Bladder cancer: Noninvasive urine test
According to a new study that was conducted on 577 subjects with a known history of hematuria i.e. presence of blood in the urine, investigators discovered a new and non-invasive diagnostic test that can accurately detect bladder cancer in males. The sensitivity of this test is up to 95% for the detection of high-risk bladder malignancies. In addition, the negative predictive value of this new test – i.e. capability to accurately detect normal tissues or non-cancers is 97%. Today we’ll investigate further into the new noninvasive urine test.
The non-invasive test that can accurately detect bladder cancer cases in majority of the cases has been named ADXBLADDER test and was first presented at Lisbon, Portugal at 37th Société Internationale D’Urologie (SIU) meeting.
The core benefits of this test besides high sensitivity and negative predictive value are:
- The results of this test remain unaffected by the presence of active inflammation or urinary tract infections (UTIs), inflammation
- The sensitivity of this test is independent of the quantity of blood present in the urine sample
- The test requires extremely small sample of urine i.e. only 10 milliliters
- It can employ sensitive enzyme assay techniques such as ELISA or Enzyme Linked Immunosorbent assay (ELISA) technology
- The results of this test are readily available within 3 hours of conducting the test
Traditional Diagnostic Procedures For The Detection Of Bladder Cancer:
Bladder cancer is one of the most frequently reported malignancies with high morbidity and mortality. Traditionally, all individuals who reports presence of blood in the urine or hematuria are subjected to invasive diagnostic procedures like cystoscopy. In other cases, more comprehensive diagnostic protocol is implemented – i.e. CT urography, bladder ultrasound, ultrasound of kidneys and urinary system and CT urography.
Unfortunately, although cystoscopy is regarded as an invasive diagnostic method, it still considered as a gold standard test and is considered more reliable over other non-invasive methods like cytology. It is noteworthy that there are several side effects associated with cystoscopy procedure; such as, not only is this method comfortable, about 5% of all the people who underwent cystoscopy develops urinary tract infection. Last but not the least, the sensitivity of this test is not very high and about 30% of the bladder tumors are missed on the cytoscopic examination. Not bad for a noninvasive urine test.
ADXBLADDER – How Does It Work?
As part of the study, the team of investigators studied 577 patients who presented with the complaints of hematuria (blood in the urine) during August 2016 to February 2017. All these patients underwent ADXBLADDER test that also employs ELISA technique in addition to other popular diagnostic procedures such as ultrasound, cystoscopy, as well as CT scanning. The working principle of ADXBLADDER test is to identify and measure the urinary levels of MCM5 – a biomarker that is associate with high replication potential of tumor cells.
It is noteworthy that healthy bladder cells do not manifest MCM5 and hence it is very easy and convenient to differentiate the urine sample of a male who has a cancer versus someone who is normal.
As part of the research study, investigators discovered that 92% patients who had hematuria did not have cancer and 7.95% patients had tumor activity that was also confirmed by other invasive tests like cystoscopy.
The results of this study are very encouraging and can potentially replace expensive, inaccurate and invasive procedures for in the workup on hematuria.
- Kendrick, J., & Kendrick, P. R. Non-invasive urine test provides game changer in bladder cancer.
- Stein, J. P., Lieskovsky, G., Cote, R., Groshen, S., Feng, A. C., Boyd, S., … & Raghavan, D. (2001). Radical cystectomy in the treatment of invasive bladder cancer: long-term results in 1,054 patients. Journal of clinical oncology, 19(3), 666-675.