Noninvasive Urine-Based Tests to Diagnose or Detect Recurrence of Bladder Cancer

Abstract

Liquid biopsies are increasingly used for the diagnosis and follow-up of cancer patients. Urine is a body fluid that can be used to detect cancers and others diseases. It is noninvasive and easy to collect. To detect Bladder Cancer (BC), cytology is the first assay used. It is an effective way to detect high grade BC but has a high rate of equivocal results, especially for low grade BC. Furthermore, cystoscopy is used to confirm cytology results and to determine cancer status. Cystoscopy is also effective but highly invasive, and not well accepted by patients, especially for BC follow-up. In this review we survey the numerous assays recently developed in order to diagnose BC at an early stage, and to facilitate the follow-up of patients. We discuss their effectiveness, ease of use, and applications. Finally, we discuss assays that, in the future, could improve the diagnosis and management of BC patients.

Keywords: bladder cancer; cytology; diagnostic; liquid biopsy; non-invasive; urine.

Figure 1

Genetical and physiological evolution of bladder cancer (BC). CIS: carcinoma in situ: “flat tumor”; T_a: noninvasive papillary carcinoma; T1: tumor invades subepithelial connective tissue; T2_a: tumor invades superficial muscularis propria (inner half); T2_b: tumor invades deep muscularis propria (outer half); T3_a: tumor invades surrounding fat/tissues microscopically; T3_b: tumor invades surrounding fat/tissues macroscopically; T4_a: tumor invades prostatic stroma, uterus, vagina; T4_b: tumor invades pelvic wall, abdominal wall. PUNLMP = papillary urothelial neoplasm of low malignant potential.

Figure 2

The different ways of detection, diagnosis, treatment, and follow-up of BC, depending on the clinical situation. ――――: Classical routine used by the clinicians nowadays; − − − − −: new methods that can be used by the clinicians nowadays.