EARLY-STAGE bladder cancer can be effectively diagnosed using unprocessed urine samples at the point of care, achieving 90% accuracy.
Bladder cancer diagnosis has traditionally been hindered by the need for laboratory processing of urine samples, especially when haematuria (blood in urine) interferes with test accuracy. Recent advancements have led to the development of a point-of-care diagnostic device that simplifies detection by removing the need for sample processing. This innovative system leverages a biomarker-based mechanism that utilises the enzymatic release of organogel particles to detect urinary hyaluronidases, a key indicator of bladder cancer. The fluorescence-based output can be read directly via a smartphone, making it accessible and user-friendly for clinicians and potentially for at-home use.
The device was evaluated in a double-blind study involving 105 participants: 80 with bladder cancer or other genitourinary conditions and 25 healthy individuals. Despite the presence of haematuria in some samples, the system accurately distinguished bladder cancer cases with an overall accuracy of 90%. This included the critical identification of early-stage cancers. The buoyancy of the organogel particles ensures a clean signal by transferring them to an organic phase, where solvatochromic fluorophores change fluorescence in the presence of cancer biomarkers. This approach eliminates interference from blood proteins, a significant challenge in traditional urine-based diagnostic methods.
The promising performance of this device highlights its potential to improve clinical practice by enabling rapid, non-invasive bladder cancer screening and surveillance, particularly in primary care or home settings. Its ability to bypass complex sample processing steps could facilitate earlier detection and intervention, which are critical for patient outcomes. Future considerations include refining the device for broader clinical validation, expanding its diagnostic capabilities, and integrating it into telemedicine frameworks. With its high accuracy and simplicity, this system represents a step forward in accessible cancer diagnostics, potentially reducing diagnostic delays and easing patient burden.
Katrina Thornber, EMJ
Reference
Keum C et al. Diagnosis of early-stage bladder cancer via unprocessed urine samples at the point of care. Nat. Biomed. Eng. 2024;DOI:10.1038/s41551-024-01298-0.
