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Espectrometria de Mobilidade Iônica , Neoplasias da Bexiga Urinária , Compostos Orgânicos Voláteis , Neoplasias da Bexiga Urinária/urina , Neoplasias da Bexiga Urinária/diagnóstico , Humanos , Compostos Orgânicos Voláteis/urina , Espectrometria de Mobilidade Iônica/métodos , Projetos PilotoAssuntos
Ácido Aminolevulínico , Carcinoma de Células de Transição , Fármacos Fotossensibilizantes , Neoplasias da Bexiga Urinária , Humanos , Ácido Aminolevulínico/administração & dosagem , Neoplasias da Bexiga Urinária/diagnóstico , Neoplasias da Bexiga Urinária/patologia , Fármacos Fotossensibilizantes/uso terapêutico , Fármacos Fotossensibilizantes/administração & dosagem , Carcinoma de Células de Transição/diagnóstico , Estudos Retrospectivos , Administração Oral , Neoplasias Renais/diagnóstico , Neoplasias Ureterais/diagnósticoRESUMO
Recent interest in noninvasive diagnostic approaches has highlighted the potential of urinary microbiota as a novel biomarker for bladder cancer. This study investigated the urinary microbiota of 30 bladder cancer patients and 32 healthy controls using a specific NGS protocol that sequences eight hypervariable regions of the 16S rRNA gene, providing detailed insights into urinary microbiota composition. The relative abundance of microbial compositions in urine samples from cancer patients and healthy controls was analyzed across various taxonomic levels. No notable differences were highlighted at the phylum, class, order, and family levels. At the genus level, 53% of detected genera were represented in either cancer patients or healthy controls. Microbial diversity was significantly lower in cancer patients. The differential analysis identified five genera, Rhodanobacter, Cutibacterium, Alloscardovia, Moryella, and Anaeroglobus, that were significantly more abundant in cancer patients. Notably, Rhodanobacter was present in 20 cancer samples but absent in healthy controls. Conversely, 40 genera, including Lactobacillus, Propionibacterium, and Bifidobacterium, exhibited reduced abundance in cancer patients. These findings suggest that some genera may serve as potential biomarkers for bladder cancer, highlighting the need for further research to explore their roles in disease pathogenesis and their potential applications in diagnostics and therapeutics.
Assuntos
Disbiose , Microbiota , RNA Ribossômico 16S , Neoplasias da Bexiga Urinária , Humanos , Neoplasias da Bexiga Urinária/urina , Neoplasias da Bexiga Urinária/microbiologia , Neoplasias da Bexiga Urinária/diagnóstico , Masculino , Feminino , Disbiose/microbiologia , Disbiose/urina , Disbiose/diagnóstico , Microbiota/genética , RNA Ribossômico 16S/genética , Pessoa de Meia-Idade , Idoso , Estudos de Casos e Controles , Bactérias/genética , Bactérias/classificação , Bactérias/isolamento & purificação , Adulto , Biomarcadores Tumorais/urinaRESUMO
INTRODUCTION: Patients with spinal cord injury/disorder (SCI/D) and neurogenic lower urinary tract dysfunction (NLUTD) are on a 16-28 folder higher risk for bladder cancer [1]. Whereas in the general population 90% of bladder tumors are transitional cell carcinoma (TCC) patients with NLUTD have a shift to squamous cell carcinoma with 36,8% and only 46.3% TCC [2]. In addition, there is a significant increase in the bladder cancer-specific death rate in SCI patients (3rd most common) compared to the general population (10th most common) [2]. Chronic inflammation and mechanical irritation by permanent indwelling catheters are discussed as risk factors for developing bladder cancer. Typical symptoms of bladder cancer are often absent in patients with NLUTD and a reliable screening has not been established. CASE PRESENTATION: We present a case series of six patients with SCI and with squamous cell carcinoma diagnosed in the last 5 years in our institution. In five patients, bladder management was performed by indwelling suprapubic catheters, one patient used reflex voiding. Three patients were diagnosed during the regular, annual neuro-urological check-up, the remaining due to increasing spasticity and autonomic dysregulation. Subsequently, five patients underwent cystectomy with ileal conduit or uretercutaneostomy, one patient refused further surgical treatment. Four patients died within one year after diagnosis. DISCUSSION: Squamous cell carcinoma of the bladder is more common in patients with NLUTD. Chronic inflammation and mechanical irritation may be the reasons for carcinoma genesis. A regular check including cystoscopy is strongly recommended to detect tumor development early.
