TY - JOUR
T1 - Molecular markers for bladder cancer screening, early diagnosis, and surveillance
T2 - The WHO/ICUD consensus
AU - Schmitz-Dräger, Bernd J.
AU - Droller, Michael
AU - Lokeshwar, Vinata B.
AU - Lotan, Yair
AU - Hudson, M'Liss A.
AU - Van Rhijn, Bas W.
AU - Marberger, Michael J.
AU - Fradet, Yves
AU - Hemstreet, George P.
AU - Malmstrom, Per Uno
AU - Ogawa, Osamu
AU - Karakiewicz, Pierre I.
AU - Shariat, Shahrokh F.
N1 - Publisher Copyright:
© 2014 S. Karger AG, Basel.
PY - 2015/2/24
Y1 - 2015/2/24
N2 - Due to the lack of disease-specific symptoms, diagnosis and follow-up of bladder cancer has remained a challenge to the urologic community. Cystoscopy, commonly accepted as a gold standard for the detection of bladder cancer, is invasive and relatively expensive, while urine cytology is of limited value specifically in low-grade disease. Over the last decades, numerous molecular assays for the diagnosis of urothelial cancer have been developed and investigated with regard to their clinical use. However, although all of these assays have been shown to have superior sensitivity as compared to urine cytology, none of them has been included in clinical guidelines. The key reason for this situation is that none of the assays has been included into clinical decision-making so far. We reviewed the current status and performance of modern molecular urine tests following systematic analysis of the value and limitations of commercially available assays. Despite considerable advances in recent years, the authors feel that at this stage the added value of molecular markers for the diagnosis of urothelial tumors has not yet been identified. Current data suggest that some of these markers may have the potential to play a role in screening and surveillance of bladder cancer. Well-designed protocols and prospective, controlled trials will be needed to provide the basis to determine whether integration of molecular markers into clinical decision-making will be of value in the future.
AB - Due to the lack of disease-specific symptoms, diagnosis and follow-up of bladder cancer has remained a challenge to the urologic community. Cystoscopy, commonly accepted as a gold standard for the detection of bladder cancer, is invasive and relatively expensive, while urine cytology is of limited value specifically in low-grade disease. Over the last decades, numerous molecular assays for the diagnosis of urothelial cancer have been developed and investigated with regard to their clinical use. However, although all of these assays have been shown to have superior sensitivity as compared to urine cytology, none of them has been included in clinical guidelines. The key reason for this situation is that none of the assays has been included into clinical decision-making so far. We reviewed the current status and performance of modern molecular urine tests following systematic analysis of the value and limitations of commercially available assays. Despite considerable advances in recent years, the authors feel that at this stage the added value of molecular markers for the diagnosis of urothelial tumors has not yet been identified. Current data suggest that some of these markers may have the potential to play a role in screening and surveillance of bladder cancer. Well-designed protocols and prospective, controlled trials will be needed to provide the basis to determine whether integration of molecular markers into clinical decision-making will be of value in the future.
KW - Bladder cancer
KW - Diagnosis
KW - Molecular markers
KW - Surveillance
KW - Urine
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U2 - 10.1159/000369357
DO - 10.1159/000369357
M3 - Review article
C2 - 25501325
AN - SCOPUS:84923574285
SN - 0042-1138
VL - 94
SP - 1
EP - 24
JO - Urologia Internationalis
JF - Urologia Internationalis
IS - 1
ER -