Urinary markers of bladder carcinoma

Abstract

Purpose: Transitional cell carcinoma of bladder is one of the most common tumors of genitourinary tract. Cystoscopy along with cytology is the mainstay for diagnosing bladder cancer. Cytology is specific for diagnosis of bladder carcinomas but less sensitive particularly in low-grade disease. Cystoscopy on the other hand is invasive and relatively costly technique and may also be inconclusive at times particularly in case of cystitis. A simple noninvasive marker for detecting bladder cancer would be helpful. A clinically useful urinary marker should be easy to perform, should have minimum requirements for sample preparations and should have high sensitivity and specificity in diagnosis. In this review we discussed the various urinary markers and their role in detection of bladder cancer. Materials and methods: We reviewed the literature on urinary markers and tests that may have clinical usefulness. Results: Several urinary markers and tests such as BTA Stat, BTA TRAK, NMP22, telomerase, HA and HAse tests, Immunocyt, Quanticyt, FDP, BLCA-4, FISH, CYFRA-21-1 have enough potential for future clinical use. BTA stat, NMP22 (bladder check)and AccuDX (FDP) tests are presently point of care tests. The rest of the tests are laboratory-based and may need trained technicians. Majorities of the urinary markers have higher sensitivity and specificity than cytology. However, voided urinary cytology has the highest specificity. Conclusions: Till now there is no urinary marker or test that can replace the need of cystoscopy. However, some markers have the potential for future clinical use.