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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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Chen R, Pagano I, Sun Y, Murakami K, Goodison S, Vairavan R, Tahsin M, Black PC, Rosser CJ, Furuya H. A Diagnostic Gene Expression Signature for Bladder Cancer Can Stratify Cases into Prescribed Molecular Subtypes and Predict Outcome. Diagnostics (Basel) 2022; 12:diagnostics12081801. [PMID: 35892512 PMCID: PMC9332739 DOI: 10.3390/diagnostics12081801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 07/13/2022] [Accepted: 07/22/2022] [Indexed: 12/14/2022] Open
Abstract
Bladder cancer is a biologically heterogeneous disease with variable clinical presentations, outcomes and responses to therapy. Thus, the clinical utility of single biomarkers for the detection and prediction of biological behavior of bladder cancer is limited. We have previously identified and validated a bladder cancer diagnostic signature composed of 10 biomarkers, which has been incorporated into a multiplex immunoassay bladder cancer test, Oncuria™. In this study, we evaluate whether these 10 biomarkers can assist in the prediction of bladder cancer clinical outcomes. Tumor gene expression and patient survival data from bladder cancer cases from The Cancer Genome Atlas (TCGA) were analyzed. Alignment between the mRNA expression of 10 biomarkers and the TCGA 2017 subtype classification was assessed. Kaplan-Meier analysis of multiple gene expression datasets indicated that high expression of the combined 10 biomarkers correlated with a significant reduction in overall survival. The analysis of three independent, publicly available gene expression datasets confirmed that multiplex prognostic models outperformed single biomarkers. In total, 8 of the 10 biomarkers from the Oncuria™ test were significantly associated with either luminal or basal molecular subtypes, and thus, the test has the potential to assist in the prediction of clinical outcome.
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Affiliation(s)
- Runpu Chen
- Department of Microbiology and Immunology, The State University of New York at Buffalo, Buffalo, NY 14260, USA;
| | - Ian Pagano
- Cancer Prevention and Control Program, University of Hawaii Cancer Center, Honolulu, HI 96813, USA;
| | - Yijun Sun
- Department of Computer Science and Engineering, The State University of New York at Buffalo, Buffalo, NY 14260, USA;
- Department of Biostatistics, The State University of New York at Buffalo, Buffalo, NY 14260, USA
| | - Kaoru Murakami
- Cedars-Sinai Medical Center, Samuel Oschin Comprehensive Cancer Institute, Los Angeles, CA 90048, USA; (K.M.); (C.J.R.)
| | - Steve Goodison
- Quantitative Health Sciences, Mayo Clinic, Jacksonville, FL 32224, USA;
| | | | - Malak Tahsin
- DiaCarta Inc., Pleasanton, CA 94588, USA; (R.V.); (M.T.)
| | - Peter C. Black
- Department of Urologic Sciences, University of British Columbia, Vancouver, BC V6T 1Z4, Canada;
| | - Charles J. Rosser
- Cedars-Sinai Medical Center, Samuel Oschin Comprehensive Cancer Institute, Los Angeles, CA 90048, USA; (K.M.); (C.J.R.)
- Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
- Nonagen Bioscience Corp., Los Angeles, CA 90010, USA
| | - Hideki Furuya
- Cedars-Sinai Medical Center, Samuel Oschin Comprehensive Cancer Institute, Los Angeles, CA 90048, USA; (K.M.); (C.J.R.)
- Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
- Correspondence: ; Tel.: +1-310-423-4607
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Sampling, Logistics, and Analytics of Urine for RT-qPCR-based Diagnostics. Cancers (Basel) 2021; 13:cancers13174381. [PMID: 34503191 PMCID: PMC8430584 DOI: 10.3390/cancers13174381] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 08/23/2021] [Accepted: 08/27/2021] [Indexed: 11/17/2022] Open
Abstract
Body fluids in the context of cancer diagnosis are the primary source of liquid biopsy, i.e., biomarker detection that includes blood and serum, urine, and saliva. RNA represents a particular class of biomarkers because it is thought to monitor the current status of gene expression in humans, in organs, and if present, also in tumors. In case of bladder cancer, we developed a scheme that describes, in detail, all steps from the collection of urine samples from patients, stabilization of samples, their transportation, storage, and marker analysis by qPCR-based technology. We find that urine samples prepared according to this protocol show stability of RNA over more than 10 days at unchilled temperatures during shipping. A specific procedure of primer design and amplicon evaluation allows a specific assignment of PCR products to human genomics and transcriptomics data collections. In summary, we describe a technical option for the robust acquisition of urine samples and the quantitative detection of RNA-based tumor markers in case of bladder cancer patients. This protocol is for general use, and we describe that it works for any RNA-based tumor marker in urine of cancer patients.
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Hirasawa Y, Pagano I, Chen R, Sun Y, Dai Y, Gupta A, Tikhonenkov S, Goodison S, Rosser CJ, Furuya H. Diagnostic performance of Oncuria™, a urinalysis test for bladder cancer. J Transl Med 2021; 19:141. [PMID: 33823873 PMCID: PMC8025333 DOI: 10.1186/s12967-021-02796-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 03/18/2021] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Due to insufficient accuracy, urine-based assays currently have a limited role in the management of patients with bladder cancer. The identification of multiplex molecular signatures associated with disease has the potential to address this deficiency and to assist with accurate, non-invasive diagnosis and monitoring. METHODS To evaluate the performance of Oncuria™, a multiplex immunoassay for bladder detection in voided urine samples. The test was evaluated in a multi-institutional cohort of 362 prospectively collected subjects presenting for bladder cancer evaluation. The parallel measurement of 10 biomarkers (A1AT, APOE, ANG, CA9, IL8, MMP9, MMP10, PAI1, SDC1 and VEGFA) was performed in an independent clinical laboratory. The ability of the test to identify patients harboring bladder cancer was assessed. Bladder cancer status was confirmed by cystoscopy and tissue biopsy. The association of biomarkers and demographic factors was evaluated using linear discriminant analysis (LDA) and predictive models were derived using supervised learning and cross-validation analyses. Diagnostic performance was assessed using ROC curves. RESULTS The combination of the 10 biomarkers provided an AUROC 0.93 [95% CI 0.87-0.98], outperforming any single biomarker. The addition of demographic data (age, sex, and race) into a hybrid signature improved the diagnostic performance AUROC 0.95 [95% CI 0.90-1.00]. The hybrid signature achieved an overall sensitivity of 0.93, specificity of 0.93, PPV of 0.65 and NPV of 0.99 for bladder cancer classification. Sensitivity values of the diagnostic panel for high-grade bladder cancer, low-grade bladder cancer, MIBC and NMIBC were 0.94, 0.89, 0.97 and 0.93, respectively. CONCLUSIONS Urinary levels of a biomarker panel enabled the accurate discrimination of bladder cancer patients and controls. The multiplex Oncuria™ test can achieve the efficient and accurate detection and monitoring of bladder cancer in a non-invasive patient setting.
