Current status of diagnosis and treatment of bladder cancer in China-Analyses of Chinese Bladder Cancer Consortium database

Objective:To investigate current status of diagnosis and treatment of bladder cancer in China.Methods:A database was generated by Chinese Bladder Cancer Consortium(CBCC).From January 2007 to December 2012,14,260 cases from 44 CBCC centers were included.Data of diagnosis,treatment and pathology were collected.Results:The average age was 63.5 year-old and most patients were male(84.3%).The most common histologic types were urothelial carcinoma(91.4%),adenocarcinoma(1.8%),and squamous carcinoma(1.9%).According to 1973 and 2004 WHO grading system,42.0%,41.0%,and 17.0% of patients were grade 1,2,and 3,and 16.0%,48.7%,and 35.3% of patients were papillary urothelial neoplasms of low malignant potential,low,and high grade,respectively.Non-muscle invasive bladder cancer(NMIBC)and muscle invasive bladder cancer(MIBC)were 25.2% and 74.1%,respectively(0.8% not clear).Carcinoma in situ was only 2.4%.Most patients were diagnosed by white-light cystoscopy with biopsy(74.3%).Fluorescence and narrow band imaging cystoscopy had additional detection rate of 1.0% and 4.0%,respectively.Diagnostic transurethral resection(TUR)provided detection rate of 16.9%.Most NMIBCs were treated with TUR(89.2%).After initial TUR,2.6%accepted second TUR,and 45.7%,69.9%,and 58.7% accepted immediate,induced,and maintenance chemotherapy instillation,respectively.Most MIBCs were treated with radical cystectomy(RC,59.7%).Laparoscopic RCs were 35.1%,while open RC 63.4%.Extended and standard pelvic lymph node dissection were 7% and 66%,respectively.Three most common urinary diversions were orthotopic neobladder(44%),ileal conduit(31%),and ureterocutaneostomy(23%).Only 2.3% of patients accepted neo-adjuvant chemotherapy and only 18%of T3 and T4 patients accepted adjuvant chemotherapy.Conclusion:Disease characteristics are similar to international reports,while differences of diagnosis and treatment exist.This study can provide evidences for revisions of the guideline on bladder cancer in China.

Case Report:Diagnosis and treatment of pheochromocytoma in urinary bladder

Objective： To study the diagnosis and treatment ofpheochromocytoma in urinary bladder. Methods： Six cases of bladder pheochromocytoma were studied. Four cases showed hypertension, 3 of which were paroxysmal hypertension during urination. Catecholamine （CA） was increased in a case, and vanillymandelic acid （VMA） was increased in 2 cases. Bladder submucosal mass was detected by B-ultrasound in 5 cases （5/5）, computerized tomography （CT） in 3 cases （3/3）, cystoscopy in 5 cases （5/6）. Four cases took a-receptor blocker for 2 weeks, 1 case took β-receptor blocker to decrease heart rate. All patients were treated with surgical operation including 4 partial cystectomies, 2 excavations. Results： Three cases had manifestations including headache, excessive perspiration and hypertension during cystoscopy. Four cases were confirmed before operation. Two cases showed hypertension during operation. All patients were pathologically diagnosed as pheochromocytoma post- operatively. In five cases followed up, blood pressure returned to normal. No patient had relapse and malignancy. Conclusions： Typical hypertension during urination comprised the main symptoms. We should highly suspect bladder pheochromocytoma if a submucosal mass was discovered with B-ultrasound, CT, ^131I-M1BG （methyliodobenzylguanidine） and cystoscopy. The determination of CA in urine is valuable for qualitative diagnosis. The preoperative management of controlling blood pressure and expansion of the blood volume are very important. Surgical operation is a good method for effective treatment. Postoperative long-time followed up is necessary.

