Researchers identified a microRNA (miR) signature in urine that can predict the presence of bladder cancer, demonstrating the feasibility of a noninvasive bladder cancer diagnostic, they wrote in Urologic Oncology. 1 The standard method for diagnosis and surveillance of bladder cancer is cystoscopy, but this can be “invasive, costly, and causes considerable patient discomfort,” they added.

To determine candidate miR markers in the urine, study researchers analyzed a training set of 384 miRs in 16 urine samples from patients with bladder cancer and patient controls. A total of 14 candidate miRs were identified and then validated in a prospective cohort of 202 urine samples from patients with bladder cancer (115 individuals) and controls with microscopic hematuria (87 individuals).

Ultimately, an miR signature of 6 miRs was identified from a multivariable logistic regression model. Overall, the 6-miR signature distinguished between patients with bladder cancer and controls with high accuracy (area under the curve [AUC] = 88.3%). The signature also achieved high accuracy in detecting muscle-invasive bladder cancer (AUC = 91.0%). The highest accuracy was achieved in detecting high-grade non-muscle invasive bladder cancer (AUC = 92.9%). The signature was deemed “capable” at detecting both low-grade and high-grade disease as well as nonmuscle and muscle-invasive bladder cancer.

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The study authors noted several limitations in their paper, such as the cohort not being matched, the inclusion of only patients with newly diagnosed bladder cancer, and the use of only urine samples that showed no signs of host infection.

“We identified a 6-gene miR signature that can accurately predict the presence of [bladder cancer] from urine samples, independent of stage and grade,” the study authors concluded. They added that the signature represents a simple urine assay that could help reduce “costs and morbidity associated with invasive diagnostics.”

Reference

  1. Hofbauer SL, de Martino M, Lucca I, et al. A urinary microRNA (miR) signature for diagnosis of bladder cancer [published online October 12, 2018]. Urol Oncol. doi: 10.1016/j.urolonc.2018.09.006