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Affiliation(s)
- Yosuke Hirasawa
- Cedars-Sinai Medical Center, Samuel Oschin Comprehensive Cancer Institute, Los Angeles, CA, USA
| | - Ian Pagano
- Cancer Prevention and Control Program, University of Hawaii Cancer Center, Honolulu, HI, USA
| | - Runpu Chen
- Department of Microbiology and Immunology, The State University of New York at Buffalo, Buffalo, NY, USA
| | - Yijun Sun
- Department of Microbiology and Immunology, The State University of New York at Buffalo, Buffalo, NY, USA
| | - Yunfeng Dai
- Department of Epidemiology, University of Florida, Gainesville, FL, USA
| | - Amit Gupta
- Division of Urology, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Sergei Tikhonenkov
- Translational and Clinical Program, University of Hawaii Cancer Center, Honolulu, HI, USA
| | - Steve Goodison
- Quantitative Health Sciences, Mayo Clinic Florida, Jacksonville, FL, USA
| | - Charles J Rosser
- Cedars-Sinai Medical Center, Samuel Oschin Comprehensive Cancer Institute, Los Angeles, CA, USA.
- Nonagen Bioscience Corp., Los Angeles, CA, USA.
| | - Hideki Furuya
- Cedars-Sinai Medical Center, Samuel Oschin Comprehensive Cancer Institute, Los Angeles, CA, USA
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Seol W, Kim H, Son I. Urinary Biomarkers for Neurodegenerative Diseases. Exp Neurobiol 2020; 29:325-333. [PMID: 33154195 PMCID: PMC7649089 DOI: 10.5607/en20042] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 10/12/2020] [Accepted: 10/19/2020] [Indexed: 12/13/2022] Open
Abstract
Global incidence of neurodegenerative diseases (NDDs) such as Alzheimer's disease (AD) and Parkinson's disease (PD) is rapidly increasing, but the diagnosis of these diseases at their early stage is challenging. Therefore, the availability of reproducible and reliable biomarkers to diagnose such diseases is more critical than ever. In addition, biomarkers could be used not only to diagnose diseases but also to monitor the development of disease therapeutics. Urine is an excellent biofluid that can be utilized as a source of biomarker to diagnose not only several renal diseases but also other diseases because of its abundance in invasive sampling. However, urine was conventionally regarded as inappropriate as a source of biomarker for neurodegenerative diseases because it is anatomically distant from the central nervous system (CNS), a major pathologic site of NDD, in comparison to other biofluids such as cerebrospinal fluid (CSF) and plasma. However, recent studies have suggested that urine could be utilized as a source of NDD biomarker if an appropriate marker is predetermined by metabolomic and proteomic approaches in urine and other samples. In this review, we summarize such studies related to NDD.
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Affiliation(s)
- Wongi Seol
- InAm Neuroscience Research Center, Gunpo 15865, Korea
| | - Hyejung Kim
- InAm Neuroscience Research Center, Gunpo 15865, Korea
| | - Ilhong Son
- InAm Neuroscience Research Center, Gunpo 15865, Korea
- Department of Neurology, Sanbon Medical Center, College of Medicine, Wonkwang University, Gunpo 15865, Korea
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Oncoprotein 18 is necessary for malignant cell proliferation in bladder cancer cells and serves as a G3-specific non-invasive diagnostic marker candidate in urinary RNA. PLoS One 2020; 15:e0229193. [PMID: 32614890 PMCID: PMC7332083 DOI: 10.1371/journal.pone.0229193] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Accepted: 06/15/2020] [Indexed: 12/28/2022] Open
Abstract
Background Urine-based diagnostics indicated involvement of oncoprotein 18 (OP18) in bladder cancer. In cell culture models we investigated the role of OP18 for malignant cell growth. Methods We analyzed 113 urine samples and investigated two human BCa cell lines as a dual model: RT-4 and ECV-304, which represented differentiated (G1) and poorly differentiated (G3) BCa. We designed specific siRNA for down-regulation of OP18 in both cell lines. Phenotypes were characterized by cell viability, proliferation, and expression of apoptosis-related genes. Besides, sensitivity to cisplatin treatment was evaluated. Results Analysis of urine samples from patients with urothelial BCa revealed a significant correlation of the RNA-ratio OP18:uroplakin 1A with bladder cancer. High urinary ratios were mainly found in moderately to poorly differentiated tumors (grade G2-3) that were muscle invasive (stage T2-3), whereas samples from patients with more differentiated non-invasive BCa (G1) showed low OP18:UPK1A RNA ratios. Down-regulation of OP18 expression in ECV-304 shifted its phenotype towards G1 state. Further, OP18-directed siRNA induced apoptosis and increased chemo-sensitivity to cisplatin. Conclusions This study provides conclusive experimental evidence for the link between OP18-derived RNA as a diagnostic marker for molecular staging of BCa in non-invasive urine-based diagnostics and the patho-mechanistic role of OP18 suggesting this gene as a therapeutic target.
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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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8
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Wong R, Rosser CJ. UroSEEK gene panel for bladder cancer surveillance. Transl Androl Urol 2019; 8:S546-S549. [PMID: 32042643 PMCID: PMC6989847 DOI: 10.21037/tau.2019.12.41] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Accepted: 12/26/2019] [Indexed: 12/20/2022] Open
Affiliation(s)
- Regan Wong
- Department of Surgery & Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Charles J Rosser
- Department of Surgery & Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
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Kim WT, Jeong P, Yan C, Kim YH, Lee IS, Kang HW, Kim YJ, Lee SC, Kim SJ, Kim YT, Moon SK, Choi YH, Kim IY, Yun SJ, Kim WJ. UBE2C cell-free RNA in urine can discriminate between bladder cancer and hematuria. Oncotarget 2018; 7:58193-58202. [PMID: 27528424 PMCID: PMC5295424 DOI: 10.18632/oncotarget.11277] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Accepted: 08/08/2016] [Indexed: 02/06/2023] Open
Abstract
Background There is growing interest in circulating nucleic acids as cancer detection biomarkers. Therefore, the aim of the present study was to identify a key urinary cell-free RNA marker that may assist in the diagnosis of BC. Results Five cell-free RNAs were selected as candidate cell-free RNAs from tissue microarray data. An area under the curve (AUC) cut-off value of 0.7 in receiver operating characteristic (ROC) curve analysis identified four urinary cell-free RNAs for further analysis (CDC20, ESM1, UBE2C, and CA9; AUC = 0.716, 0.704, 0.721, and 0.702, respectively). Binary logistic regression analysis revealed that high expression of UBE2C was significantly associated with BC (OR, 1.754; CI, 1.147–2.682; p = 0.010). Analysis of UBE2C expression in urine samples from BC patients and hematuria controls yielded an AUC of 0.839, with a sensitivity of 82.5% and a specificity of 76.2%. UBE2C levels was significantly increased in G2 and G3 tumors compared to normal controls (p <0.001, respectively). Materials and Methods Urine samples from 212 BC patients and 106 normal controls (64 healthy individuals and 42 with hematuria) were examined. The candidate cell-free RNAs identified from tissue microarrays derived from BC and normal control tissues was then measured in the urine samples. Conclusions The levels of urinary UBE2C cell-free RNA were significantly higher in BC samples than in normal and hematuria control samples. The higher levels of urinary UBE2C cell-free RNA in BC might reflect high expression in BC tissues. Therefore, urinary UBE2C cell-free RNA may be a valuable diagnostic marker for BC.
