022] Open
Abstract
Bladder cancer (BC) is the most frequent malignancy of the urinary tract with a high incidence in men and smokers. Currently, there are no non-invasive markers useful for BC diagnosis and subtypes classification that could overcome invasive procedures such as cystoscopy. Dysregulated miRNA profiles have been associated with numerous cancers, including BC. Cell-free miRNAs are abundantly present in a variety of biofluids including urine and make them promising candidates in cancer biomarker discovery. In the present study, the identification of miRNA fingerprints associated with different BC status was performed by next-generation sequencing on urine samples from 66 BC and 48 controls. Three signatures based on dysregulated miRNAs have been identified by regression models, assessing the power to discriminate different BC subtypes. Altered miRNAs according to invasiveness and grade were validated by qPCR on 112 cases and 65 controls (among which 46 cases and 16 controls were an independent group of subjects while the rest were replica samples). The area under the curve (AUC) computed including three miRNAs (miR-30a-5p, let-7c-5p and miR-486-5p) altered in all BC subtypes showed a significantly increased accuracy in the discrimination of cases and controls (AUC model = 0.70; p-value = 0.01). In conclusions, the non-invasive detection in urine of a selected number of miRNAs altered in different BC subtypes could lead to an accurate early diagnosis of cancer and stratification of patients.
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Affiliation(s)
- Barbara Pardini
- Italian Institute for Genomic Medicine, Turin, Italy.,Department of Medical Sciences, University of Turin, Turin, Italy
| | | | | | - Clara Viberti
- Italian Institute for Genomic Medicine, Turin, Italy.,Department of Medical Sciences, University of Turin, Turin, Italy
| | - Giovanni Birolo
- Italian Institute for Genomic Medicine, Turin, Italy.,Department of Medical Sciences, University of Turin, Turin, Italy
| | - Marco Oderda
- Department of Surgical Sciences, University of Turin and Città della Salute e della Scienza, Turin, Italy
| | - Cornelia Di Gaetano
- Italian Institute for Genomic Medicine, Turin, Italy.,Department of Medical Sciences, University of Turin, Turin, Italy
| | - Maddalena Arigoni
- Molecular Biotechnology Center, Department of Biotechnology and Health Sciences, University of Turin, Turin, Italy
| | - Federica Martina
- Department of Computer Science, University of Turin, Turin, Italy
| | - Raffaele A Calogero
- Molecular Biotechnology Center, Department of Biotechnology and Health Sciences, University of Turin, Turin, Italy
| | | | - Paolo Gontero
- Department of Surgical Sciences, University of Turin and Città della Salute e della Scienza, Turin, Italy
| | - Paolo Vineis
- Italian Institute for Genomic Medicine, Turin, Italy.,MRC-HPA Centre for Environment and Health, School of Public Health, Imperial College London, London, United Kingdom
| | - Giuseppe Matullo
- Italian Institute for Genomic Medicine, Turin, Italy.,Department of Medical Sciences, University of Turin, Turin, Italy
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