OPTICAL COHERENCE TOMOGRAPHY FOR BLADDER CANCER DIAGNOSIS:FROM ANIMAL STUDY TO CLINICAL DIAGNOSIS

This paper summarizes the recent technological development in our lab on cystoscopic optical coherence tomography(COCT)by integrating time-domain OCT(TDOCT)and spectral-domain OCT(SDOCT)with advanced MEMS-mirror technology for endoscopic laser scanning imaging.The COCT catheter can be integrated into the instrument channel of a commercial 22Fr rigid cystoscopic sheath for in vivo imaging of human bladder under the cystosocopic visual guidance;the axial/transverse resolutions of the COCT catheter are roughly 9μm and 12μm,respectively,and 2D COCT imaging can be performed with over 110dB dynamic range at 4–8 fps.To examine the utility and potential limitations of OCT for bladder cancer diagnosis,systemic ex vivo rat bladder carcinogenesis studies were performed to follow various morphological changes induced by tumor growth and in vivo porcine study was performed to examine the feasibility of COCT for in vivo imaging.Justified by promising results of the animal studies,preliminary clinical study was conducted on patients scheduled for operating-room cystoscopy for bladder cancers.Double-blind clinical results reveal that COCT can delineate detailed bladder architectures(e.g.,urothelium,lamina propria,muscularis)at high resolution and detect bladder cancers based on enhanced urothelial heterogeneity as a result of excessive growing nature of bladder cancers.The diagnostic sensitivity and specificity can be enhanced to 92%and 85%,respectively.Results also suggest that due to reduced imaging depth of COCT in cancerous lesions,staging of bladder cancers may be limited to Ta or T1 for non-outgrowing cancerous lesions.

Diagnosis and treatment of primary small cell carcinoma of urinary bladder

Objective To investigate clinical and pathological features of small cell carcinoma of urinary bladder. Methods The pathological and clinical data of 9 cases of small cell carcinoma were analyzed retrospectively.

The practical value of 3-dimensional computed tomography on diagnosis of bladder tumor

Objective To study the practical value of 3-dimensional computed tomography on diagnosis of bladder tumor, Methods Fifteen patients with bladder masses were examined by thin-layer computed tomography. The results of 3-dimensional reconstructed images were compared with the final diagnosis and the pathological stages. Results According to 3-dimensional reconstructed images, among the 15 cases, 12 cases of bladder cancer were diagnosed, and the pathological types were transitional carcinoma. Two cases were diagnosed as benign tumor (leiomyoma), and the other one was colon cancer, which invaded bladder. The accuracy was 100% . The clinical stages were determined. Of the 12 bladder carcinomas,5 was in stage T1, 3 in T2,, 3 in T3 and 1 in T4.The accuracy of staging was up to 83% (10/12) compared with pathological stages. Conclusion The 3-dimensional reconstructed technology may improve the accuracy of staging of bladder carcinoma, and to provide important evidence for surgery options. 3 refs,2 figs.

Potential clinical application of microRNAs in bladder cancer

Bladder cancer(BC)is the tenth most prevalent malignancy globally,presenting significant clinical and societal challenges because of its high incidence,rapid progression,and frequent recurrence.Presently,cystoscopy and urine cytology serve as the established diagnostic methods for BC.However,their efficacy is limited by their invasive nature and low sensitivity.Therefore,the development of highly specific biomarkers and effective noninvasive detection strategies is imperative for achieving a precise and timely diagnosis of BC,as well as for facilitating an optimal tumor treatment and an improved prognosis.microRNAs(miRNAs),short noncoding RNA molecules spanning around 20–25 nucleotides,are implicated in the regulation of diverse carcinogenic pathways.Substantially altered miRNAs form robust functional regulatory networks that exert a notable influence on the tumorigenesis and progression of BC.Investigations into aberrant miRNAs derived from blood,urine,or extracellular vesicles indicate their potential roles as diagnostic biomarkers and prognostic indicators in BC,enabling miRNAs to monitor the progression and predict the recurrence of the disease.Simultaneously,the investigation centered on miRNA as a potential therapeutic agent presents a novel approach for the treatment of BC.This review comprehensively analyzes biological roles of miRNAs in tumorigenesis and progression,and systematically summarizes their potential as diagnostic and prognostic biomarkers,as well as therapeutic targets for BC.Additionally,we evaluate the progress made in laboratory techniques within this field and discuss the prospects.