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Affiliation(s)
- Won Tae Kim
- Department of Urology, Chungbuk National University College of Medicine, Cheongju, Chungbuk, South Korea
| | - Pildu Jeong
- Department of Urology, Chungbuk National University College of Medicine, Cheongju, Chungbuk, South Korea
| | - Chunri Yan
- Department of Urology, Chungbuk National University College of Medicine, Cheongju, Chungbuk, South Korea
| | - Ye Hwan Kim
- Department of Urology, Chungbuk National University College of Medicine, Cheongju, Chungbuk, South Korea
| | - Il-Seok Lee
- Department of Urology, Chungbuk National University College of Medicine, Cheongju, Chungbuk, South Korea
| | - Ho-Won Kang
- Department of Urology, Chungbuk National University College of Medicine, Cheongju, Chungbuk, South Korea
| | - Yong-June Kim
- Department of Urology, Chungbuk National University College of Medicine, Cheongju, Chungbuk, South Korea
| | - Sang-Cheol Lee
- Department of Urology, Chungbuk National University College of Medicine, Cheongju, Chungbuk, South Korea
| | - Sang Jin Kim
- Department of Urology, Myongji Hospital, Seonam University College of Medicine, Goyang, South Korea.,Department of Urology, Graduate School of Medicine, Hanyang University, Seoul, South Korea
| | - Yong Tae Kim
- Department of Urology, Graduate School of Medicine, Hanyang University, Seoul, South Korea
| | - Sung-Kwon Moon
- School of Food Science and Technology, Chung-Ang University, Anseong, South Korea
| | - Yung-Hyun Choi
- Department of Biochemistry, Dongeui University College of Oriental Medicine, Busan, South Korea
| | - Isaac Yi Kim
- Section of Urological Oncology, The Cancer Institute of New Jersey, Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - Seok Joong Yun
- Department of Urology, Chungbuk National University College of Medicine, Cheongju, Chungbuk, South Korea
| | - Wun-Jae Kim
- Department of Urology, Chungbuk National University College of Medicine, Cheongju, Chungbuk, South Korea
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Kim WT, Kim YH, Jeong P, Seo SP, Kang HW, Kim YJ, Yun SJ, Lee SC, Moon SK, Choi YH, Lee GT, Kim IY, Kim WJ. Urinary cell-free nucleic acid IQGAP3: a new non-invasive diagnostic marker for bladder cancer. Oncotarget 2018; 9:14354-14365. [PMID: 29581849 PMCID: PMC5865675 DOI: 10.18632/oncotarget.24436] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Accepted: 07/12/2017] [Indexed: 12/23/2022] Open
Abstract
Background There is growing interest in developing new non-invasive diagnostic tools for
bladder cancer (BC) that have better sensitivity and specificity than cystoscopy
and cytology. This study examined the value of urinary cell-free nucleic acid (NA)
as a diagnostic marker for BC. Material and methods A total of 81 patients (74 BC and 7 normal controls) were used for a tissue set,
and 212 patients (92 BC and 120 normal controls) were used as a urine set.
Expression of tissue mRNA and urinary cell-free NAs was then examined. Results Four candidate genes were top-ranked in the tissue microarray. Expression levels
of two of these (IQGAP3 and TOP2A) in BC tissue and urine samples from BC patients
were significantly higher than those in samples from the control groups. Binary
logistic regression analysis of cell-free NA levels in urine samples revealed that
IQGAP3 was significantly associated with BC: PicoGreen-adjusted odds ratio (OR),
3.434; confidence interval (CI), 2.999–4.180;
P<0.001; RiboGreen-adjusted OR, 2.242; CI,
1.793–2.840; P<0.001. Further analysis of IQGAP3
urinary cell-free NAs with respect to tumor invasiveness and grade also yielded a
high AUC, suggesting that IQGAP3 can discriminate between BC patients and
non-cancer patients with hematuria. Conclusions Levels of IQGAP3 urinary cell-free NA in BC patients were significantly higher
than those in normal controls or patients with hematuria. High levels of IQGAP3
urinary cell-free NA also reflected high expression in BC tissues. Therefore,
IQGAP3 urinary cell-free NA may be a complementary diagnostic biomarker for
BC.
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Affiliation(s)
- Won Tae Kim
- Department of Urology, Chungbuk National University College of Medicine, Cheongju, Chungbuk, South Korea.,Department of Urology, Chungbuk National University Hospital, Cheongju, Chungbuk, South Korea.,Section of Urological Oncology, The Cancer Institute of New Jersey, Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - Ye Hwan Kim
- Department of Urology, Chungbuk National University College of Medicine, Cheongju, Chungbuk, South Korea
| | - Pildu Jeong
- Department of Urology, Chungbuk National University College of Medicine, Cheongju, Chungbuk, South Korea
| | - Sung-Pil Seo
- Department of Urology, Chungbuk National University College of Medicine, Cheongju, Chungbuk, South Korea.,Department of Urology, Chungbuk National University Hospital, Cheongju, Chungbuk, South Korea
| | - Ho-Won Kang
- Department of Urology, Chungbuk National University College of Medicine, Cheongju, Chungbuk, South Korea.,Department of Urology, Chungbuk National University Hospital, Cheongju, Chungbuk, South Korea
| | - Yong-June Kim
- Department of Urology, Chungbuk National University College of Medicine, Cheongju, Chungbuk, South Korea.,Department of Urology, Chungbuk National University Hospital, Cheongju, Chungbuk, South Korea
| | - Seok Joong Yun
- Department of Urology, Chungbuk National University College of Medicine, Cheongju, Chungbuk, South Korea.,Department of Urology, Chungbuk National University Hospital, Cheongju, Chungbuk, South Korea
| | - Sang-Cheol Lee
- Department of Urology, Chungbuk National University College of Medicine, Cheongju, Chungbuk, South Korea.,Department of Urology, Chungbuk National University Hospital, Cheongju, Chungbuk, South Korea
| | - Sung-Kwon Moon
- School of Food Science and Technology, Chung-Ang University, Anseong, South Korea
| | - Yung-Hyun Choi
- Department of Biochemistry, Dongeui University College of Oriental Medicine, Busan, South Korea
| | - Geun Taek Lee
- Section of Urological Oncology, The Cancer Institute of New Jersey, Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - Isaac Yi Kim
- Section of Urological Oncology, The Cancer Institute of New Jersey, Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - Wun-Jae Kim
- Department of Urology, Chungbuk National University College of Medicine, Cheongju, Chungbuk, South Korea.,Department of Urology, Chungbuk National University Hospital, Cheongju, Chungbuk, South Korea
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Lin SY, Linehan JA, Wilson TG, Hoon DS. Emerging Utility of Urinary Cell-free Nucleic Acid Biomarkers for Prostate, Bladder, and Renal Cancers. Eur Urol Focus 2017; 3:265-272. [DOI: 10.1016/j.euf.2017.03.009] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2017] [Revised: 03/06/2017] [Accepted: 03/15/2017] [Indexed: 01/05/2023]
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12