Assuntos
Carcinoma de Células Escamosas , Traumatismos da Medula Espinal , Neoplasias da Bexiga Urinária , Humanos , Traumatismos da Medula Espinal/complicações , Neoplasias da Bexiga Urinária/complicações , Neoplasias da Bexiga Urinária/diagnóstico , Carcinoma de Células Escamosas/complicações , Carcinoma de Células Escamosas/diagnóstico , Masculino , Pessoa de Meia-Idade , Feminino , Idoso , Adulto , Bexiga Urinaria Neurogênica/etiologia , Bexiga Urinaria Neurogênica/complicações , Doença CrônicaRESUMO
PURPOSE: Categorizing patients with cancer by their disease stage can be an important tool when conducting administrative claims-based studies. As claims databases frequently do not capture this information, algorithms are increasingly used to define disease stage. To our knowledge, to date, no study has used an algorithm to categorize patients with bladder cancer (BC) by disease stage (non-muscle-invasive BC [NMIBC], muscle-invasive BC [MIBC], or locally advanced/metastatic urothelial carcinoma [la/mUC]) in a US-based health care claims database. METHODS: A claims-based algorithm was developed to categorize patients by disease stage on the basis of the administrative claims portion of the SEER-Medicare linked data. The algorithm was validated against a reference SEER registry, and the algorithm's parameters were iteratively modified to improve its performance. Patients were included if they had an initial diagnosis of BC between January 2016 and December 2017 recorded in SEER registry data. Medicare claims data were available for these patients until December 31, 2019. The algorithm was evaluated by assessing percentage agreement, Cohen's kappa (κ), specificity, positive predictive value (PPV), and negative predictive value (NPV) against the SEER categorization. RESULTS: A total of 15,484 patients with SEER-confirmed BC were included: 10,991 (71.0%) with NMIBC, 3,645 (23.5%) with MIBC, and 848 (5.5%) with la/mUC. After multiple rounds of algorithm optimization, the final algorithm had an agreement of 82.5% with SEER, with a κ of 0.58, a PPV of 87.0% for NMIBC, and 76.8% for MIBC and a high NPV for la/mUC of 98.0%. CONCLUSION: This claims-based algorithm could be a useful approach for researchers conducting claims-based studies categorizing patients with BC at diagnosis.
Assuntos
Algoritmos , Medicare , Estadiamento de Neoplasias , Programa de SEER , Neoplasias da Bexiga Urinária , Humanos , Neoplasias da Bexiga Urinária/diagnóstico , Neoplasias da Bexiga Urinária/epidemiologia , Neoplasias da Bexiga Urinária/patologia , Estados Unidos/epidemiologia , Masculino , Idoso , Feminino , Idoso de 80 Anos ou mais , Bases de Dados Factuais , Revisão da Utilização de SegurosRESUMO
Telomerase reverse transcriptase promoter (TERTp) mutations are frequently targeted tumor markers, however, they reside in regions with high GC content, which poses challenges when examined with simple molecular techniques or even with next-generation sequencing (NGS). In bladder cancer (BC), TERTp mutations are particularly frequent, however, none of the available tools have demonstrated efficacy in detecting TERTp mutations via a simple noninvasive technique. Therefore, we developed a novel PCR-based method for the detection of the two most common TERTp mutations and demonstrated its use for the analysis of BC samples. The developed SHARD-PCR TERTp mutation detection technique requires PCR and restriction digestion steps that are easily implementable even in less well-equipped laboratories. Cell lines with known mutational status were utilized for method development. Matching urine and tumor tissue samples from BC patients were analyzed, and the results were validated by next-generation sequencing. Analysis of eighteen urine and corresponding tumor tissue samples by SHARD-PCR revealed perfect matches in sample pairs, which paralleled the corresponding NGS results: fourteen samples exhibited mutations at the -124 position, two samples showed mutations at the -146 position, and no mutations were detected in two samples. Our study serves as a proof-of-concept and is limited by its small sample size, nonetheless, it demonstrates that SHARD-PCR is a simple, economic and highly reliable method for detecting TERTp mutations, which are common in different cancer types. For bladder cancer, SHARD-PCR can be performed with the use of noninvasive samples and could replace or complement currently used techniques.
