Enhanced detection of bladder cancer using combined circulating tumor cells, urine-derived epithelial cells, and molecular biomarkers

Purpose The sensitivity of bladder cancer detection using a single biomarker from single sample type is limited. This study aimed to investigate whether a combined approach utilizing multiple biomarkers from different clinical samples could improve detection sensitivity. Methods A total of 85 patients with bladder cancer and 30 healthy individuals were enrolled in this study. Urine and blood samples were collected for the isolation of urine-derived epithelial cells(UDECs)and circulating tumor cells (CTCs). These cells were then analyzed via PD-L1 assay and fluorescence in situ hybridization (FISH) targeting chromosomes 7 and 8. In parallel, matched urine samples from patients underwent conventional urine exfoliation cytology testing (UEC). All data were analyzed in conjunction with pathological information using specialized statistical software. Results Analysis of CTCs demonstrated a significantly higher bladder cancer detection rate (78.6%) compared to UEC (36.7%). The combination of UDEC-FISH and CTC analysis utilizing urine and blood samples achieved a higher detection rate (94.1%) than the combination of UDEC-FISH with UEC performed on the same urine sample (79.8%). Furthermore, combined analysis of three markers of CTC, UEC, and UDEC-FISH (96.5%) or CTC, UEC, and UDEC-PD-L1 (90.6%) yielded significantly higher detection rates than any single biomarker analysis alone. Conclusion Integrating multiple biomarkers from distinct sample types significantly enhances the detection sensitivity for bladder cancer.