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Huang S, Kou L, Furuya H, Yu C, Goodison S, Kattan MW, Garmire L, Rosser CJ. A Nomogram Derived by Combination of Demographic and Biomarker Data Improves the Noninvasive Evaluation of Patients at Risk for Bladder Cancer. Cancer Epidemiol Biomarkers Prev 2016; 25:1361-6. [PMID: 27383773 DOI: 10.1158/1055-9965.epi-16-0260] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2016] [Accepted: 06/23/2016] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Improvements in the noninvasive clinical evaluation of patients at risk for bladder cancer would be of benefit both to individuals and to health care systems. We investigated the potential utility of a hybrid nomogram that combined key demographic features with the results of a multiplex urinary biomarker assay in hopes of identifying patients at risk of harboring bladder cancer. METHODS Logistic regression analysis was used to model the probability of bladder cancer burden in a cohort of 686 subjects (394 with bladder cancer) using key demographic features alone, biomarker data alone, and the combination of demographic features and key biomarker data. We examined discrimination, calibration, and decision curve analysis techniques to evaluate prediction model performance. RESULTS Area under the receiver operating characteristic curve (AUC) analyses revealed that demographic features alone predicted tumor burden with an accuracy of 0.806 [95% confidence interval (CI), 0.76-0.85], while biomarker data had an accuracy of 0.835 (95% CI, 0.80-0.87). The addition of molecular data into the nomogram improved the predictive performance to 0.891 (95% CI, 0.86-0.92). Decision curve analyses showed that the hybrid nomogram performed better than demographic or biomarker data alone. CONCLUSION A nomogram construction strategy that combines key demographic features with biomarker data may facilitate the accurate, noninvasive evaluation of patients at risk of harboring bladder cancer. Further research is needed to evaluate the bladder cancer risk nomogram for potential clinical utility. IMPACT The application of such a nomogram may better inform the decision to perform invasive diagnostic procedures. Cancer Epidemiol Biomarkers Prev; 25(9); 1361-6. ©2016 AACR.
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Affiliation(s)
- Sijia Huang
- Cancer Epidemiology Research Program, University of Hawaii Cancer Center, Honolulu, Hawaii
| | - Lei Kou
- Department of Biostatistics, Cleveland Clinic, Cleveland, Ohio
| | - Hideki Furuya
- Clinical and Translational Research Program, University of Hawaii Cancer Center, Honolulu, Hawaii
| | - Changhong Yu
- Department of Biostatistics, Cleveland Clinic, Cleveland, Ohio
| | - Steve Goodison
- Nonagen Bio-Science Corp., Jacksonville, Florida. Department of Health Sciences Research, Mayo Clinic Florida, Jacksonville, Florida
| | | | - Lana Garmire
- Cancer Epidemiology Research Program, University of Hawaii Cancer Center, Honolulu, Hawaii
| | - Charles J Rosser
- Clinical and Translational Research Program, University of Hawaii Cancer Center, Honolulu, Hawaii. Nonagen Bio-Science Corp., Jacksonville, Florida.
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Darwiche F, Parekh DJ, Gonzalgo ML. Biomarkers for non-muscle invasive bladder cancer: Current tests and future promise. Indian J Urol 2015; 31:273-82. [PMID: 26604437 PMCID: PMC4626910 DOI: 10.4103/0970-1591.166448] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
The search continues for optimal markers that can be utilized to improve bladder cancer detection and to predict disease recurrence. Although no single marker has yet replaced the need to perform cystoscopy and urine cytology, many tests have been evaluated and are being developed. In the future, these promising markers may be incorporated into standard practice to address the challenge of screening in addition to long-term surveillance of patients who have or are at risk for developing bladder cancer.
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Affiliation(s)
- Fadi Darwiche
- Department of Urology, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Dipen J Parekh
- Department of Urology, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Mark L Gonzalgo
- Department of Urology, Miller School of Medicine, University of Miami, Miami, FL, USA
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Tilki D, Zlotta AR. Utility of urine biomarkers. Bladder Cancer 2015. [DOI: 10.1002/9781118674826.ch3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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15
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Chen LM, Chang M, Dai Y, Chai KX, Dyrskjøt L, Sanchez-Carbayo M, Szarvas T, Zwarthoff EC, Lokeshwar V, Jeronimo C, Parker AS, Ross S, Borre M, Orntoft TF, Jaeger T, Beukers W, Lopez LE, Henrique R, Young PR, Urquidi V, Goodison S, Rosser CJ. External validation of a multiplex urinary protein panel for the detection of bladder cancer in a multicenter cohort. Cancer Epidemiol Biomarkers Prev 2014; 23:1804-12. [PMID: 24920641 DOI: 10.1158/1055-9965.epi-14-0029] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Because of the faltering sensitivity and/or specificity, urine-based assays currently have a limited role in the management of patients with bladder cancer. The aim of this study was to externally validate our previously reported protein biomarker panel from multiple sites in the United States and Europe. METHODS This multicenter external validation study included a total of 320 subjects (bladder cancer = 183). The 10 biomarkers (IL8, MMP9, MMP10, SERPINA1, VEGFA, ANG, CA9, APOE, SDC1, and SERPINE1) were measured using commercial ELISA assays in an external laboratory. The diagnostic performance of the biomarker panel was assessed using receiver operator curves (ROC) and descriptive statistical values. RESULTS Utilizing the combination of all 10 biomarkers, the area under the ROC for the diagnostic panel was noted to be 0.847 (95% confidence interval, 0.796-0.899), outperforming any single biomarker. The multiplex assay at optimal cutoff value achieved an overall sensitivity of 0.79, specificity of 0.79, positive prediction value of 0.73, and negative prediction value of 0.84 for bladder cancer classification. Sensitivity values of the diagnostic panel for high-grade bladder cancer, low-grade bladder cancer, muscle invasive bladder cancer, and non-muscle invasive bladder cancer were 0.81, 0.90, 0.95, and 0.77, respectively. CONCLUSIONS Urinary levels of the biomarker panel enabled discrimination of patients with bladder cancer and controls, and the levels of biomarker subsets were associated with advancing tumor grade and stage. IMPACT If proven to be reliable, urinary diagnostic biomarker assays can detect bladder cancer in a timely manner such that the patient can expect improvements in overall survival and quality of life.
