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Kravchuk AP, Wolff I, Gilfrich C, Wirtz RM, Soares P, Braun KP, Brookman-May SD, Kollitsch L, Hauner K, Burchardt M, Bründl J, Burger M, May M. Urine-Based Biomarker Test Uromonitor ® in the Detection and Disease Monitoring of Non-Muscle-Invasive Bladder Cancer-A Systematic Review and Meta-Analysis of Diagnostic Test Performance. Cancers (Basel) 2024; 16:753. [PMID: 38398144 PMCID: PMC10886463 DOI: 10.3390/cancers16040753] [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: 12/23/2023] [Revised: 02/05/2024] [Accepted: 02/06/2024] [Indexed: 02/25/2024] Open
Abstract
Optimal urine-based diagnostic tests (UBDT) minimize unnecessary follow-up cystoscopies in patients with non-muscle-invasive bladder-cancer (NMIBC), while accurately detecting high-grade bladder-cancer without false-negative results. Such UBDTs have not been comprehensively described upon a broad, validated dataset, resulting in cautious guideline recommendations. Uromonitor®, a urine-based DNA-assay detecting hotspot alterations in TERT, FGFR3, and KRAS, shows promising initial results. However, a systematic review merging all available data is lacking. Studies investigating the diagnostic performance of Uromonitor® in NMIBC until November 2023 were identified in PubMed, Embase, Web-of-Science, Cochrane, Scopus, and medRxiv databases. Within aggregated analyses, test performance and area under the curve/AUC were calculated. This project fully implemented the PRISMA statement. Four qualifying studies comprised a total of 1190 urinary tests (bladder-cancer prevalence: 14.9%). Based on comprehensive analyses, sensitivity, specificity, positive-predictive value/PPV, negative-predictive value/NPV, and test accuracy of Uromonitor® were 80.2%, 96.9%, 82.1%, 96.6%, and 94.5%, respectively, with an AUC of 0.886 (95%-CI: 0.851-0.921). In a meta-analysis of two studies comparing test performance with urinary cytology, Uromonitor® significantly outperformed urinary cytology in sensitivity, PPV, and test accuracy, while no significant differences were observed for specificity and NPV. This systematic review supports the use of Uromonitor® considering its favorable diagnostic performance. In a cohort of 1000 patients with a bladder-cancer prevalence of ~15%, this UBDT would avert 825 unnecessary cystoscopies (true-negatives) while missing 30 bladder-cancer cases (false-negatives). Due to currently limited aggregated data from only four studies with heterogeneous quality, confirmatory studies are needed.
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Affiliation(s)
- Anton P. Kravchuk
- Department of Urology, St. Elisabeth Hospital Straubing, 94315 Straubing, Germany
| | - Ingmar Wolff
- Department of Urology, University Medicine Greifswald, 17475 Greifswald, Germany
| | - Christian Gilfrich
- Department of Urology, St. Elisabeth Hospital Straubing, 94315 Straubing, Germany
| | - Ralph M. Wirtz
- STRATIFYER Molecular Pathology GmbH, 50935 Cologne, Germany
| | - Paula Soares
- IPATIMUP-Institute of Molecular Pathology and Immunology, University of Porto, 4200-135 Porto, Portugal
- Department of Pathology and Oncology, Faculty of Medicine, University of Porto, 4200-139 Porto, Portugal
| | - Kay-Patrick Braun
- Institute of General Practice, Otto-von-Guericke-University Magdeburg, 39120 Magdeburg, Germany
| | - Sabine D. Brookman-May
- Department of Urology, Ludwig-Maximilians-University, 81377 Munich, Germany
- Johnson and Johnson Innovative Medicine, Research & Development, Spring House, PA 19477, USA
| | - Lisa Kollitsch
- Department of Urology and Andrology, Klinik Donaustadt, A1220 Vienna, Austria
| | - Katharina Hauner
- Department of Urology, University Hospital MRI-TUM (München rechts der Isar), 81675 Munich, Germany
| | - Martin Burchardt
- Department of Urology, University Medicine Greifswald, 17475 Greifswald, Germany
| | - Johannes Bründl
- Department of Urology, Caritas St. Josef Medical Centre, University of Regensburg, 93053 Regensburg, Germany
| | - Maximilian Burger
- Department of Urology, Caritas St. Josef Medical Centre, University of Regensburg, 93053 Regensburg, Germany
| | - Matthias May
- Department of Urology, St. Elisabeth Hospital Straubing, 94315 Straubing, Germany
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Ouyang W, Xu R, Yao H, Jiang S, Lu Q, Lv C, Li P, Xu G, Liu J, Wang L. Urinary DNA methylation-based risk stratification model to triage patients for repeat transurethral resection of bladder tumours. Clin Transl Med 2024; 14:e1549. [PMID: 38251828 PMCID: PMC10802133 DOI: 10.1002/ctm2.1549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 12/28/2023] [Accepted: 01/06/2024] [Indexed: 01/23/2024] Open
Affiliation(s)
- Wei Ouyang
- Department of UrologyThe Third Xiangya HospitalCentral South UniversityChangshaChina
| | - Ran Xu
- Department of UrologyThe Second Xiangya HospitalCentral South UniversityChangshaChina
| | - Hanyu Yao
- Department of UrologyThe Third Xiangya HospitalCentral South UniversityChangshaChina
| | - Shusuan Jiang
- Department of UrologyHunan Cancer HospitalThe Affiliated Cancer Hospital of Xiangya School of MedicalCentral South UniversityChangshaChina
| | - Qiang Lu
- Department of UrologyHunan Provincial People's HospitalFirst Affiliated Hospital of Hunan Normal UniversityChangshaChina
| | - Cai Lv
- Department of UrologyAffiliated Haikou Hospital of Xiangya Medical CollegeCentral South UniversityHaikouChina
| | - Pei Li
- Yearth Biotechnology Co. Ltd.ChangshaChina
| | - Genming Xu
- Yearth Biotechnology Co. Ltd.ChangshaChina
| | - Jianye Liu
- Department of UrologyThe Third Xiangya HospitalCentral South UniversityChangshaChina
| | - Long Wang
- Department of UrologyThe Third Xiangya HospitalCentral South UniversityChangshaChina
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