SYSTEMATIC REVIEW article
Front. Oncol.
Sec. Genitourinary Oncology
Volume 15 - 2025 | doi: 10.3389/fonc.2025.1649420
Integrated Assessment of Non-Invasive Diagnostic Tools for Bladder Cancer: A Network Meta-Analysis
Provisionally accepted
- Department of Urology, West China Hospital, Sichuan University, Chengdu, China
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Background: Bladder cancer is a common and recurrent urologic malignancy. Although cystoscopy remains the diagnostic gold standard, its invasiveness, high cost, and limited patient compliance restrict its routine application. Non-invasive biomarkers have emerged as promising alternatives; however, their diagnostic performance has not yet been systematically compared across studies. Methods: We searched PubMed, Embase, Web of Science, and the Cochrane Library for publications available until February 21, 2025. Twenty-six original studies on non-invasive diagnostic methods for bladder cancer were included. A Bayesian network meta-analysis was performed to compare biomarkers derived from urine and blood samples. Diagnostic performance was evaluated using sensitivity, specificity, diagnostic odds ratio (DOR), and the superiority index. Subgroup analyses were conducted for microRNAs and combined biomarker strategies. Study quality was assessed with the QUADAS-2 tool, and model convergence was verified using Rhat values. Results: Significant differences in biomarker performance were identified. In urine samples, angiogenin achieved the highest superiority index (5.28), while miR-125b was the best-performing microRNA (10.97). Combined detection strategies involving TERT/FGFR3/TP53/PIK3CA/KRAS demonstrated strong performance (8.54). In blood samples, miR-181b-5p and fibronectin had an index of 3.02, whereas miR-301a-3p exhibited the greatest superiority (50.71). Conclusion: This study is the first to systematically compare non-invasive bladder cancer biomarkers within a Bayesian framework. Specific microRNAs and combined detection strategies demonstrated robust diagnostic potential, providing a promising alternative to cystoscopy, particularly for early screening and patient monitoring.
Keywords: Bladder cancer, Non-invasive diagnosis, biomarker, Network meta-analysis, Superiority index
Received: 18 Jun 2025; Accepted: 30 Sep 2025.
Copyright: © 2025 Zhang, Chen, Ye, Bai and Han. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Yunjin Bai, baiyunjin@scu.edu.cn
Ping Han, hanping@scu.edu.cn
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