Assuntos
Mutação , Reação em Cadeia da Polimerase , Regiões Promotoras Genéticas , Telomerase , Neoplasias da Bexiga Urinária , Humanos , Neoplasias da Bexiga Urinária/genética , Neoplasias da Bexiga Urinária/diagnóstico , Telomerase/genética , Reação em Cadeia da Polimerase/métodos , Masculino , Feminino , Sequenciamento de Nucleotídeos em Larga Escala/métodos , Idoso , Pessoa de Meia-Idade , Análise Mutacional de DNA/métodos , Biomarcadores Tumorais/genética , Linhagem Celular TumoralRESUMO
Tumors of the urinary system, such as prostate cancer, bladder cancer, and renal cell carcinoma, are among the most prevalent types of tumors. They often remain asymptomatic in their early stages, with some patients experiencing recurrence or metastasis post-surgery, leading to disease progression. Lactate dehydrogenase A (LDHA) plays a crucial role in the glycolysis pathway and is closely associated with anaerobic glycolysis in urinary system tumors. Therefore, a comprehensive investigation into the intricate mechanism of LDHA in these tumors can establish a theoretical foundation for early diagnosis and advanced treatment. This review consolidates the current research and applications of LDHA in urinary system tumors, with the aim of providing researchers with a distinct perspective.
Assuntos
L-Lactato Desidrogenase , Humanos , L-Lactato Desidrogenase/urina , Pesquisa Biomédica , Neoplasias Urológicas/diagnóstico , Neoplasias da Bexiga Urinária/diagnóstico , Isoenzimas/urina , Lactato Desidrogenase 5 , MasculinoRESUMO
Current diagnostic methods for canine urothelial carcinoma (UC) are technically challenging or can lack specificity, hence there is a need for novel biomarkers of UC. To this end, we analysed the microRNA (miRNA) cargo of extracellular vesicles (EVs) from urine samples of dogs with UC to identify candidate miRNA biomarkers. Urine was fractionated using ultrafiltration combined with size-exclusion chromatography and small RNA sequencing analysis was performed on both the EV enriched and (EV free) protein fractions. A greater number of candidate miRNA biomarkers were detected in the EV fraction than the protein fraction, and further validation using droplet digital PCR (ddPCR) was performed on the EV enriched fraction of a second cohort of dogs with UC which indicated that miR-182, miR-221 and miR-222 were significantly overrepresented in dogs with UC when compared with healthy dogs and dogs with urinary tract infections. Pathway analysis confirmed that these three miRNAs are involved in cancer. In addition, their potential downstream gene targets were predicted and PIK3R1, a well-known oncogene is likely to be a shared target between miRNA-182 and miRNA-221/222. In summary, this study highlights the potential of urinary EV-associated miRNAs as a source of biomarkers for the diagnosis of canine UC.
