Urine test detects bladder cancer accurately
By Agata Buczak
A retrospective study published in BMC Cancer reports that a non-invasive urine DNA detection panel, using the methylation biomarkers vimentin and POU4F2, demonstrates high diagnostic performance for bladder carcinoma (BC).
Jialong Zhang (The First Affiliated Hospital of Anhui Medical University, Hefei, China) and colleagues assessed methylation levels of vimentin and POU4F2 in a training set of 306 urine samples (92 cases and 214 controls), and in an independent validation set of 161 samples (59 cases and 102 controls) using real-time polymerase chain reaction.
The combined panel achieved an area under the receiver operating characteristics (ROC) curve of 0.935, with a sensitivity of 86.44%, specificity of 96.08%, and accuracy of 92.55% in the validation set. Sensitivity was 90.00% for both stage 1 and low-grade BC, indicating potential for early detection.
The study population included patients with BC, benign urinary conditions, and malignancies in other organ systems. The panel’s performance was consistent across age and gender subgroups, with an area under the ROC of 0.947 in patients aged ≥50 years and 0.955 in males.
The panel maintained high specificity when distinguishing BC from other conditions. Specificity was 96.30% for urinary diseases and 95.83% for non-urothelial malignancies.
Positive and negative predictive values were also high, at 92.73% and 92.45%, respectively, indicating strong alignment with clinical diagnostic outcomes. The authors conclude that the dual-gene methylation panel offers a low likelihood of missed diagnoses or false positives and aligns more closely with clinical diagnostic outcomes than single-gene approaches.
Jialong Zhang and colleagues note that current diagnostic methods, such as cystoscopy, cytology, and CT urography, are limited by invasiveness, cost, and low sensitivity. The vimentin/POU4F2 panel offers a cost-effective, non-invasive alternative that may reduce unnecessary procedures in patients with benign conditions.
The study’s limitations include the case–control design and lack of concurrent cytology testing. The authors recommend further validation in large, multicenter trials and direct comparison with existing diagnostic methods.
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