Abstract
Urinary bladder cancer is a common urological cancer. Although flexible cystoscopy is widely employed in bladder cancer detection, it is expensive, invasive, and uncomfortable to the patients. Recently, urinary cell-free DNA (ucfDNA) isolated from urine supernatant has been shown to have great potential in bladder cancer detection and surveillance. Molecular features, such as integrity and concentration of ucfDNA, have been shown to be useful for differentiating bladder cancer patients from healthy controls. Besides, bladder cancer also exhibits unique genetic features that can be identified from sequencing and expression of ucfDNA. Apart from bladder cancer detection, ucfDNA is also useful for molecular classification. For example, ucfDNA exhibits significant differences, both molecularly and genetically, in non-muscle-invasive and muscle-invasive bladder cancers. There is no doubt that ucfDNA is a very promising tool for future applications in the field of bladder cancer.
Highlights
Since the bladder is in direct contact with the urine, detecting overexpressed downregulated genes from exfoliated bladder tumor cells in urinary cell-free DNA (ucfDNA) that are associatedor downregulated genes from tumor cells in ucfDNAofthat are associated with cancer progression, this exfoliated can be an bladder approach for early detection bladder cancers with cancer progression, this can be an approach for early detection of bladder cancers (Table 1)
The authors observed that ucfDNA integrity had a higher sensitivity than conventional non-invasive cytology, especially for early-stage and low-grade tumors, suggesting that ucfDNA could be a promising biomarker in the early detection of bladder cancer
As the values of urinary biochemicals are widely adjusted by urine creatinine (UCr) value and varies depending on urine volume [20,21,22], the authors determined relative ucfDNA concentrations by dividing ucfDNA by UCr concentrations. They compared the sensitivity and specificity of two methods, PicoGreen and 400-bp amplicon, of ucfDNA quantification. Their results showed that ucfDNA/UCr were significantly higher in all bladder cancer patients when compared to controls for both PicoGreen and 400-bp methods
Summary
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. Flexible cystoscopy is the gold standard for diagnosing bladder cancer It is an invasive approach, and subtle malignant changes can be missed. Several studies reveal that ucfDNA had a higher tumoral genome than cellular DNA, which gives rise to the utilization of ucfDNA in bladder cancer detection [6]. We discuss the application of ucfDNA in the detection and diagnosis of urinary bladder cancer, as wells as the limitations and future development of this non-invasive biomarker.
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