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Affiliation(s)
- Li-Mei Chen
- Burnett School of Biomedical Sciences, College of Medicine, University of Central Florida, Orlando, Florida
| | - Myron Chang
- Department of Biostatistics, The University of Florida, Gainesville, Florida
| | - Yunfeng Dai
- Department of Biostatistics, The University of Florida, Gainesville, Florida
| | - Karl X Chai
- Burnett School of Biomedical Sciences, College of Medicine, University of Central Florida, Orlando, Florida
| | - Lars Dyrskjøt
- Department of Molecular Medicine, Aarhus University Hospital, Aarhus, Denmark
| | | | - Tibor Szarvas
- Department of Urology, University Hospital Duisburg-Essen, Essen, Germany
| | | | - Vinata Lokeshwar
- Department of Urology, University of Miami Miller School of Medicine, Miami, Florida. Department of Cell Biology, University of Miami Miller School of Medicine, Miami, Florida
| | - Carmen Jeronimo
- Cancer Epigenetics Group, Research Center Portuguese Oncology Institute, Porto, Portugal. Department of Pathology and Molecular Immunology, Institute of Biomedical Sciences Abel Salazar, University of Porto, Porto, Portugal
| | | | - Shanti Ross
- Cancer Research Institute, MD Anderson Cancer Center, Orlando, Florida
| | - Michael Borre
- Department of Molecular Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Torben F Orntoft
- Department of Molecular Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Tobias Jaeger
- Department of Urology, University Hospital Duisburg-Essen, Essen, Germany
| | | | - Luis E Lopez
- Department of Urology, University of Miami Miller School of Medicine, Miami, Florida. Department of Cell Biology, University of Miami Miller School of Medicine, Miami, Florida
| | - Rui Henrique
- Cancer Epigenetics Group, Research Center Portuguese Oncology Institute, Porto, Portugal. Department of Pathology and Molecular Immunology, Institute of Biomedical Sciences Abel Salazar, University of Porto, Porto, Portugal
| | - Paul R Young
- Department of Urology, Mayo Clinic Florida, Jacksonville, Florida
| | - Virginia Urquidi
- Cancer Research Institute, MD Anderson Cancer Center, Orlando, Florida. Nonagen Bioscience Corp., Jacksonville, Florida
| | - Steve Goodison
- Cancer Research Institute, MD Anderson Cancer Center, Orlando, Florida. Nonagen Bioscience Corp., Jacksonville, Florida. Department of Health Sciences Research, Mayo Clinic, Jacksonville, Florida
| | - Charles J Rosser
- Cancer Research Institute, MD Anderson Cancer Center, Orlando, Florida. Nonagen Bioscience Corp., Jacksonville, Florida. University of Hawaii, Honolulu, Hawaii.
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Ralla B, Stephan C, Meller S, Dietrich D, Kristiansen G, Jung K. Nucleic acid-based biomarkers in body fluids of patients with urologic malignancies. Crit Rev Clin Lab Sci 2014; 51:200-31. [PMID: 24878357 DOI: 10.3109/10408363.2014.914888] [Citation(s) in RCA: 54] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
This review focuses on the promising potential of nucleic acids in body fluids such as blood and urine as diagnostic, prognostic, predictive and monitoring biomarkers in urologic malignancies. The tremendous progress in the basic knowledge of molecular processes in cancer, as shown in the companion review on nucleic acid-based biomarkers in tissue of urologic tumors, provides a strong rationale for using these molecular changes as non-invasive markers in body fluids. The changes observed in body fluids are an integrative result, reflecting both tissue changes and processes occurring in the body fluids. The availability of sensitive methods has only recently made possible detailed studies of DNA- and RNA-based markers in body fluids. In addition to these biological aspects, methodological aspects of the determination of nucleic acids in body fluids, i.e. pre-analytical, analytical and post-analytical issues, are particularly emphasized. The characteristic changes of RNA (differential mRNA and miRNA expression) and DNA (concentrations, integrity index, mutations, microsatellite and methylation alterations) in serum/plasma and urine samples of patients suffering from the essential urologic cancers of the prostate, bladder, kidney and testis are summarized and critically discussed below. To translate the promising results into clinical practice, laboratory scientists and clinicians have to collaborate to resolve the challenges of harmonized and feasible pre-analytical and analytical conditions for the selected markers and to validate these markers in well-designed and sufficiently powered multi-center studies.
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Affiliation(s)
- Bernhard Ralla
- Department of Urology, Charité - Universitätsmedizin Berlin , Berlin , Germany
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Ben-Dov IZ, Tan YC, Morozov P, Wilson PD, Rennert H, Blumenfeld JD, Tuschl T. Urine microRNA as potential biomarkers of autosomal dominant polycystic kidney disease progression: description of miRNA profiles at baseline. PLoS One 2014; 9:e86856. [PMID: 24489795 PMCID: PMC3906110 DOI: 10.1371/journal.pone.0086856] [Citation(s) in RCA: 72] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2013] [Accepted: 12/14/2013] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Autosomal dominant polycystic kidney disease (ADPKD) is clinically heterogenic. Biomarkers are needed to predict prognosis and guide management. We aimed to profile microRNA (miRNA) in ADPKD to gain molecular insight and evaluate biomarker potential. METHODS Small-RNA libraries were generated from urine specimens of ADPKD patients (N = 20) and patients with chronic kidney disease of other etiologies (CKD, N = 20). In this report, we describe the miRNA profiles and baseline characteristics. For reference, we also examined the miRNA transcriptome in primary cultures of ADPKD cyst epithelia (N = 10), normal adult tubule (N = 8) and fetal tubule (N = 7) epithelia. RESULTS In primary cultures of ADPKD kidney cells, miRNA cistrons mir-143(2) (9.2-fold), let-7i(1) (2.3-fold) and mir-3619(1) (12.1-fold) were significantly elevated compared to normal tubule epithelia, whereas mir-1(4) members (19.7-fold), mir-133b(2) (21.1-fold) and mir-205(1) (3.0-fold) were downregulated (P<0.01). Expression of the dysregulated miRNA in fetal tubule epithelia resembled ADPKD better than normal adult cells, except let-7i, which was lower in fetal cells. In patient biofluid specimens, mir-143(2) members were 2.9-fold higher in urine cells from ADPKD compared to other CKD patients, while expression levels of mir-133b(2) (4.9-fold) and mir-1(4) (4.4-fold) were lower in ADPKD. We also noted increased abundance mir-223(1) (5.6-fold), mir-199a(3) (1.4-fold) and mir-199b(1) (1.8-fold) (P<0.01) in ADPKD urine cells. In ADPKD urine microvesicles, miR-1(2) (7.2-fold) and miR-133a(2) (11.8-fold) were less abundant compared to other CKD patients (P<0.01). CONCLUSIONS We found that in ADPKD urine specimens, miRNA previously implicated as kidney tumor suppressors (miR-1 and miR-133), as well as miRNA of presumed inflammatory and fibroblast cell origin (miR-223/miR-199), are dysregulated when compared to other CKD patients. Concordant with findings in the primary tubule epithelial cell model, this suggests roles for dysregulated miRNA in ADPKD pathogenesis and potential use as biomarkers. We intend to assess prognostic potential of miRNA in a followup analysis.