Effects of OGFOD1 in bladder cancer progression and its prognostic significance:Insights from bioinformatics analysis

Background:Previous studies have established the role of 2-oxoglutarate and Fe(II)-dependent oxygenase domain–containing protein 1(OGFOD1)in oncogenesis.The objective of this investigation was to discern the diagnostic and prognostic relevance of OGFOD1 within the context of bladder cancer(BLCA)using bioinformatics methodologies.Methods:We collected RNA sequencing data from The Cancer Genome Atlas database and verified it using the GSE13507 dataset.Immunohistochemical analysis was based on data from the human protein atlas,and the protein-protein interaction network was constructed using the STRING database.Bioinformatics analysis was performed using the R application,analyzing the correlation between clinical characteristics and OGFOD1 expression,exploring the potential mechanisms of OGFOD1 in BLCA through Kyoto Encyclopedia of Genes and Genomes analysis,and evaluating the diagnostic and prognostic value of OGFOD1 expression in BLCA through receiver operating characteristic curve analysis,Kaplan-Meier analysis,and multivariate Cox analysis.Furthermore,a BLCA prognostic nomogram was constructed.Results:We report higher expression levels of OGFOD1 in BLCA specimens compared with those in noncancerous tissues;this can be used to predict the outcome of the disease.Further,results suggest that OGFOD1 is implicated in the activation of the peroxisome proliferator-activated receptor signaling cascade,potentially interacting with other genes linked to expression in promoting the onset and progression of BLCA.Conclusions:OGFOD1 is a promising candidate as a prognostic indicator in BLCA.

Sandwich ELISA for detecting urinary Survivin in bladder cancer

Objective： Survivin as a tumor marker in the diagnosis of bladder cancer has not been completely confirmed yet and there are few reports about using Survivin enzyme-linked immunosorbent assay （ELISA） kit to detect the urine of bladder cancer patients. This study aimed to develop a Survivin ELISA and validate its value in the detection of bladder cancer. Methods： Through square matrix titration, different combinations of coating antibody and detecting antibody, a Survivin ELISA was constructed. This assay was evaluated according to intra-assay precision, inter-assay precision and minimum detectable dose （MDD）. Survivin levels were detected and analyzed in 102 bladder cancer patients and 102 healthy people by established ELISA. Then cutoff value was defined according to the analysis of receiver operating characteristic （ROC） curve. The sensitivity and specificity of detection were calculated on the basis of cutoff value to diagnose bladder cancer patients. Furthermore, the value of Survivin expression detected by ELISA among different clinicopathological characteristics of patients was also compared. Results： Through optimization of different conditions, intra-assay precision was 8.39%, inter-assay precision 8.57% and MDD 0.0625 ng/mL in this assay. When the optical density at 450 nm （OD 450 ） was 0.09, it could get the optimized diagnostic cutoff value. According to this value, the sensitivity and specificity of diagnosis in bladder cancer patients were 70.6% and 89.2%, respectively. The associations between patients＇ clinical variables and OD 450 were not significant except tumor numbers in patients. Conclusions： This experiment has preliminarily developed a Survivin ELISA and confirmed Survivin as a biomarker which owned a practical and significant value in the diagnosis of bladder cancer.

