ReviewBladder cancer (Amsterdam, Netherlands)2018
Urinary Biomarkers in the Evaluation of Primary Hematuria: A Systematic Review and Meta-Analysis.
Review in Bladder cancer (Amsterdam, Netherlands), 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 2 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
22 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Urinary biomarkers for bladder cancer diagnosis and NMIBC follow-up: a systematic review.World journal of urology · 2023Pooled it
- Ureteral involvement by metastatic malignant disease.Clinical & experimental metastasis · 2019Pooled it
- Multidimensional liquid biopsy in bladder cancer: advances in circulating tumor cells, circulating tumor DNA, exosomes, and metabolomics.The oncologist · 2026Review
- Integrated Proteogenomic Approach for Discovering Potential Biomarkers in Urothelial Carcinoma of the Bladder.Biomedicines · 2025Article
- Tropomyosin Isoforms as Biomarkers for Urothelial Bladder Cancer: Promise and Challenges.Cureus · 2025Review
- Review
- Unleashing the power of urine‑based biomarkers in diagnosis, prognosis and monitoring of bladder cancer (Review).International journal of oncology · 2025Review
- Reliability of the IDENTIFY calculator in stratifying risk of urothelial carcinoma in patients with haematuria: An initial evaluation at an Australian centre.BJUI compass · 2024Article
- Accurate Detection of Urothelial Bladder Cancer Using Targeted Deep Sequencing of Urine DNA.Cancers · 2023Article
- Article
- Identification and validation of methylated PENK gene for early detection of bladder cancer using urine DNA.BMC cancer · 2022Article
- Detection of Urinary Molecular Marker Test in Urothelial Cell Carcinoma: A Review of Methods and Accuracy.Diagnostics (Basel, Switzerland) · 2022Review
- BladMetrix: a novel urine DNA methylation test with high accuracy for detection of bladder cancer in hematuria patients.Clinical epigenetics · 2022Article
- Utility of urinary biomarkers in primary haematuria: Systematic review and meta-analysis.BJUI compass · 2022Review
- Review
- Article
- Flexible Cystoscopy in the Setting of Macroscopic Hematuria: Do the Findings Justify Its Use?Urologia internationalis · 2022Article
- UroVysion fluorescence in situ hybridization in urothelial carcinoma: a narrative review and future perspectives.Translational andrology and urology · 2021Review
- Comparison of the performances of the ADXBLADDER test and urinary cytology in the follow-up of non-muscle-invasive bladder cancer: a blinded prospective multicentric study.BJU international · 2021Article
- Urinary hyaluronic acid: a versatile marker of bladder cancer.International urology and nephrology · 2020Article
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionUrinary biomarkers are entering the clinical landscape as a non-invasive method to evaluate patients for bladder cancer, however it is currently predominantly used in the surveillance setting. The use of biomarkers in the setting of primary hematuria is not widespread despite initial promising results. This study comprehensively reviews the literature on the diagnostic performance of FDA-approved biomarkers in the evaluation of primary hematuria.
methodsAccording to the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) statement, MEDLINE, EMBASE, ScienceDirect, Cochrane Libraries, HTA database, Google Scholar and Web of Science were searched up to June 2017 for studies assessing the diagnostic accuracy of FDA-approved urinary biomarkers amongst patients presenting with primary hematuria. The quality of included studies was assessed using the QUADAS-2 tool.
resultsFourteen studies met the pre-specified eligibility criteria and were included for analysis. The biomarkers assessed in these studies were AssureMDx, Bladder tumor antigen, CxBladder, NMP22, UroVysion and uCyt+. Across these four biomarkers, the sensitivity ranged from 0.67 to 0.95, and specificity from 0.68 to 0.93, respectively. There was significant heterogeneity between the included studies. Limited head-to-head comparison with urine cytology demonstrated that in general, the biomarkers have superior sensitivity but inferior specificity. Overall, the quality of evidence was graded as moderate primarily because of inadequate blinding.
conclusionThe current diagnostic performance of biomarkers are inadequate to replace cystoscopy in the primary hematuria setting. However, AssureMDx in particular may have a role as a triage test for cystoscopy but further prospective data is required to validate these findings. Given the current evidence, the use of these markers as an adjunct to cystoscopy for the evaluation of hematuria should be considered investigational.
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