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Affiliation(s)
- Iddo Z. Ben-Dov
- Laboratory of RNA Molecular Biology, Howard Hughes Medical Institute, The Rockefeller University, New York, New York, United States of America
- * E-mail:
| | - Ying-Cai Tan
- Molecular Pathology Laboratory, New York Presbyterian Hospital, Cornell University, New York, New York, United States of America
- Pathology and Laboratory Medicine, Weill Medical College, Cornell University, New York, New York, United States of America
| | - Pavel Morozov
- Laboratory of RNA Molecular Biology, Howard Hughes Medical Institute, The Rockefeller University, New York, New York, United States of America
| | - Patricia D. Wilson
- Centre for Nephrology, University College London Medical School, London, United Kingdom
| | - Hanna Rennert
- Molecular Pathology Laboratory, New York Presbyterian Hospital, Cornell University, New York, New York, United States of America
- Pathology and Laboratory Medicine, Weill Medical College, Cornell University, New York, New York, United States of America
| | - Jon D. Blumenfeld
- Rogosin Institute, Weill Medical College of Cornell University, New York, New York, United States of America
| | - Thomas Tuschl
- Laboratory of RNA Molecular Biology, Howard Hughes Medical Institute, The Rockefeller University, New York, New York, United States of America
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Eissa S, Matboli M. Integrated technologies in the post-genomic era for discovery of bladder cancer urinary markers. World J Clin Urol 2013; 2:20-31. [DOI: 10.5410/wjcu.v2.i3.20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2013] [Revised: 11/10/2013] [Accepted: 11/21/2013] [Indexed: 02/06/2023] Open
Abstract
The incidence of bladder cancer (BC) continues to rise with high recurrence and mortality rate, especially in the past three decades. The development of accurate and successful BC treatment relies mainly on early diagnosis. BC is a heterogeneous disease reflected by the presence of many potential biomarkers associated with different disease phenotypes. Nowadays, cystoscopy and urinary cytology are considered the gold standard diagnostic tools for BC. There are many limitations to cystoscopy including being invasive, labor-intensive and carcinoma in situ of the bladder may easily be missed. Urinary cytology is still a noninvasive technique with high accuracy in high-grade BC with a median sensitivity of 35%. Furthermore, the need for a sensitive, specific, non invasive, easily accessible BC biomarker is a major clinical need. The field of urinary BC biomarkers discovery is still a rapidly evolving discipline in which more recent technologies are evaluated and often optimized if they are not clinically significant to the urologists. Most of the current strategies for BC urinary biomarker detection depend on integration of information gleaned from the fields of genomics, transcriptomics, proteomics, epigenetics, metabolomics and bionanotechnology. Effort is currently being made to identify the most potentially beneficial urinary biomarkers. The purpose of this review is to summarize and explore the efficacy of gathering the information revealed from the cooperation of different omic strategies that paves the way towards various urinary markers discovery for screening, diagnosis and prognosis of human BC.
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Rosser CJ, Urquidi V, Goodison S. Urinary biomarkers of bladder cancer: an update and future perspectives. Biomark Med 2013; 7:779-90. [DOI: 10.2217/bmm.13.73] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Bladder cancer is one of the most prevalent cancers worldwide. Early detection of bladder tumors is critical for improved patient outcomes. The standard method for detection and surveillance of bladder tumors is cystoscopy with urinary cytology. Limitations of cystoscopy and urinary cytology have brought to light the need for more robust diagnostic assays. Ideally, such assays would be applicable to noninvasively obtained, voided urine, and be designed not only for diagnosis, but also for monitoring disease recurrence and response to therapy. Consequently, the development of a noninvasive urine-based assay would be of tremendous benefit to both patients and healthcare systems. This article reports some of the more prominent urine-based biomarkers reported in the literature. In addition, some new technologies that have been used to identify novel urinary biomarkers are highlighted.
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Affiliation(s)
- Charles J Rosser
- Department of Urology, University of Central Florida College of Medicine, Orlando, FL 32527, USA
- Nonagen Bioscience Corporation, Orlando, FL 32527, USA
| | - Virginia Urquidi
- Nonagen Bioscience Corporation, Orlando, FL 32527, USA
- Cancer Research Institute, MD Anderson Cancer Center Orlando, Orlando, FL 32527, USA
| | - Steve Goodison
- Nonagen Bioscience Corporation, Orlando, FL 32527, USA
- Cancer Research Institute, MD Anderson Cancer Center Orlando, Orlando, FL 32527, USA
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20
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Bladder cancer detection and monitoring: assessment of urine- and blood-based marker tests. Mol Diagn Ther 2013; 17:71-84. [PMID: 23479428 PMCID: PMC3627848 DOI: 10.1007/s40291-013-0023-x] [Citation(s) in RCA: 78] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Bladder cancer is one of the most prevalent cancers worldwide, but the treatment and management of this disease can be very successful if the disease is detected early. The development of molecular assays that could diagnose bladder cancer accurately, and at an early stage, would be a significant advance. Ideally, such molecular assays would be applicable to non-invasively obtained body fluids, and be designed not only for diagnosis but also for monitoring disease recurrence and response to treatment. In this article, we assess the performance of current diagnostic assays for bladder cancer and discuss some of the emerging biomarkers that could be developed to augment current bladder cancer detection strategies.
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Wu W, Zhang S, Li X, Xue M, Cao S, Chen W. Ets-2 regulates cell apoptosis via the Akt pathway, through the regulation of urothelial cancer associated 1, a long non-coding RNA, in bladder cancer cells. PLoS One 2013; 8:e73920. [PMID: 24069250 PMCID: PMC3771932 DOI: 10.1371/journal.pone.0073920] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2013] [Accepted: 07/24/2013] [Indexed: 02/07/2023] Open
Abstract
The majority of the human genome is transcribed and generates non-coding RNAs (ncRNAs) that fail to encode protein information. Long non-coding RNAs (lncRNAs) are emerging as a novel class of ncRNAs, but our knowledge about these ncRNAs is limited. Previously, our laboratory has identified that a lncRNA, Urothelial cancer associated 1 (UCA1), played an important role in bladder cancer. Despite the recent interest in UCA1 as a diagnostic marker for bladder cancer, little is known about its transcriptional regulation. To elucidate the regulation of UCA1 gene expression, we have characterized the human UCA1 gene promoter. A 2.0-kb fragment of its 5' flanking region was cloned into a luciferase reporter vector. Deletion and mutation analysis suggested that an Ets-2 binding site was critical for UCA1 gene promoter activity. Further analysis of this site by gel shifting, chromatin immune precipitation (ChIP), and co-transfection experiments showed that transcription factor Ets-2 directly bound to the UCA1 promoter region and stimulated UCA1 promoter activity in bladder cancer cells. Taking into account the anti-apoptosis function of Ets-2, our data suggested that Ets-2 regulates apoptosis process by regulating the expression of UCA1, moreover UCA1 may be involved in the activation of Akt signaling pathway by Ets-2 in bladder cancer cells.