Plasmacytoid Transitional Cell Carcinoma of Bladder： A Clinico-pathological Study and Review of Literatures

Objective： To study the pathologic features of plasmacytoid transitional cell carcinoma of the bladder, and to analyze the diagnostic features, criteria for differential diagnosis and the clinical significance of the tumor. Methods： Two cases of bladder plasmacytoid transitional cell carcinoma were studied. Routine paraffin sections with HE staining, Pap smear and immunohistochemistry by S-P method were observed under a light microscope. Pathological and clinical data were analyzed by comparison with early reported cases in literatures. Results： A characteristic feature of this tumor was of deep invasion in the lamina propria and/or muscularis propria, in addition to the component of carcinoma in situ in the mucosa, when tumors were diagnosed. The histological pattern and cytological features showed similarity to a plasmacytoid tumor. The tumor cells were strongly positive for AE1/AE3, CEA and CK18. The prognosis appeared to be worse than ordinary transitional cell carcinoma. Conclusion： The plasmacytoid transitional cell carcinoma of bladder is rare but has typical pathological, immunohistological and clinical features. Pathologists should be aware of this kind of primary tumor of bladder.

Narrow band imaging for bladder cancer

Narrow band imaging(NBI)is a newly developed technology aiming to provide additional endoscopic information for patients with bladder cancer.This review focuses on the diagnostic accuracy and treatment outcome using NBI cystoscopy for the treatment of nonmuscle invasive bladder cancer.Current results showed improved sensitivity of NBI cystoscopy compared to conventional white light cystoscopy,although lower specificity and increased false-positive results were reported using NBI cystoscopy.The treatment outcome using NBI technology in transurethral resection of bladder tumor had a positive impact while decreased number of residual tumors and tumor recurrence at follow-up were reported.In the future,the application of NBI technology might refine the treatment and follow-up protocol in patients with non-muscle invasive bladder cancer.However,this large scale prospective studies are required to confirm the real cost-effectiveness of this new technology.

Clinicopathologic Observation of 6 Cases with Neuroendocrine Carcinoma of the Urinary Bladder

OBJECTIVE To discuss the pathologic characteristics and theprognosis of neuroendocrine carcinoma of the bladder(NECB)in order to assist in making a precise diagnosis and to effectivelytreat the disease.METHODS Clinicopathologic features of the 6 cases with NECBwere analyzed retrospectively.The personal data of the patientsand the pathologic and immunohistochemical characteristics ofthe tumor were investigated.The follow-up of these patients wasconducted over a time period ranging from 3 months to 9 years.RESULTS Transurethral resection of the bladder tumorwas performed in all 6 patients.Based on the results of thepathologic examination,4 of the cases were diagnosed as smallcell neuroendocrine carcinoma and the other 2 were diagnosedas atypical carcinoid tumor.On immunohistochemical stainingall tumors expressed neuroendocrine markers includingneuronspecific enolase(CD56),synaptophysin(Syn)andchromogranin(CgA).In patients receiving partial cystectomyfollowed by postoperative chemotherapy,relapse was found in 4of the 6 cases on follow up.CONCLUSION NECB is a rare entity and a tumor with highmalignant potential and characteristic pathologic features.Hematuria is the cardinal symptom of NECB.Metastasis mayoccur at an early stage and the prognosis of the disease is poor.Final diagnosis of NECB depends on histopathologic examinationand immunohistochemical assays.Surgical excision combinedwith radiotherapy and chemotherapy is considered an effectivetreatment.

Nonfunctional bladder paraganglioma misdiagnosed as hemangioma:A case report

BACKGROUND Paraganglioma of the urinary bladder(PUB)is a nonepithelial tumor of the bladder that is also known as bladder pheochromocytoma.The incidence of nonfunctional paraganglioma of the urinary bladder is rare in clinical practice.CASE SUMMARY A case of nonfunctional paraganglioma of the urinary bladder diagnosed and treated in our hospital is reported herein.A 2.5 cm×2.1 cm moderate-echo mass protruding into the right anterior wall of the bladder was incidentally found during transvaginal color Doppler ultrasound examination.Based on a contrastenhanced computed tomography scan of the bladder,the right anterior wall of the bladder was considered to present a hemangioma.The patient underwent laparoscopic partial resection of the bladder wall in our hospital,and pathological results showed paraganglioma of the bladder.At present,we have followed up with the patient for half a year,and there has been no recurrence of the tumor.CONCLUSION The imaging patterns of PUB and bladder hemangioma are similar.In clinical practice,the possibility of PUB should be considered for a single wide-based isoechoic mass in the bladder,especially functional PUB may cause some adverse effects during surgery.

