The Clinical Study Of Urine Liquid Biopsy For Preoperative Detection Of Primary Urothelial Carcinoma

ObjectiveTo explore the possibility of urine liquid biopsy as a primary urothelial detection method and provides a new method for clinical urothelial neoplasm detection.MethodsA total of 60 patients with hematuria or suspected bladder tumors were divided into tumor group and non-tumor group.The patients in tumor group were divided into two groups according to the anatomical location of the lesions: UTUC group(upper urinary tract urothelial tumors group)and UBC group(bladder urothelial tumors group).Then the bladder urothelial tumors group was divided into some groups by pathological grades.Urine samples were collected for NGS gene mutation detection and gene methylation detection,and liquid biopsy results were obtained.The sensitivity and specificity of liquid biopsy were determined according to the results of cystoscopy and operation pathology,and the results were analyzed statistically.Results(1)According to the diagnosis of urothelial tumors,60 patients were divided into tumor group and non-tumor group.The tumour group consisted of 35 patients with confirmed urothelial tumors and the non-tumour group consisted of 25 patients with non-urothelial tumors.The results of liquid biopsy were positive in 32 cases and negative in 3 cases in the tumor group,and that is positive in 3 cases and negative in 22 cases in the non-tumor group.The sensitivity and specificity of liquid biopsy were 91.4% and 88% respectively.There were significant statistical differences in the detection rate between tumour group and non-tumour group.(2)Among 35 patients with confirmed urothelial tumors,they were divided into two groups according to the location of the lesions: UTUC group(upper urinary tract urothelial tumors group)and UBC group(bladder urothelial tumors group).Urine liquid biopsy was positive in 4 cases and negative in 1 case in UTUC group.Urine liquid biopsy was positive in 28 cases and negative in 2 cases in UBC group.The sensitivity of urine liquid biopsy to UTUC was 80%,and to UBC was 93.3%.There was no significant statistical difference in the detection rate of urothelial tumors at different locations,and there was no significant statistical difference between the detection rate of each group and the overall detection rate.(3)Further detection and analysis of data in confirmed bladder urothelial tumors showed that there were 6 cases of high-grade urothelial carcinoma.5 cases were positive and 1 case was negative liquid biopsy with a sensitivity of 83.3%.In 20 cases of low-grade urothelial carcinoma,19 cases were positive and 1 case was negative liquid biopsy with a sensitivity of 95%.And 3 cases of low-grade malignant potential urothelial papillary tumor(PUNLMP),3 cases of liquid biopsy.There were 3 positive cases and 0 negative cases with 100% sensitivity.The 1 mucinous cancer,1 liquid biopsy and 0 negative cases with 100% sensitivity.There was no significant difference between the detection rate of high-grade urothelial cancer and low-grade urothelial cancer.ConclusionLiquid biopsy has high sensitivity and specificity for the detection of urinary tract epithelial neoplasm,and can maintain a high detection rate for urinary tract epithelial neoplasm at different locations.In particular,the upper urinary tract urothelial neoplasms are also highly sensitive.The test efficiency was higher than urine-based cytology.Cystoscopy is a potential method for prolonging the cystoscopy interval without delay during postoperative follow-up for bladder cancer,or even replacing urine-based cytology.