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Affiliation(s)
- Wenjing Wu
- Clinical Laboratory, the First Affiliated Hospital, School of Medicine, Xi’an Jiaotong University, Xi’an, China
| | - Shuwan Zhang
- Clinical Laboratory, the First Affiliated Hospital, School of Medicine, Xi’an Jiaotong University, Xi’an, China
- Clinical Laboratory, Xi’an Children’s Hospital, Xi’an, China
| | - Xu Li
- Translational Medicine Center, the First Affiliated Hospital, School of Medicine, Xi’an Jiaotong University, Xi’an, China
| | - Mei Xue
- Translational Medicine Center, the First Affiliated Hospital, School of Medicine, Xi’an Jiaotong University, Xi’an, China
| | - Sancheng Cao
- Clinical Laboratory, Xi’an Children’s Hospital, Xi’an, China
| | - Wei Chen
- Clinical Laboratory, the First Affiliated Hospital, School of Medicine, Xi’an Jiaotong University, Xi’an, China
- * E-mail:
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Urquidi V, Rosser CJ, Goodison S. Molecular diagnostic trends in urological cancer: biomarkers for non-invasive diagnosis. Curr Med Chem 2012; 19:3653-63. [PMID: 22680923 DOI: 10.2174/092986712801661103] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2011] [Revised: 01/17/2012] [Accepted: 01/25/2012] [Indexed: 11/22/2022]
Abstract
The early detection of urological cancers is pivotal for successful patient treatment and management. The development of molecular assays that can diagnose disease accurately, or that can augment current methods of evaluation, would be a significant advance. Ideally, such molecular assays would be applicable to non-invasively obtained body fluids, enabling not only diagnosis of at risk patients, but also asymptomatic screening, monitoring disease recurrence and response to treatment. The advent of advanced proteomics and genomics technologies and associated bioinformatics development is bringing these goals into focus. In this article we will discuss the promise of biomarkers in urinalysis for the detection and clinical evaluation of the major urological cancers, including bladder, kidney and prostate. The development of urine-based tests to detect urological cancers would be of tremendous benefit to both patients and the healthcare system.
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Affiliation(s)
- V Urquidi
- Cancer Research Institute, MD Anderson Cancer Center Orlando, 6900 Lake Nona Blvd, Orlando, FL 32827, USA
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Zheng M, Lv LL, Cao YH, Zhang JD, Wu M, Ma KL, Phillips AO, Liu BC. Urinary mRNA markers of epithelial-mesenchymal transition correlate with progression of diabetic nephropathy. Clin Endocrinol (Oxf) 2012; 76:657-64. [PMID: 21824169 DOI: 10.1111/j.1365-2265.2011.04192.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
OBJECTIVE Epithelial-mesenchymal transition (EMT) plays an important role in the pathogenesis and progression of diabetic nephropathy (DN). Quantification of messenger RNA (mRNA) expression in urinary sediment is emerging as a noninvasive method of screening DN-associated biomarkers. The aim of our study was to examine whether urinary mRNA profile of EMT-associated genes may provide valuable clinical insight into the different stages of DN. DESIGN AND METHODS Diabetic nephropathy patients (n = 44) and healthy controls (n = 12) were enrolled in this study. DN patients were divided into three groups according to the levels of estimated glomerular filtration rate (eGFR): Group A (eGFR > 60 ml/min per 1·73 m(2), n = 27), Group B (45 < eGFR < 60 ml/min per 1·73 m(2), n = 9), and Group C (eGFR < 45 ml/min per 1·73 m(2), n = 8). Relative mRNA abundance of α-smooth muscle actin (α-SMA), fibronectin, FSP1 and matrix metalloproteinase-9 (MMP-9) were quantified, and correlations between target mRNAs and clinical parameters were examined. RESULTS The urinary mRNA levels of α-SMA, fibronectin and MMP-9 were significantly higher in the DN group compared with controls (P < 0·05), and mRNA levels increased with DN progression. Urinary mRNA levels of all target genes positively correlated with both urinary albumin excretion (UAE) and blood urea nitrogen (BUN). Moreover, the expression of α-SMA, fibronectin and MMP-9 mRNA correlated with serum creatinine levels (r = 0·514, r = 0·53 and r = 0·469, all P < 0·001) and GFR levels (r = -0·374, r = -0·392 and r = -0·487, all P < 0·01). CONCLUSIONS Quantification of EMT-associated genes in urinary sediment may be a novel approach for searching new biomarkers of DN.
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Affiliation(s)
- Min Zheng
- Institute of Nephrology, Zhong Da Hospital, Southeast University School of Medicine, Nanjing, China
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Boopathi E, Gomes CM, Goldfarb R, John M, Srinivasan VG, Alanzi J, Malkowicz SB, Kathuria H, Zderic SA, Wein AJ, Chacko S. Transcriptional repression of Caveolin-1 (CAV1) gene expression by GATA-6 in bladder smooth muscle hypertrophy in mice and human beings. THE AMERICAN JOURNAL OF PATHOLOGY 2011; 178:2236-51. [PMID: 21514437 DOI: 10.1016/j.ajpath.2011.01.038] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2010] [Revised: 12/28/2010] [Accepted: 01/25/2011] [Indexed: 01/08/2023]
Abstract
Hypertrophy occurs in urinary bladder wall smooth muscle (BSM) in men with partial bladder outlet obstruction (PBOO) caused by benign prostatic hyperplasia (BPH) and in animal models of PBOO. Hypertrophied BSM from the rabbit model exhibits down-regulation of caveolin-1, a structural and functional protein of caveolae that function as signaling platforms to mediate interaction between receptor proteins and adaptor and effector molecules to regulate signal generation, amplification, and diversification. Caveolin-1 expression is diminished in PBOO-induced BSM hypertrophy in mice and in men with BPH. The proximal promoter of the human and mouse caveolin-1 (CAV1) gene was characterized, and it was observed that the transcription factor GATA-6 binds this promoter, causing reduced expression of caveolin-1. Furthermore, caveolin-1 expression levels inversely correlate with the abundance of GATA-6 in BSM hypertrophy in mice and human beings. Silencing of GATA6 gene expression up-regulates caveolin-1 expression, whereas overexpression of GATA-6 protein sustains the transcriptional repression of caveolin-1 in bladder smooth muscle cells. Together, these data suggest that GATA-6 acts as a transcriptional repressor of CAV1 gene expression in PBOO-induced BSM hypertrophy in men and mice. GATA-6-induced transcriptional repression represents a new regulatory mechanism of CAV1 gene expression in pathologic BSM, and may serve as a target for new therapy for BPH-induced bladder dysfunction in aging men.