Assuntos
Biomarcadores Tumorais , Doenças do Cão , Vesículas Extracelulares , MicroRNAs , Animais , Cães , MicroRNAs/urina , MicroRNAs/genética , Vesículas Extracelulares/genética , Vesículas Extracelulares/metabolismo , Biomarcadores Tumorais/urina , Biomarcadores Tumorais/genética , Doenças do Cão/urina , Doenças do Cão/genética , Doenças do Cão/diagnóstico , Neoplasias da Bexiga Urinária/urina , Neoplasias da Bexiga Urinária/genética , Neoplasias da Bexiga Urinária/veterinária , Neoplasias da Bexiga Urinária/diagnóstico , Regulação Neoplásica da Expressão Gênica , MasculinoRESUMO
Nursing and physical examination early screening of multiple tumors is helpful to find tumors early, so as to improve the cure rate. Studying its molecular mechanisms is urgent. By logging into gene expression omnibus database, we found laryngeal cancer dataset GSE127165, bladder cancer dataset GSE65635, oral cancer dataset GSE146483, obtain differentially expressed genes, subsequently, weighted gene co-expression network analysis, protein-protein interaction networks, functional enrichment analysis, immune infiltration analysis, survival analysis, comparative toxicogenomics database analysis were conducted. Draw a heatmap of gene expression. Use targetScan to search for miRNA information about core DEG. Got 53 differentially expressed genes. In GOKEGG analysis, they were clustered in cell cycle processes, spindle poles, and protein serine/threonine/tyrosine kinase activity cell cycle, transcriptional dysregulation in cancer, RIG-I-like receptor signaling pathway, P53 signaling pathway. Protein-protein interaction analysis screened out 5 genes (NEK2, BUB1, HMMR, TTK, CCNB2). Cyclin B2 (CCNB2) and budding uninhibited by benzimidazole 1 (BUB1) were highly expressed in laryngeal cancer, bladder cancer, oral cancer. Comparative toxicogenomics database analysis found that core genes (CCNB2, BUB1) are associated with tumors, necrosis, and inflammation. Related miRNA of CCNB2 gene is hsa-miR-670-3p; related miRNAs of BUB1 gene are hsa-miR-5688, hsa-miR-495-3p. CCNB2 and BUB1 exhibit high expression in laryngeal cancer, bladder cancer, and oral cancer, suggesting their potential as molecular targets for precision therapy in these cancers.
Assuntos
Biomarcadores Tumorais , Detecção Precoce de Câncer , Humanos , Biomarcadores Tumorais/genética , Detecção Precoce de Câncer/métodos , Mapas de Interação de Proteínas/genética , Exame Físico , MicroRNAs/genética , Neoplasias da Bexiga Urinária/genética , Neoplasias da Bexiga Urinária/diagnóstico , Neoplasias da Bexiga Urinária/patologia , Neoplasias Bucais/genética , Neoplasias Bucais/diagnóstico , Neoplasias Laríngeas/genética , Regulação Neoplásica da Expressão Gênica , Perfilação da Expressão Gênica , Neoplasias/genéticaRESUMO
BACKGROUND: Urachal carcinoma is an extremely rare malignant tumor originating from the urachus. Urachal adenocarcinoma has never been reported in patients under 20 years of age. In this case, we describe a 15-year-old patient with urachal adenocarcinoma and propose possible risk factors. CASE PRESENTATION: The patient presented with hematuria for two months and dysuria for one month, and had a history of smoking and alcohol consumption for three years. Ultrasonography showed an irregular mass on the anterior wall of the bladder. Contrast-enhanced computed tomography revealed a pedicled soft tissue mass measuring 2.6×2.4 cm within the bladder, showing significant enhancement. Partial cystectomy was conducted, and a histopathological diagnosis of urachal adenocarcinoma (T2N0M0) was made. During eight months of follow-up, the patient remained asymptomatic with no evidence of recurrence. CONCLUSIONS: Urachal remnants may lead to urinary symptoms and the development of urachal carcinoma. A history of smoking and alcohol consumption could be possible risk factors for urachal adenocarcinoma in this case. It is possible that urachal remnants can undergo malignant transformation, even at ages as young as 15 years. Regular follow-up should be recommended for patients whose urachal remnants persist beyond childhood.
