Электронный нос с точностью 87,5% выявляет рак мочевого пузыря по анализу мочи

Urinary volatile organic compound profiling using an electronic nose (eNose) demonstrates high accuracy for distinguishing bladder cancer from a healthy bladder, a study finds. eNose might be used as a noninvasive adjunct biomarker test for bladder cancer detection and clinical triage in selected risk-enriched populations, Alession Filianoti, MD, PhD, of Regina Elena National Cancer Institute, Rome, Italy, and colleagues suggested in Urologic Oncology: Seminars and Original Investigations. In the prospective single-center study of 192 patients with histologically confirmed bladder cancer and 143 healthy control patients, the eNose achieved a cross-validated accuracy of 87.5% (P <.001), with 81.8% sensitivity and 95.1% specificity. The area under the receiver operating characteristic curve was 0.926. Investigators prospectively enrolled consecutive patients with suspected primary or recurrent bladder cancer and collected sterile first-morning urine before transurethral resection of bladder tumor or radical cystectomy. The control group was recruited from an institutional outpatient clinic after neoplasia and urinary infection had been excluded. Participants with ongoing gross hematuria or concomitant urinary infection were excluded. Urine samples underwent analysis with a 32-sensor eNose (Cyranose C320), followed by principal component analysis and canonical discriminant analysis. The study groups had similar baseline characteristics, such as age and comorbidities, although histories of acute myocardial infarction and chronic obstructive pulmonary disease differed. The bladder cancer cohort included both non-muscle-invasive and muscle-invasive disease, as well as low-grade and high-grade tumors. On 2-dimensional principal component analysis, 157 of 192 cases of bladder cancer and 136 of 143 healthy controls were correctly classified. Canonical discriminant analysis produced a positive predictive value of 96% and negative predictive value of 80%, while positive and negative likelihood ratios were 16.69 and 0.19, respectively. Findings remained consistent when investigators analyzed serial urine specimens collected from the same patients at different time points. The repeated analysis yielded a cross-validated accuracy of 87.2%, area under the receiver operating characteristic curve of 0.90, sensitivity of 80.8%, and specificity of 94.7%, supporting reproducibility of the volatilome-based approach. Exploratory analyses also suggested sustained discrimination across non-muscle-invasive and muscle-invasive disease, although the study was not powered to establish stage- or grade-specific diagnostic performance, particularly for low-grade Ta tumors. Several barriers remain before eNose testing could become a routine diagnostic strategy. Urinary volatilomes may be influenced by exogenous factors, including diet, medications, smoking, and alcohol, potentially introducing artifacts. Moreover, eNose platforms identify composite molecular patterns rather than individual chemical compounds and cannot characterize every constituent of a urine sample. The inclusion of primary and recurrent tumors and the binary design further limited assessment of tumor differentiation. External validation is needed. “Building on our previous experience with urinary volatilome analysis using eNose technology in other urologic malignancies, the present findings extend this research line to bladder cancer and reinforce the potential role of volatilome profiling across urologic oncology,” Dr Filianoti’s team wrote. References: Filianoti A, Costantini M, Rosca V, et al. Electronic nose-based urinary volatilome profiling accurately discriminates bladder cancer from healthy controls: A prospective diagnostic study. Urol Oncol. Published online July 23, 2026. doi:10.1016/j.urolonc.2026.06.012