The diagnostic accuracy of methylation markers in urine for the detection of bladder cancer: a systematic review

Several urinary hypermethylation-markers (hmDNA) have been described for bladder cancer (BC) detection, but none have been able to replace cystoscopy yet. We systematically reviewed and evaluated current literature on urinary hmDNA markers for BC diagnostics.

A systematic search of PubMed, EMBASE.com and The Cochrane Library up to February 2017 using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines, was conducted.

A total of 30/42 studies included compared gene panels, with varying sensitivities (52-100%) and specificities (0-100%). Considerable heterogeneity across studies was observed and most was case-control studies.

Reported diagnostic accuracy of urinary hmDNA for BC detection is highly variable and there is a lack of validation studies. Recent studies indicate that complementary markers are needed to allow for clinical implementation.

Epigenomics. 2018 Apr 25 [Epub ahead of print]

Judith Bosschieter, Catrin Lutz, Loes I Segerink, André N Vis, Ellen C Zwarthoff, R Jeroen A van Moorselaar, Bas Wg van Rhijn, Martijn W Heymans, Elizabeth P Jansma, Renske Dm Steenbergen, Jakko A Nieuwenhuijzen

Department of Urology, VU University Medical Center, Amsterdam, The Netherlands., Department of Pathology, VU University Medical Center, Amsterdam, The Netherlands., BIOS Lab on a Chip group, MESA+ & MIRA institutes, University of Twente, Enschede, The Netherlands., Department of Pathology, Erasmus Medical Center, Rotterdam, The Netherlands., Department of Urology, The Netherlands Cancer Institute, Amsterdam, The Netherlands., Department of Epidemiology & Biostatistics, VU University Medical Center, Amsterdam, The Netherlands., Medical Library, VU University Medical Center, Amsterdam, The Netherlands.