Assuntos
Adenocarcinoma , Neoplasias da Bexiga Urinária , Humanos , Adolescente , Masculino , Neoplasias da Bexiga Urinária/cirurgia , Neoplasias da Bexiga Urinária/patologia , Neoplasias da Bexiga Urinária/diagnóstico , Adenocarcinoma/diagnóstico , Adenocarcinoma/cirurgia , Adenocarcinoma/patologia , Cistectomia , Tomografia Computadorizada por Raios X , Fatores de Risco , Úraco/anormalidadesRESUMO
RATIONALE: Bladder urothelial carcinoma (UC) is a common urinary system tumor that is generally diagnosed by cystoscopy combined with pathological biopsy. However, complete exophytic UC of the bladder is very rare and difficult to diagnose. Early diagnosis and accurate identification of such tumors, followed by aggressive surgical treatment, is essential for the management of these patients. PATIENT CONCERNS: An 84-year-old man was admitted to the hospital with dysuria, a poor diet, and significant weight loss. DIAGNOSIS: Pelvic computed tomography and magnetic resonance imaging revealed an exteriophytic round mass on the right lateral wall of the bladder. Cystoscopy revealed a necrotic mass on the right lateral wall of the bladder cavity, and no tumor cells were found following the biopsy. The tumor was removed via partial cystectomy, and the pathological result indicated high-grade muscle-invasive UC. INTERVENTIONS: The patient refused radical cystectomy and underwent laparoscopic partial cystectomy plus pelvic lymph node dissection followed by cisplatin plus gemcitabine chemotherapy. OUTCOMES: The patient's mental state and appetite were significantly improved after the urinary tube was removed 1 week after surgery. His general state was significantly improved after 1 month of follow-up but died of acute cerebral infarction 3 months after surgery. LESSONS: UC of the bladder may grow completely out of the bladder without symptoms such as gross hematuria; thus, early diagnosis is difficult. For high-risk individuals, regular imaging tests may help to detect tumors early. Partial cystectomy is a reliable surgical modality for bladder preservation in such patients.
Assuntos
Cistectomia , Neoplasias da Bexiga Urinária , Humanos , Masculino , Neoplasias da Bexiga Urinária/patologia , Neoplasias da Bexiga Urinária/diagnóstico , Neoplasias da Bexiga Urinária/cirurgia , Idoso de 80 Anos ou mais , Cistectomia/métodos , Carcinoma de Células de Transição/diagnóstico , Carcinoma de Células de Transição/cirurgia , Carcinoma de Células de Transição/patologia , Evolução Fatal , Tomografia Computadorizada por Raios X , Imageamento por Ressonância MagnéticaRESUMO
RATIONALE: Bladder carcinosarcoma (BC) is a malignant tumor composed of a mixture of malignant epithelial and stromal components. Carcinosarcoma mostly occurs in the upper respiratory tract and upper gastrointestinal tract and is less common in the urinary system. The incidence of malignant tumors of the urinary system is <3%. It rarely occurs in the bladder and accounts for approximately 0.31% of all malignant bladder tumors. A literature review and this report will help to further improve our understanding, diagnosis, and treatment of bladder carcinosarcoma (BC). PATIENT CONCERN: We describe the case of an 80-year-old female patient who was admitted to the hospital with a history of intermittent hematuria for 3 years. Furthermore, total cystectomy was refused when a BC was diagnosed. Palliative resection surgery was necessary because of the recurrent hematuria and abdominal pain. DIAGNOSES: Pathologically confirmed BC after surgery. INTERVENTIONS: The patient's first transurethral resection of bladder tumor (TURBT) was diagnosed as BC. However, the patient refused a total cystectomy. Two months after intravesical treatment with epirubicin, bladder tumor recurrence was observed during follow-up cystoscopy. The patient underwent a second TURBT for hemostatic treatment due to persistent hematuria. Due to hematuria and abdominal pain, a third TURBT was performed to reduce tumor size and stop bleeding. Finally, tumor recurrence resulted in bilateral hydronephrosis, and the patient underwent bilateral renal catheter drainage guided by B-ultrasound. OUTCOMES: Bladder carcinosarcoma caused uremia, electrolyte imbalance, and sepsis. Approximately 19 months after the discovery of the tumor, the patient died. LESSONS: Radical bladder resection is recommended once a BC is diagnosed. By reporting the cases and reviewing the literature in the database, we will summarize the epidemiology, origin, etiology, clinical features, existing treatments, and prognostic factors of BC, and propose new prospects for BC therapy.