Radical cystoprostatectomy with orthotopic neobladder for a case of treatment emergent neuroendocrine prostate cancer presenting as bladder mass with hematuriaea rare instance of tumor remission after local control

Dear editor Treatment emergent neuroendocrine prostate cancer(tNEPC)is most commonly observed after development of resistance to androgen deprivation therapy(ADT)and is associated with rapid progression and widespread metastases with survival less than 1 year from diagnosis[1].Management of this disease is mainly through cytotoxic chemotherapy and there is no published evidence of treating the primary prostatic lesion in this stage of the disease,unlike that of localized prostate cancer or castrate sensitive metastatic prostate cancer[2].In this letter,we report the only known case of t-NEPC who presented with an initial diagnosis of bladder urothelial carcinoma and was treated by early radical surgery and chemotherapy,which led to longterm disease control and preservation of quality of life.

Rare cavernous lymphangioma of the bladder in an adult female: treatment and review of the literature

Objective： Lymphangioma is a benign tumor representing a congenital malformation of the lymphatic channels. The cavernous lymphangioma of the bladder did not report before. Here we report 1 case of cavernous lymphangioma of the bladder in an adult female and review the literature in order to accumulate the experience of diagnosis and treatment for these diseases. Methods： In our case a 50-year-old woman presented with irritative voiding symptoms and had painless macroscopic hematuria at times. Cystoscopy showed a non-papillary tumor at apex vesicae and mucous membrane hyperaemia between the two orifices within the trigone. The pathologic diagnosis was cystitis glandularis with hyperplasia of urothelium and cavernous lymphangioma in lamina propria. Transurethral resection was performed and then bleomycin A5 was injected into lesion multipoint applying ureteral catheter with puncture needle. Results： Two months after operation the irritative voiding symptoms improved and the urine analysis was normal. Cystoscopy showed no residual tumor. Bleomycin A5 was injected into the lesion area again just like the operation before. All symptoms disappeared completely when the patient was examined a month later. There was no side effect after injection and no recurrence during the follow-up of 1 year. Conclusion： Lymphangioma of the bladder can be diagnosed exactly by cystoscopy and pathological examination. Surgery may be the best treatment. The bleomycin A5 intralesional sclerosant is also an effective therapy for the disease after surgical removal.

基于超声特征的列线图模型鉴别诊断膀胱隆起样病变良恶性的价值

目的构建基于超声特征的列线图模型,探讨其鉴别诊断良、恶性膀胱隆起样病变的价值。资料与方法回顾性分析2016年1月—2022年1月四川省人民医院经手术病理证实的膀胱隆起样病变538例(良性84例,恶性454例)的超声资料,对膀胱病变超声特征(病灶部位、数目、最大径线、回声、形态、基底、钙化、彩色多普勒血流显像信号)及患者简要临床指标(性别、年龄、泌尿系恶性肿瘤史、肉眼血尿)行Logistic单因素及多因素回归分析,筛选出独立预测因子,并构建预测模型。通过Bootstrap重抽样进行内部验证。绘制受试者工作特征曲线、校正曲线、临床决策曲线评估模型。结果单因素及多因素Logistic回归分析结果显示,性别(OR=1.822,P=0.038)、年龄(OR=1.044,P=0.000)、病灶部位(OR=0.359,P=0.000)、血流信号(OR=2.052,P=0.007)是预测恶性膀胱隆起样病变的独立因素,基于单因素结果构建的列线图预测模型的曲线下面积为0.780,敏感度为72.91%,特异度为71.43%,准确度为72.68%。校正曲线显示模型的一致性较好。临床决策曲线显示临床净获益良好。结论基于超声特征和简要临床指标构建的列线图模型鉴别诊断良、恶性膀胱隆起样病变具有较高的准确度和潜在的临床应用价值。

