Development of a 90-Minute Integrated Noninvasive Urinary Assay for Bladder Cancer Detection

Ellen Wallace, Russell Higuchi, Malini Satya, Leena McCann, Mandy L.Y. Sin, Julia A. Bridge, Huilin Wei, Jun Zhang, Edith Wong, Andrew Hiar, Kathleen E. Mach, Douglas Scherr, R. Blair Egerdie, Shoichiro Ohta, Wade J. Sexton, Maxwell V. Meng, Alon Z. Weizer, Michael Woods, G. Kenneth Jansz, Joseph ZadraYair Lotan, Bernard Goldfarb, Joseph C. Liao

Research output: Contribution to journalArticlepeer-review

48 Scopus citations


Purpose: Despite suboptimal sensitivity urine cytology is often performed as an adjunct to cystoscopy for bladder cancer diagnosis. We aimed to develop a noninvasive, fast molecular diagnostic test for bladder cancer detection with better sensitivity than urine cytology while maintaining adequate specificity. Materials and Methods: Urine specimens were collected at 18 multinational sites from subjects prior to cystoscopy or tumor resection, and from healthy and other control subjects without evidence of bladder cancer. The levels of 10 urinary mRNAs were measured in a training cohort of 483 subjects and regression analysis was used to identify a 5-mRNA model to predict cancer status. The performance of the GeneXpert® Bladder Cancer Assay, an assay labeled for investigational use only to detect the 5 mRNAs ABL1, CRH, IGF2, ANXA10 and UPK1B, was evaluated in an independent test cohort of 450 participants. Results: In the independent test cohort the assay ROC curve AUC was 0.87 (95% CI 0.81–0.92). At an example cutoff point of 0.4 overall sensitivity was 73% while specificity was 90% and 77% in the hematuria and surveillance patient populations, respectively. Conclusions: We developed a 90-minute, urine based test that is simple to perform for the detection of bladder cancer. The test can help guide physician decision making in the management of bladder cancer. Additional evaluation in a prospective study is needed to establish the clinical usefulness of this assay.

Original languageEnglish (US)
Pages (from-to)655-662
Number of pages8
JournalJournal of Urology
Issue number3
StatePublished - Mar 2018


  • RNA
  • early detection of cancer
  • hematuria
  • messenger
  • molecular
  • pathology
  • urinary bladder neoplasms

ASJC Scopus subject areas

  • Urology


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