Assuntos
Carcinossarcoma , Neoplasias da Bexiga Urinária , Humanos , Feminino , Carcinossarcoma/diagnóstico , Carcinossarcoma/terapia , Carcinossarcoma/patologia , Idoso de 80 Anos ou mais , Neoplasias da Bexiga Urinária/diagnóstico , Neoplasias da Bexiga Urinária/patologia , Hematúria/etiologia , Recidiva Local de Neoplasia , CistectomiaAssuntos
Carcinoma de Células Renais , Neoplasias Renais , Humanos , Neoplasias Renais/genética , Neoplasias Renais/diagnóstico , Neoplasias Renais/patologia , Carcinoma de Células Renais/genética , Carcinoma de Células Renais/diagnóstico , Carcinoma de Células Renais/patologia , Carcinoma de Células de Transição/genética , Carcinoma de Células de Transição/diagnóstico , Carcinoma de Células de Transição/patologia , Achados Incidentais , Neoplasias da Bexiga Urinária/genética , Neoplasias da Bexiga Urinária/diagnóstico , Neoplasias da Bexiga Urinária/patologia , Detecção Precoce de Câncer , Neoplasias Urológicas/genética , Neoplasias Urológicas/diagnóstico , Neoplasias Urológicas/patologiaRESUMO
An 8-year-old castrated male Maltese dog was presented with a urinary bladder mass, urolithiasis, and hematuria. A solitary, pedunculated, intraluminal mass on the caudodorsal wall was identified with extensive irregular bladder wall thickening, and the mass was surgically removed. Postoperative histopathology demonstrated a submucosal lesion comprising spindle cells with marked inflammatory cell infiltration, without malignant changes. Immunohistochemical staining revealed vimentin and desmin positivity in the mass. An inflammatory myofibroblastic tumor (IMT) was definitively diagnosed. No recurrence was observed during a 43-month follow-up period. Although IMTs are rare in dogs, they should be considered a differential diagnosis for mass-like urinary bladder lesions accompanying a chronic inflammatory disease process. Key clinical message: Canine IMT should be included in the differential diagnoses of bladder masses, especially when dogs exhibit chronic irritation and inflammation.
Tumeur myofibroblastique inflammatoire de la vessie chez un chienUn chien maltais mâle castré de 8 ans a été présenté avec une masse à la vessie, une lithiase urinaire et une hématurie. Une masse intraluminale pédonculée solitaire sur la paroi caudodorsale a été identifiée avec un épaississement important et irrégulier de la paroi vésicale, et la masse a été retirée chirurgicalement. L'histopathologie postopératoire a mis en évidence une lésion à la sous-muqueuse comprenant des cellules fusiformes avec une infiltration cellulaire inflammatoire marquée, sans modification maligne. La coloration immunohistochimique a révélé une positivité à la vimentine et à la desmine dans la masse. Une tumeur myofibroblastique inflammatoire (IMT) a été définitivement diagnostiquée. Aucune récidive n'a été observée au cours d'une période de suivi de 43 mois. Bien que les IMT soient rares chez le chien, ils doivent être considérés comme un diagnostic différentiel des lésions de la vessie de type masse accompagnant un processus de maladie inflammatoire chronique.Message clinique clé:L'IMT canine doit être incluse dans les diagnostics différentiels des masses vésicales, en particulier lorsque les chiens présentent une irritation et une inflammation chroniques.(Traduit par Dr Serge Messier).