尿液循环肿瘤DNA在膀胱癌早期诊断及预后预测中的价值

目的探讨尿液循环肿瘤DNA(ctDNA)在膀胱癌早期诊断及预后预测中的价值。方法选取68例膀胱癌患者作为观察组,77例健康体检者作为对照组。比较两组患者的尿液ctDNA浓度,采用多因素Logistic回归模型分析膀胱癌患者预后的影响因素。绘制受试者工作特征(ROC)曲线,分析ctDNA对早期膀胱癌的诊断价值及对预后的预测价值。结果观察组患者尿液ctDNA浓度明显高于对照组,差异有统计学意义(P﹤0.01)。尿液ctDNA诊断早期膀胱癌的灵敏度为0.868,特异度为0.985,ROC曲线的曲线下面积为0.975(95%CI:0.953~0.996)。多因素Logistic回归分析结果显示,ctDNA浓度是早期膀胱癌患者预后的影响因素(P﹤0.05)。尿液ctDNA预测早期膀胱癌患者预后的灵敏度为0.833,特异度为0.860,曲线下面积为0.864(95%CI:0.759~0.970)。结论检测尿液中ctDNA的浓度有助于诊断膀胱癌,且操作简单方便、无创伤性。尿液中ctDNA浓度对膀胱癌预后具有一定的预测价值,且特异度和灵敏度较高。

尿液中期因子作为膀胱癌非侵入性诊断指标的价值研究

目的分析尿液中期因子在膀胱癌诊断中的应用价值。方法选取2019年7月—2023年6月枣庄市薛城区人民医院和枣庄市立医院82例膀胱癌患者作为A组,选取同时间段82例良性泌尿系统疾病患者作为B组,再选取同时间段82例健康体检者作为C组,三组均行尿液中期因子检查,并比较三组检查结果的差异;以手术病理组织学检查结果作为金标准,评估尿液中期因子的诊断价值;最后观察膀胱癌患者临床资料与尿液中期因子的相关性。结果A组尿液中期因子明显高于B组、C组,差异有统计学意义(P<0.05),B组尿液中期因子高于C组,差异有统计学意义(P<0.05);尿液中期因子诊断结果为膀胱癌82例,漏诊16例,误诊6例,尿液中期因子的敏感度为80.5%,特异度为90.2%,准确度为87.0%,阳性预测值为80.5%,阴性预测值为90.2%;膀胱癌患者中不同肿瘤数量、肌肉侵袭性、淋巴结转移的尿液中期因子水平比较,差异有统计学意义(P<0.05)。结论尿液中期因子在膀胱癌诊断中具有较高的敏感度与特异性,能够作为非侵入性诊断的评估指标。

磁共振联合血清KMT2D检测在膀胱癌诊断中的临床意义

目的分析磁共振联合血清组蛋白赖氨酸甲基转移酶2D(KMT2D)检测对膀胱癌的诊断价值。方法以本院154例膀胱癌患者作为膀胱癌组(BC组),根据临床金标准分为肌层浸润性膀胱癌94例(MIBC组)和非肌层浸润性膀胱癌60例(NMIBC组)。对照组为同期100例健康体检者。比较各组血清KMT2D表达水平差异,受试者工作特征(ROC)曲线分析血清KMT2D对MIBC膀胱癌诊断价值。磁共振、血清KMT2D及二者联合诊断与临床“金标准”的一致性采用Kappa检验。结果BC组血清KMT2D表达水平低于对照组,MIBC组KMT2D表达水平低于NMIBC组,差异有统计学意义(P<0.05)。血清KMT2D诊断MIBC膀胱癌的截断值为0.68,曲线下面积为0.855。磁共振检查诊断MIBC膀胱癌与临床“金标准”检查一致性较好(Kappa=0.744,P<0.05)。磁共振检查联合血清KMT2D诊断MIBC膀胱癌与临床“金标准”结果相比的Kappa值为0.932(P<0.05)。磁共振检查联合血清KMT2D诊断MIBC膀胱癌的灵敏度、准确率及特异度优于单独诊断。结论磁共振联合血清KMT2D检测对MIBC膀胱癌诊断价值较高,有助于术前明确膀胱癌浸润程度。

