URINE BIOMARKERS IN CANCER DETECTION: A SYSTEMATIC REVIEW OF PRE-ANALYTICAL PARAMETERS AND APPLIED METHODS.

The aim of this review was to explore the status of urine sampling as a liquid biopsy for non-invasive cancer research by reviewing used pre-analytical parameters and protocols. We searched two main health sciences databases, PubMed and Web of Science. From all eligible publications (2010-2022), information was extracted regarding: (i) study population characteristics, (ii) cancer type, (iii) urine pre-analytics, (iv) analyte class, (v) isolation method, (vi) detection method, (vii) comparator used, (viii) biomarker type, (ix) conclusion, and (x) sensitivity and specificity. The search query identified 7835 records, of which 924 unique publications remained after screening the title, abstract and full text. Our analysis demonstrated that many publications did not report information about the pre-analytical parameters of their urine samples, even though several other studies have shown the importance of standardization of sample handling. Interestingly, it was noted that urine is used for many cancer types and not just cancers originating from the urogenital tract. Many different types of relevant analytes have been shown to be found in urine. Additionally, future considerations and recommendations are discussed: (i) the heterogeneous nature of urine, (ii) the need for standardized practice protocols, and (iii) the road towards the clinic. Urine is an emerging liquid biopsy with broad applicability in different analytes and several cancer types. However, standard practice protocols for sample handling and processing would help to elaborate the clinical utility of urine in cancer research, detection, and disease monitoring. This article is protected by copyright. All rights reserved.