Potential of Urinary Mutation and Methylation Biomarkers in Selecting Candidates for Repeat Transurethral Resection of Bladder Tumor in Non–muscle-invasive Bladder Cancer: A Prospective Multicenter Study

作者：Xiao Yang, Lingkai Cai, Yaqun Xin, Xinfeng Chen, Bing Zheng, Jie Han, Lin Yuan, Xuejian Yang, Pengchao Li, Juntao Zhuang, Peikun Liu, Ruixi Yu, Rongjie Bai, Yiyang Liu, Tonghui Ma, Qiang Cao, Qiang Lü · 发表于：European Urology Open Science · 年份：2025 · DOI：10.1016/j.euros.2025.05.011 · 被引用次数：2 · 研究领域：Bladder and Urothelial Cancer Treatments、Urinary and Genital Oncology Studies、Esophageal Cancer Research and Treatment

Background and objective The necessity of repeat transurethral resection of bladder tumor (re-TURBT) in patients with non–muscle-invasive bladder cancer (NMIBC) remains a matter of debate. The role of liquid biopsy in predicting residual tumor status and selecting patients who can be spared re-TURBT is still undefined. The aim of our study was to assess the efficacy of the urinary OncoUrine assay for mutation and methylation markers in determining the necessity for re-TURBT in NMIBC. Methods We prospectively recruited patients with NMIBC who were candidates for re-TURBT. Urine samples for OncoUrine testing and exfoliated cytology analysis were collected after initial TURBT, followed by re-TURBT. Key findings and limitations Among 151 patients with NMIBC, 48 (32%) had residual tumor at re-TURBT, and 87 (58%) had detrusor muscle (DM) in their initial TURBT specimen. The OncoUrine test showed sensitivity of 77%, specificity of 78%, positive predictive value of 62%, and negative predictive value (NPV) of 88% for residual tumor, while exfoliated cytology showed corresponding values of 20%, 96%, 69%, and 72%. Stratified analyses revealed higher OncoUrine accuracy in predicting disease-free status in intermediate-risk NMIBC (NPV 98%) and in high-risk NMIBC cases with DM in the initial TURBT specimen (NPV 92%). At 18-mo follow-up for 131 patients, 20 had experienced tumor recurrence, for which OncoUrine positivity was the only independent factor predictive for the risk of recurrence ...