Urinary Biomarkers for Detection, Treatment Decision and Prognosis of Cancer

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Background

Current cancer diagnosis relies on tissue biopsy, which is invasive and painful. Reliable and noninvasive biomarkers for cancer are an unmet need. Urine is a complex fluid containing numerous cells and small molecule metabolites, which allows for completely non-invasive sampling, large-volume collection, and easy repeat measurements. In addition to urinary tumor biomarkers, urine also contains tumor biomarkers of a variety of other organs, because the kidneys are organs that produce urine with abundant blood supply and are important organs for the excretion of human metabolic waste. Markers with very low concentrations in urine can accumulate through the overrate and concentration function of the kidneys, resulting in higher concentrations. Non-invasive urinary biomarkers for detection, treatment decision, and prognosis are beneficial for cancer patients.

Genome : A series of studies have shown that urine DNA methylation detection is helpful for the early detection and recurrence monitoring of bladder cancer and upper tract urothelial carcinoma, with high sensitivity and specificity for low-grade tumors, and can reduce the number of cystoscopy examinations and the burden of secondary surgery. In prostate cancer, the 14-gene panel urine test is more accurate than PSA and Gleason scores in risk stratification and can be used to detect high-risk prostate cancer to aid treatment decisions. Urine DNA testing can dynamically track EGFR mutations in patients with non-small cell lung cancer treated with EGFR-TKIs. Urinary cell-free DNA may be a potential alternative to traditional primary tissue-based detection of EGFR mutations.
Transcriptome : Urine exosome analysis has been a research hotspot in recent years. Exosomes contain a variety of characteristic proteins and RNAs, which change according to cancer type and tumor progression stage and are a promising biomarker for cancer surveillance and non-invasive diagnosis. There was overexpression of miR-224-5p in urinary exosomes of patients with renal cell carcinoma. miR-224-5p suppressed RCC cell proliferation and induced cell cycle arrest through inhibiting cyclin D1 expression. PD-L1 protein abundance was increased by miR-224-5p, and this regulation could be transmitted via exosomes intercellularly. These findings may shed light on biomarker discovery for RCC immunotherapy. Urine transcriptional levels of CK20 and IGF2 were significantly higher in bladder cancer patients than in healthy controls.
Proteome : Urine contains complex protein components, which are closely related to the occurrence, development, and prognosis of tumors. Studies have shown that LYVE1, REG1A, and TFF1 can be used for the early diagnosis of pancreatic ductal adenocarcinoma. Urine proteome also shows potential as a biomarker for other non-urinary cancers, such as colon, ovarian, lung, and bile duct cancers. Urine DickOPF-3 (DKK3), a stress-induced tubular epithelial-derived fibrogenic glycoprotein, identifies patients at short-term risk for loss of EGFR.
Metabolome : There are many metabolites in urine, which are closely related to the function of organs, the occurrence, development, treatment, and prognosis of tumors. Activin A is a multifunctional cytokine in the TGF-βsuperfamily, which is involved in the occurrence and development of a variety of renal diseases. Activin A in urine cannot be detected in healthy people, and its elevation and decrease are closely related to the progression of the disease and the therapeutic effect. The urinary metabolite group can be used to detect/diagnose pancreatic ductal adenocarcinoma (PDAC), and statistical analysis identified a six-metabolite group that showed a high potential for the diagnosis of PDAC. Urinary metabolites of polycyclic aromatic hydrocarbons (PAH) are associated with the risk of papillary thyroid carcinoma (PTC) and nodular goiter (NG). PAH exposure may increase the risk of NG/PTC, and there may be a gender-specific effect of PAH exposure on the development of NG/PTC.

At present, because of the cross-interaction between various diseases, the specificity of urinary biomarkers is not good, and the conversion rate of clinical application is not high. The lack of systematic research on urinary biomarkers in several human systems is not conducive to understanding and clinical application. For this Research Topic, we aimed to bring together recent advances on screening and validating potential urinary biomarkers for detection, treatment, and prognosis of cancer. Various methodologies can be used to elucidate the pathophysiology of cancer markers or discovery based on clinical application.

This Research Topic welcomes submissions of Original Research and Reviews on novel or established genomic, proteomic, transcriptomic, or metabolomic urinary biomarkers, for cancer detection, treatment, and prognosis. Specific subject areas of interest include but are not limited to:
- Urine DNA methylation biomarkers in the diagnosis, treatment, and prognosis of tumors
- The correlation between urine metabolites and organ function and disease occurrence and development
- Correlation between urine metabolites and the efficacy of antitumor drugs
- The role of urine exosome analysis in the diagnosis, treatment, and prognosis of tumors
- Diagnosis and prognostic monitoring of urinary FISH in tumors

Important note: All contributions to this Research Topic must be within the scope of the section and journal to which they are submitted, as defined in their mission statements. Frontiers reserves the right to guide an out-of-scope manuscript to a more suitable section or journal at any stage of peer review.

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