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Affiliation(s)
- Ettickan Boopathi
- Division of Urology, University of Pennsylvania, Glenolden, Pennsylvania, USA
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Tzimagiorgis G, Michailidou EZ, Kritis A, Markopoulos AK, Kouidou S. Recovering circulating extracellular or cell-free RNA from bodily fluids. Cancer Epidemiol 2011; 35:580-9. [PMID: 21514265 DOI: 10.1016/j.canep.2011.02.016] [Citation(s) in RCA: 81] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2010] [Revised: 02/28/2011] [Accepted: 02/28/2011] [Indexed: 12/18/2022]
Abstract
The presence of extracellular circulating or cell-free RNA in biological fluids is becoming a promising diagnostic tool for non invasive and cost effective cancer detection. Extracellular RNA or miRNA as biological marker could be used either for the early detection and diagnosis of the disease or as a marker of recurrence patterns and surveillance. In this review article, we refer to the origin of the circulating extracellular RNA, we summarise the data on the biological fluids (serum/plasma, saliva, urine, cerebrospinal fluid and bronchial lavage fluid) of patients suffering from various types of malignancies reported to contain a substantial amount of circulating extracellular (or cell-free) RNAs and we discuss the appropriate reagents and methodologies needed to be employed in order to obtain RNA material of high quality and integrity for the majority of the experimental methods used in RNA expression analysis. Furthermore, we discuss the advantages and disadvantages of the RT-PCR or microarray methodology which are the methods more often employed in procedures of extracellular RNA analysis.
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Affiliation(s)
- Georgios Tzimagiorgis
- Laboratory of Biological Chemistry, Medical School, Aristotle University of Thessaloniki, 540 06 Thessaloniki, Greece.
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Methods for the discovery of low-abundance biomarkers for urinary bladder cancer in biological fluids. Bioanalysis 2011; 2:295-309. [PMID: 21083311 DOI: 10.4155/bio.09.174] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
For the study of bladder cancer and the identification of respective tumor markers, blood and, in particular, urine constitute suitable sources of biological material, while both harboring their specific challenges for analytics concerning low-abundance biomarkers. Dissolved proteins and nucleic acids as well as cells and cell-bound molecules can be the analytes. In urine, exfoliated bladder tumor cells have to be identified and in blood, circulating tumor cells have to be detected among huge amounts of other cells. For the detection of both low-abundance cells and molecules, their specific enrichment prior to analysis is advantageous or even necessary. Adapted methods for the analysis of proteomes and subproteomes by 2D-gel electrophoresis, multidimensional chromatography and antibody arrays are discussed. Analysis of nucleic acid-based markers exploits the high amplification power of PCR and modified PCR combined with previous (subtransciptomes) or subsequent (microarray) enrichment to sensitively and specifically detect markers. DNA mutations, DNA-methylation status and apoptotic DNA fragments, as well as levels of ribonucleic acids including microRNAs, can be analyzed by means of these methods. Finally, the challenge of identifying circulating tumor cells and assigning them to their original tissue is critically discussed.
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Abstract
PURPOSE OF REVIEW Bladder cancer remains a highly prevalent and lethal malignancy. Early diagnosis and prompt treatment have been shown to improve survival at both initial diagnosis and recurrence. A vast number of tumor markers have been identified and rigorously evaluated in attempts to improve noninvasive diagnostic accuracy of bladder cancer. Hematuria was the first tumor marker in a field that has grown to include soluble markers, cell-surface antigens, cell-cycle-related proteins, and genetic alterations. We aim to provide a critical appraisal of newer markers and the current state of research. RECENT FINDINGS The number of tumor markers identified has been exponentially increasing. For a variety of reasons, many are unsuitable for clinical practice. More promising recent markers include those discovered in the fields of genomics, proteomics, and epigenetics. Much of the recent work is focused on molecular genetic pathways in bladder cancer. SUMMARY The field of bladder cancer tumor markers remains a rapidly evolving area in which newer markers are constantly identified, evaluated, and often discarded if they do not add significantly to the urologists' armamentarium. Newer markers rely on genetic rearrangements, molecular changes, and cell-cycle-related proteins. Work is currently being done to identify the most promising markers.
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Hanke M, Hoefig K, Merz H, Feller AC, Kausch I, Jocham D, Warnecke JM, Sczakiel G. A robust methodology to study urine microRNA as tumor marker: microRNA-126 and microRNA-182 are related to urinary bladder cancer. Urol Oncol 2009; 28:655-61. [PMID: 19375957 DOI: 10.1016/j.urolonc.2009.01.027] [Citation(s) in RCA: 459] [Impact Index Per Article: 30.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2008] [Revised: 01/20/2009] [Accepted: 01/22/2009] [Indexed: 12/29/2022]
Abstract
OBJECTIVES MicroRNAs have been shown to be related to specific types of malignant cell growth. In case of urothelial bladder cancer (BCa), novel noninvasive diagnosis is particularly required and it is attractive to consider, as urine is an easily available source for molecular markers including RNA. In this context, we aimed to develop a clinically applicable and sensitive protocol for the preparation and molecular analysis of low molecular weight RNA from urine samples obtained from bladder cancer patients or healthy volunteers. MATERIALS AND METHODS First, a method was developed for the preparation of low molecular weight RNA from a set of urine samples from different donor groups: (1) patients with low-grade BCa, (2) patients with high-grade BCa, (3) patients with urinary tract infections, (4) healthy donors; each n = 9. The RNA extracts were then used to monitor a number of 157 microRNA species by quantitative reverse transcriptase-polymerase chain reaction. Subsequently, those microRNAs that showed a higher abundance in urine samples from BCa patients were detected in an independent set of urine samples (n = 47). RESULTS The significance and diagnostic usefulness of this methodology is reflected by the finding that the RNA ratio of microRNA-126:microRNA-152 enabled the detection of BCa from urine at a specificity of 82% and a sensitivity of 72%, with an area under the curve of 0.768 (95% confidence interval, 0.605-0.931). CONCLUSIONS This study describes a novel, robust, and useful technology platform that is suitable to analyze small RNAs, including novel RNA-based tumor markers, in urine samples. A detailed technical analysis of this methodology provides new insights into the characteristics of urine microRNA such as composition and the donor-dependent variability.
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Affiliation(s)
- Merle Hanke
- Kompetenzzentrum für Drug Design und Target Monitoring, Lübeck, Germany
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Nezos A, Pissimisis N, Lembessis P, Sourla A, Dimopoulos P, Dimopoulos T, Tzelepis K, Koutsilieris M. Detection of circulating tumor cells in bladder cancer patients. Cancer Treat Rev 2008; 35:272-9. [PMID: 19103472 DOI: 10.1016/j.ctrv.2008.11.003] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2008] [Revised: 11/06/2008] [Accepted: 11/10/2008] [Indexed: 12/31/2022]
Abstract
The methods employed for the detection of circulating bladder cancer cells (CBCs) and their use as a molecular staging tool in clinical settings are thoroughly reviewed. CBC isolation and enrichment methods are discussed according to their advantages and pitfalls along with the clinical data of PCR-based techniques used for CBC detection. In addition, we review the specificity of molecular markers that have been proposed so far for CBC identification, and we comment on the controversial clinical data, proposing laboratory approaches which may improve the clinical significance of CBC detection in bladder cancer.
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Affiliation(s)
- Adrianos Nezos
- Department of Experimental Physiology, Medical School, National and Kapodistrian University of Athens, 75 Mikras Asias, Goudi 115 27, Athens, Greece
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30
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