膀胱癌早诊早治专家共识(2024年版)

膀胱癌是常见的泌尿系统恶性肿瘤之一,严重威胁着中国人民的生命健康。近年来,随着人均寿命的延长,以及人口老龄化的加速,膀胱癌的发病率和死亡率呈逐年上升趋势。提高早期膀胱癌的检出率并进行及时有效的治疗,既可改善患者的预后和生存质量,又能减轻其经济负担,但目前中国尚缺乏膀胱癌早诊早治的统一规范。因此,中国肿瘤医院泌尿肿瘤协作组的相关专家,根据近年的膀胱癌国内外指南、研究进展和临床实践经验,通过专家会议讨论、德尔菲问卷调查等形式,对专家意见进行调查汇总、归纳整理和修改完善,最终形成《膀胱癌早诊早治专家共识(2024年版)》。希望通过本共识,推进中国膀胱癌早诊早治的规范化,也为相关临床工作者提供相应的指导意见和规范依据。本共识已在国际实践指南注册与透明化平台(Practice guideline REgistration for transPAREncy,PREPARE)上注册,注册号为PREPARE-2024CN458。

Comparison of seven screening methods in the diagnosis of bladder cancer

Background We compared the validity （evaluated by sensitivity and specificity）, reliability （evaluated by reproducibility） and yield （evaluated by predictive value, examining complexity and cost） of individual and combined tests for bladder tumour antigen stat （BTAstat）, nuclear matrix protein 22 （NMP22）, hyaluronic acid （HA）, survivin, CD44v6, vascular endothelial growth factor （VEGF）, and voided urine cytology （VUC） in detecting bladder cancer. And at the same time we evaluated the clinical value of these seven detecting methods in the diagnosis of bladder cancer. Methods The six markers and VUC were detected in the urine of cancer group （151 patients with bladder cancer） and two control groups （50 patients with benign urological diseases and 50 healthy controls）. The sensitivity, specificity, predictive value, reproducibility, examining complexity and checking cost of each marker and combined markers were calculated. Results There was a significant difference between bladder cancer group and the two control groups. The sensitivity, specificity and positive predictive value were as follows： VUC （36.4%, 100.0%, 100%）, BTAstat （76.8%, 87.0%, 89.9%）, NMP22 （77.5%, 81.0%, 86.0%）, HA （82.8%, 83.0%, 88.0%）, survivin （70.2%, 85.0%, 87.6%）, CD44v6 （50.3%, 79.0%, 78.4%）, and VEGF （68.2%, 93.0%, 93.6%）. The highest sensitivities were 91.4% for NMP22＋BTAstat and HA＋NMP22, whereas the combined marker with the lowest sensitivity （62.3%） was VUC＋CD44v6. The highest specificity was 93.0% for the combined use of VUC＋VEGF and HA＋CD44v6 had the lowest specificity （73.0%）. The most convenient examining method was the detection for BTAstat, the lowest cost was the detection for HA, and the best reproducibility were the detection for BTAstat and VUC. Conclusions All the markers have obvious clinical value in diagnosis of bladder cancer. The use of BTAstat＋HA or NMP22＋BTAstat are better examining methods in terms of validity, reliability, and yield.