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Bladder cancer risk stratification using a urinary mRNA biomarker panel - A path towards cystoscopy triaging.
Shkolyar, Eugene; Zhao, Qian; Mach, Kathleen E; Teslovich, Nikola C; Lee, Timothy J; Cox, Susanne; Skinner, Eila C; Lu, Ying; Liao, Joseph C.
Afiliación
  • Shkolyar E; Department of Urology, Stanford University School of Medicine, Stanford, USA; Veterans Affairs Palo Alto Health Care System, Palo Alto, USA.
  • Zhao Q; Department of Biomedical Data Science, Stanford University, Stanford, USA; Department of Epidemiology and Medical Statistics, School of Public Health, Guangzhou Medical University, Guangzhou, China.
  • Mach KE; Department of Urology, Stanford University School of Medicine, Stanford, USA; Veterans Affairs Palo Alto Health Care System, Palo Alto, USA.
  • Teslovich NC; Department of Urology, Stanford University School of Medicine, Stanford, USA.
  • Lee TJ; Department of Urology, Stanford University School of Medicine, Stanford, USA; Veterans Affairs Palo Alto Health Care System, Palo Alto, USA.
  • Cox S; Veterans Affairs Palo Alto Health Care System, Palo Alto, USA.
  • Skinner EC; Department of Urology, Stanford University School of Medicine, Stanford, USA.
  • Lu Y; Department of Biomedical Data Science, Stanford University, Stanford, USA.
  • Liao JC; Department of Urology, Stanford University School of Medicine, Stanford, USA; Veterans Affairs Palo Alto Health Care System, Palo Alto, USA. Electronic address: jliao@stanford.edu.
Urol Oncol ; 39(8): 497.e9-497.e15, 2021 08.
Article en En | MEDLINE | ID: mdl-33766467
OBJECTIVES: The risk of bladder cancer (BCa) diagnosis and recurrence necessitates cystoscopy. Improved risk stratification may inform personalized triage and surveillance strategies. We aim to develop a urinary mRNA biomarker panel for risk stratification in patients undergoing BCa screening and surveillance. METHODS AND MATERIALS: Urine samples were collected from patients undergoing cystoscopy for BCa screening or surveillance. In patients who underwent transurethral resection of bladder tumor, urine samples were categorized based on tumor histopathology, size, and focality. Subjects with intermediate and high-risk BCa based on American Urological Association (AUA) guideline for non-muscle invasive bladder cancer were classified as "increased-risk"; those with no cancer and AUA low-risk BCa were classified as "low-risk". Urine was evaluated for ROBO1, WNT5A, CDC42BPB, ABL1, CRH, IGF2, ANXA10, and UPK1B expression. A diagnostic model to detect "increased-risk" BCa was created using forward logistic regression analysis of cycle threshold values. Model validation was performed with ten-fold cross-validation. Sensitivity and specificity for detection of "increased-risk" BCa was determined and net benefit analysis performed. RESULTS: Urine samples (n = 257) were collected from 177 patients (95 screening, 76 surveillance, 6 both). There were 65 diagnoses of BCa (12 low, 22 intermediate, 31 high risk). ROBO1, CRH, and IGF2 expression correlated with "increased-risk" disease yielding sensitivity of 92.5% (95% CI, 84.9%-98.1%) and specificity of 73.5% (95% CI, 67.7-79.9%). The overall calculated standardized net benefit of the model was 0.81 (95%CI, 0.71-0.90). CONCLUSIONS: A 3-marker urinary mRNA panel allows for non-invasive identification of "increased-risk" BCa and with further validation may prove to be a tool to reduce the need for cystoscopies in low-risk patients.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias de la Vejiga Urinaria / ARN Mensajero / Biomarcadores de Tumor / Medición de Riesgo / Cistoscopía Tipo de estudio: Etiology_studies / Guideline / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Aged / Female / Humans / Male Idioma: En Revista: Urol Oncol Asunto de la revista: NEOPLASIAS / UROLOGIA Año: 2021 Tipo del documento: Article País de afiliación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias de la Vejiga Urinaria / ARN Mensajero / Biomarcadores de Tumor / Medición de Riesgo / Cistoscopía Tipo de estudio: Etiology_studies / Guideline / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Aged / Female / Humans / Male Idioma: En Revista: Urol Oncol Asunto de la revista: NEOPLASIAS / UROLOGIA Año: 2021 Tipo del documento: Article País de afiliación: Estados Unidos
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