What is the role of urinary biomarkers used in the diagnosis of bladder cancer?

Updated: Nov 01, 2018
  • Author: Gary David Steinberg, MD, FACS; Chief Editor: Bradley Fields Schwartz, DO, FACS  more...
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Answer

Answer

For the present, cystoscopy remains the gold standard for detecting bladder cancers. However, it is invasive, relatively expensive, and operator dependent, and has potential complications that include infection, bleeding, perforation, and urinary retention. [3]

Urine cytology is still the most accurate noninvasive test for bladder cancer that is in routine clinical use, with a sensitivity of 80–90% and a specificity of 98–100% for detection of high-grade lesions and carcinoma in situ (CIS). The disadvantages of urine cytology are that it is relatively ineffective at detecting low-grade malignancy, and benign inflammatory conditions may result in false positive results. [4]

Use of urine biomarkers in the initial diagnosis of bladder cancer is controversial. [5, 6, 7] All of these assays may yield false-positive and false-negative results. .At present, guidelines do not recommend using the biomarker assays that are currently available to replace cystoscopy. However, biomarker assays may provide additional molecular information to guide individualized surveillance and therapy. [3]  In the future, other newer assays based on telomerase and microsatellite analysis may prove to be a better detection method than urinary cytology. [8]  

For more information, see Bladder Cancer, as well as Cystoscopy and Surveillance for Recurrent Bladder Cancer.


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