Abstract
BackgroundGenetic biomarkers are a promising and growing field in the management of bladder cancer in all stages. The aim of this paper is to understand the role of genetic urinary biomarkers in the follow up of patients with non muscle invasive bladder cancer where there is increasing evidence that they can play a role in avoiding invasive techniques.MethodsFollowing PRISMA criteria, we have performed a systematic review. The search yielded 164 unique articles, of which 21 articles were included involving a total of 7261 patients. Sixteen of the articles were DNA based biomarkers, analyzing different methylations, microsatellite aberrations and gene mutations. Five articles studied the role of RNA based biomarkers, based on measuring levels of different combinations of mRNA. QUADAS2 critical evaluation of each paper has been reported.ResultsThere are not randomized control trials comparing any biomarker with the gold standard follow-up, and the level of evidence is 2B in almost all the studies. Negative predictive value varies between 55 and 98.5%, being superior in RNA based biomarkers.ConclusionsAlthough cystoscopy and cytology are the gold standard for non muscle invasive bladder cancer surveillance, genetic urinary biomarkers are a promising tool to avoid invasive explorations to the patients with a safe profile of similar sensitivity and negative predictive value. The accuracy that genetic biomarkers can offer should be taken into account to modify the paradigm of surveillance in non muscle invasive bladder cancer patients, especially in high-risk ones where many invasive explorations are recommended and biomarkers experiment better results.
Highlights
Genetic biomarkers are a promising and growing field in the management of bladder cancer in all stages
In order to obtain a practical and visual description of the different studies, we divided the biomarkers by method into DNA-based (Table 1) and RNA-based (Table 2) tests
DNA tests (Table 1) DNA tests used for surveillance are based on microsatellite analysis (MA)
Summary
Genetic biomarkers are a promising and growing field in the management of bladder cancer in all stages. Cystoscopy is an invasive procedure that carries the risks of painful micturition, urinary frequency and macroscopic haematuria of 50, 37 and 19%, respectively [5], while cytology has a very low sensitivity, especially for low-grade tumours [6, 7]. For this reason there has been an increase in research over the past years into urinary biomarkers for the three scenarios of haematuria, diagnosis and surveillance. Such a signature would prove useful in disease detection and follow-up and in the facilitation of more precise treatment by avoiding unhelpful therapies that may delay the best oncological pathway
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
