MP38-05 EXTRACELLULAR VESICLE RNA ISOLATED FROM URINE FOR DIAGNOSING HIGH-RISK NON-MUSCLE INVASIVE BLADDER CANCER

Abstract

You have accessJournal of UrologyBladder Cancer: Epidemiology & Evaluation I (MP38)1 Sep 2021MP38-05 EXTRACELLULAR VESICLE RNA ISOLATED FROM URINE FOR DIAGNOSING HIGH-RISK NON-MUSCLE INVASIVE BLADDER CANCER Keita Minami, Takahiro Osawa, Hiroshi Harada, Toru Harabayashi, Norikata Takada, Akira Kashiwagi, Haruka Miyata, Kazushi Hirakawa, Yasuyuki Sato, Ryuji Matsumoto, Hiroshi Kikuchi, Takashige Abe, Sachiyo Murai, and Nobuo Shinohara Keita MinamiKeita Minami More articles by this author , Takahiro OsawaTakahiro Osawa More articles by this author , Hiroshi HaradaHiroshi Harada More articles by this author , Toru HarabayashiToru Harabayashi More articles by this author , Norikata TakadaNorikata Takada More articles by this author , Akira KashiwagiAkira Kashiwagi More articles by this author , Haruka MiyataHaruka Miyata More articles by this author , Kazushi HirakawaKazushi Hirakawa More articles by this author , Yasuyuki SatoYasuyuki Sato More articles by this author , Ryuji MatsumotoRyuji Matsumoto More articles by this author , Hiroshi KikuchiHiroshi Kikuchi More articles by this author , Takashige AbeTakashige Abe More articles by this author , Sachiyo MuraiSachiyo Murai More articles by this author , and Nobuo ShinoharaNobuo Shinohara More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002053.05AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Patients who are diagnosed with high grade Ta, T1, or any Tis are generally regarded as high-risk non-muscle invasive bladder cancer (HR-NMIBC) according to the several practice guidelines. Patients categorized as HR-NMIBC are exposed to higher risk of both recurrence and progression compared to those who are categorized as low-risk (LR) NMIBC (low grade Ta). Pathological specimen collected with transurethral resection (TUR) is crucial for diagnosing HR- or LR-NMIBC, because cystoscopy itself is not reliable for distinguish these two. Herein, we develop the new method to diagnose NMIBC, especially HR-NMIBC, both pre-operatively and non-invasively. METHODS: In this multi-center prospective study, 231 patients who were clinically diagnosed as NMIBC were enrolled prior to TUR and were followed up periodically. Urine specimens were collected every outpatient visit during the follow-up with cystoscopy examination. As we previously reported, we confirmed that urinary extracellular vesicle (EV) SLC2A1 (basal type), GPRC5A (luminal type) and KRT17(basal type) were elevated in HR-NMIBC as potential biomarkers as well as EV RNA markers (NET1, MDK, NONO). In this study, diagnostic performances of these new markers were evaluated and compared to urine cytology, NMP22 (Abbott, IL), and BTA stat (Polymedco, NY) tests by the area under the curve (AUC) in ROC curve analysis. RESULTS: Tumor stages of the 231 participants were low grade Ta (N=44), high grade Ta (N=51), T1 (N=39), any Tis (N=22), >pT2 (N=12), benign tumors or no tumor (N=139). In this cohort, we validated that urinary EV markers were elevated in HR-NMIBC compared to LR-NMIBC and benign/no-tumor controls. Individual markers such as NET1 and KRT17 were the most promising and able to identify HR-NMIBC with remarkable diagnostic performance as high as AUC = 0.860 (0.794–0.927). EV NET1 was useful even to detect LR-NMIBC with AUC 0.798 (0.654–0.941)). Support logistic regression analysis of multiple EV markers allowed us to detect HR- and LR-NMIBC with AUC 0.918 (0.878–0.959) and 0.928 (0.876–0.979), respectively (Table 1, Figure 1). CONCLUSIONS: Taken together, our findings suggest that the combination of these urinary EV mRNA were promising biomarkers for recurrence monitoring of NMIBC as well as preoperative precise risk stratification of NMIBC. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e693-e694 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Keita Minami More articles by this author Takahiro Osawa More articles by this author Hiroshi Harada More articles by this author Toru Harabayashi More articles by this author Norikata Takada More articles by this author Akira Kashiwagi More articles by this author Haruka Miyata More articles by this author Kazushi Hirakawa More articles by this author Yasuyuki Sato More articles by this author Ryuji Matsumoto More articles by this author Hiroshi Kikuchi More articles by this author Takashige Abe More articles by this author Sachiyo Murai More articles by this author Nobuo Shinohara More articles by this author Expand All Advertisement Loading ...