bladder cancer molecular diagnosis

Introduction Bladder cancer is a prevalent malignancy, particularly affecting the urinary system. It ranks as the sixth most common cancer in Iran and is associated with significant morbidity and mortality. Common symptoms include hematuria, and while non-muscle invasive bladder cancer (NMIBC) constitutes about ۸۰% of diagnosed cases, the disease is characterized by a high recurrence rate. The current gold standard for diagnosis, cystoscopy, is invasive and costly, prompting the need for non-invasive alternatives. Bladder Cancer in Iran Bladder cancer remains a pressing public health issue in Iran, with rising incidence and mortality rates. The disease is particularly prevalent among men due to lifestyle risk factors such as smoking and opium use, as well as occupational exposure to industrial chemicals. A systematic review of epidemiological data revealed that bladder cancer accounts for approximately ۷% of all cancers in Iran, with a higher incidence in urban areas like Tehran and Eastern Azerbaijan. Despite advancements in treatment, the ۵-year survival rate in Iran remains lower than in developed countries, partly due to delayed diagnoses and limited access to specialized care. Molecular Diagnostic Techniques for Bladder Cancer Recent advances in molecular diagnostics offer hope for more accurate, non-invasive detection of bladder cancer. Various urinary markers have been identified, including Nuclear Matrix Protein-۲۲ (NMP-۲۲), Bladder Tumor Antigen (BTA), and UroVysion fluorescence in situ hybridization (FISH). These tests detect cancer-specific genetic alterations, such as mutations in the FGFR۳ and TERT genes, which are common in bladder cancer. Additionally, urine-based microRNA (miRNA) panels and cell-free DNA (cfDNA) analysis have emerged as promising tools for early detection and monitoring. Urine-Based Diagnosis: A Viable Solution Urine cytology and other molecular diagnostic methods offer a non-invasive and patient-friendly approach to bladder cancer screening. While traditional urine cytology shows high specificity, it suffers from low sensitivity, particularly in low-grade cancers. However, newer technologies, such as the detection of cfDNA and methylated DNA in urine, have demonstrated superior sensitivity and specificity, making them viable alternatives to invasive cystoscopy. This is especially important for populations in Iran where access to advanced medical care may be limited. Urine-based diagnostics could revolutionize early detection, improving outcomes and reducing the need for invasive procedures.

کلیدواژه ها:

Bladder cancer ، Molecular Diagnostic Techniques ، Urine-Based Diagnosis