title: Gene-based urinary biomarkers for bladder cancer: an unfulfilled promise?
abstract: OBJECTIVE
  Noninvasive biomarkers are used routinely in the clinical management of several cancers but bladder cancer detection and surveillance remains dependent on invasive procedures such as cystoscopy. No validated biomarker currently exists in routine clinical practice other than cytology. Gene-based testing has shown great promise for biomarker profiling and this review addresses the current state of biomarker research in bladder cancer.
  
  
  METHODS
  A comprehensive review of all published literature on urinary biomarkers from 1970 - 2012 was conducted in PubMed. Keywords used alone or in combination were bladder cancer, diagnosis, surveillance, urinary biomarker, molecular biomarkers, methylation, gene expression, single nucleotide polymorphism and microRNA. The cited references of the manuscripts included in the review were also screened.
  
  
  RESULTS
  We have reviewed various strategies currently used for gene-based biomarker profiling of bladder cancer. We have comprehensively summarized the performance of several biomarkers in the diagnosis and surveillance of bladder cancer. Finally we have identified biomarkers that have shown potential and now deserve the opportunity to be validated in the clinical setting.
  
  
  CONCLUSIONS
  Several gene-based urinary biomarkers have demonstrated promise in initial studies, which now need to be rigorously validated in the clinical setting for them to be translated into clinically useful tests in diagnosis, surveillance or risk-stratification of bladder cancer.
authors.affiliation: Department of Urology, Royal Melbourne Hospital, Parkville, Victoria, Australia; Department of Surgery, University of Melbourne, Parkville, Victoria, Australia. Electronic address: sapni973@gmail.com.
authors.forename: Nikhil
authors.initials: N
authors.lastname: Sapre
authors.affiliation: Department of Urology, Royal Melbourne Hospital, Parkville, Victoria, Australia; Department of Surgery, University of Melbourne, Parkville, Victoria, Australia.
authors.forename: Paul D
authors.initials: PD
authors.lastname: Anderson
authors.affiliation: Department of Urology, Royal Melbourne Hospital, Parkville, Victoria, Australia; Department of Surgery, University of Melbourne, Parkville, Victoria, Australia.
authors.forename: Anthony J
authors.initials: AJ
authors.lastname: Costello
authors.affiliation: Department of Urology, Royal Melbourne Hospital, Parkville, Victoria, Australia; Department of Surgery, University of Melbourne, Parkville, Victoria, Australia.
authors.forename: Christopher M
authors.initials: CM
authors.lastname: Hovens
authors.affiliation: Department of Urology, Royal Melbourne Hospital, Parkville, Victoria, Australia; Department of Surgery, University of Melbourne, Parkville, Victoria, Australia.
authors.forename: Niall M
authors.initials: NM
authors.lastname: Corcoran
mesh_terms: D014408:Biomarkers, Tumor / Q000235:genetics* / Q000652:urine*; D003558:Cystoscopy; D019175:DNA Methylation; D006801:Humans; D035683:MicroRNAs / Q000235:genetics; D018895:Microsatellite Repeats / Q000235:genetics; D020641:Polymorphism, Single Nucleotide; D012680:Sensitivity and Specificity; D001749:Urinary Bladder Neoplasms / Q000175:diagnosis* / Q000235:genetics*
chemical_list: D014408:Biomarkers, Tumor; D035683:MicroRNAs
keywords: Bladder cancer; Molecular biomarkers; Recurrence; Urinary biomarker; microRNA