Metabolomics for the diagnosis of bladder cancer: A systematic review
Herney Andre´s Garcı´a-Perdomo a,b,*,
Ange´lica Marı´a Da´vila-Raigoza b, Fernando Korkes
Abstract Objective: Metabolomics has been extensively utilized in bladder cancer (BCa)
research, employing mass spectrometry and nuclear magnetic resonance spectroscopy to
compare various variables (tissues, serum, blood, and urine). This study aimed to identify potential
biomarkers for early BCa diagnosis.
Methods: A search strategy was designed to identify clinical trials, descriptive and analytical
observational studies from databases such as Medline, Embase, Cochrane Central Register of
Controlled Trials, and Latin American and Caribbean Literature in Health Sciences. Inclusion
criteria comprised studies involving BCa tissue, serum, blood, or urine profiling using widely
adopted metabolomics techniques like mass spectrometry and nuclear magnetic resonance.
Primary outcomes included description of metabolites and metabolomics profiling in BCa patients
and the association of metabolites and metabolomics profiling with BCa diagnosis
compared to control patients. The risk of bias was assessed using the Quality Assessment of
Studies of Diagnostic Accuracy.
Results: The search strategy yielded 2832 studies, of which 30 case-control studies were
included. Urine was predominantly used as the primary sample for metabolite identification.
Risk of bias was often unclear inpatient selection, blinding of the index test, and reference
standard assessment, but no applicability concerns were observed. Metabolites and metabolomics
profiles associated with BCa diagnosis were identified in glucose, amino acids, nucleotides,
lipids, and aldehydes metabolism.
Conclusion: The identified metabolites in urine included citric acid, valine, tryptophan,
taurine, aspartic acid, uridine, ribose, phosphocholine, and carnitine. Tissue samples exhibited
elevated levels of lactic acid, amino acids, and lipids. Consistent findings across tissue,
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