Assuntos
Doenças do Cão , Neoplasias da Bexiga Urinária , Cães , Animais , Masculino , Doenças do Cão/patologia , Doenças do Cão/cirurgia , Doenças do Cão/diagnóstico , Neoplasias da Bexiga Urinária/veterinária , Neoplasias da Bexiga Urinária/cirurgia , Neoplasias da Bexiga Urinária/patologia , Neoplasias da Bexiga Urinária/diagnóstico , Neoplasias de Tecido Muscular/veterinária , Neoplasias de Tecido Muscular/patologia , Neoplasias de Tecido Muscular/cirurgia , Neoplasias de Tecido Muscular/diagnóstico , Diagnóstico Diferencial , Inflamação/veterináriaRESUMO
BACKGROUND AND AIMS: Bladder cancer (BCa) is a highly aggressive malignancy of the urinary system. Timely detection is imperative for enhancing BCa patient prognosis. MATERIALS AND METHODS: This study introduces a novel approach for detecting long non-coding RNA (lncRNA) Mitochondrial RNA Processing Endoribonuclease (RMRP) in urine exosomes from BCa patients using the reverse transcription recombinase-aided amplification (RT-RAA) and clustered regularly interspaced short palindromic repeats and associated Cas12a proteins (CRISPR/Cas12a) technique. Various statistical methods were used to evaluate its diagnostic value for BCa. RESULTS: The specificity of urine exosomal RMRP detection for BCa diagnosis was enhanced by using RT-RAA combined with CRISPR/Cas12a. The testing process duration was reduced to 30 min, which supports rapid detection. Moreover, this approach allows the identification of target signals in real-time using blue light, facilitating immediate detection. In clinical sample analysis, this methodology exhibited a high level of diagnostic efficacy. This was evidenced by larger area under the curve values with receiver operating characteristic curve analysis compared with using traditional RT-qPCR methods, indicating superior diagnostic accuracy and sensitivity. Furthermore, the combined analysis of RMRP expression in urine exosomes detected by RT-RAA-CRISPR/Cas12a and NMP-22 expression may further enhance diagnostic accuracy. CONCLUSIONS: The RT-RAA-CRISPR/Cas12a technology is a swift, sensitive, and uncomplicated method for nucleic acid detection. Because of its convenient and non-invasive sampling approach, user-friendly operation, and reproducibility, this technology is very promising for automated detection and holds favorable application possibilities within clinical environments.
Assuntos
Sistemas CRISPR-Cas , Exossomos , RNA Longo não Codificante , Neoplasias da Bexiga Urinária , Humanos , Neoplasias da Bexiga Urinária/diagnóstico , Neoplasias da Bexiga Urinária/urina , Neoplasias da Bexiga Urinária/genética , RNA Longo não Codificante/urina , RNA Longo não Codificante/genética , Exossomos/genética , Sistemas CRISPR-Cas/genética , Masculino , Pessoa de Meia-Idade , Feminino , IdosoRESUMO
PURPOSE: To compare the diagnostic performance of photodynamic diagnosis (PDD) enhanced with oral 5-aminolaevulinic acid between the suspected upper tract urothelial carcinoma (UTUC) and bladder urothelial carcinoma (BUC) cases. METHODS: This retrospective study included 18 patients with suspected UTUC who underwent ureteroscopy (URS) with oral 5-ALA in the PDD-URS cohort between June 2018 and January 2019; and 110 patients with suspected BUC who underwent transurethral resection of bladder tumour (TURBT) in the PDD-TURBT cohort between January 2019 and March 2023. Sixty-three and 708 biopsy samples were collected during diagnostic URS and TURBT, respectively. The diagnostic accuracy of white light (WL) and PDD in the two cohorts was evaluated, and false PDD-positive samples were pathologically re-evaluated. RESULTS: The area under the receiver operating characteristic curve (AUC) of PDD was significantly superior to that of WL in both cohorts. The per biopsy sensitivity, specificity, and positive and negative predictive values of PDD in patients in the PDD-URS and PDD-TURBT cohorts were 91.2 vs. 71.4, 75.9 vs. 75.3, 81.6 vs. 66.3, and 88.0 vs. 79.4%, respectively. The PDD-URS cohort exhibited a higher AUC than did the PDD-TURBT cohort (0.84 vs. 0.73). Seven of four false PDD-positive samples (57.1%) in the PDD-URS cohort showed potential precancerous findings compared with eight of 101 (7.9%) in the PDD-TURBT cohort. CONCLUSION: The diagnostic performance of PDD in the PDD-URS cohort was at least equivalent to that in the PDD-TURBT cohort.