Luminophore Chemistry for Detection of Urinary Bladder Cancer - Comparison to Cytology and Urinary Rapid Tests (BTA stat^®, NMP22^® BladderChek^® and UBC^® Rapid Test)

Background/aim: New luminometric chelates were developed for the detection of urinary bladder cancer and compared to cytology and urinary rapid tests BTA stat^®, NMP22^® BladderChek^® and UBC^® Rapid Test.

Materials and methods: This single-center study analyzed urine from two different cohorts: Firstly, a retrospective pilot cohort (n=27) and secondly a prospective validation cohort (n=60) including patients with bladder cancer and healthy controls. The samples were studied with nine different terbium and europium chelates to detect cancer cases. After identification of an efficient luminophore in the first cohort, the second validation cohort was run with the selected chelates to re-evaluate the results and compare them with urinary rapid tests and cytology.

Results: The compared methods showed area under the curve (AUC) values ranging from 0.567 to 0.767. Tb³⁺-chelate-based assay detected high-grade cancer cases (p=0.035) with an AUC of 0.663. The Eu-probe signal level was higher in cancer cases of any grade than in healthy controls (p=0.001) with an AUC of 0.759. The Eu-probe had a sensitivity of 46.7% and a specificity of 100% in cancer detection.

Conclusion: Evaluation of terbium and europium chelates for the detection of urinary bladder cancer showed highest specificity among all methods and improved overall performance (characterized by AUC) compared to commercial urine-based rapid tests and cytology. The Eu-probe has the potential to be clinically valuable in urine-based detection of bladder cancer, especially for high-grade cancer.