尿検査で10人中9人以上の膀胱がんを検出、臨床研究で判明(Urine test identifies more than 9 in 10 bladder cancers, clinical study finds)

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2026-09-02 バーミンガム大学

バーミンガム大学とNonacusの研究チームは、尿中DNAを解析して膀胱がんを検出する非侵襲的検査「GALEAS Bladder」の実臨床での有効性を評価した。英国NHSの7つの泌尿器科施設で964人を対象に前向き観察研究を行った結果、膀胱がん77例のうち71例を検出し、感度は92%、特異度は92%、陰性的中率は99%以上だった。特に筋層浸潤性膀胱がん17例は全例、高悪性度がん36例中35例を検出した。検査は23遺伝子の変異を次世代シーケンシングで解析し、陽性者を緊急膀胱鏡検査へ優先的に回す一方、陰性者では臨床的に適切なら検査を延期できる可能性がある。全員に緊急膀胱鏡検査を行う場合と比べ、1,000人当たり730件の緊急検査を削減できると推定された。膀胱がん診断における分子尿検査による低侵襲なトリアージ技術として期待される。

尿検査で10人中9人以上の膀胱がんを検出、臨床研究で判明(Urine test identifies more than 9 in 10 bladder cancers, clinical study finds)

<関連情報>

英国国民保健サービス(NHS)の血尿外来における膀胱がん検出のためのGALEAS Bladderの実世界多施設評価 Real-World Multicentre Evaluation of GALEAS Bladder for Detecting Bladder Cancer in UK NHS Haematuria Clinics

Lee Silcock ∙ Robert K. Hastings ∙ Samuel Clokie ∙ … ∙ Uwais Mufti ∙ Douglas G. Ward ∙ Richard T. Bryan
European Urology Oncology  Published:September 1, 2026
DOI:https://doi.org/10.1016/j.euo.2026.08.005

Abstract

Background and objective
Cystoscopy is a core component of haematuria investigations; however, it is invasive and resource intensive. GALEAS Bladder is a DNA-based diagnostic urine test that measures mutations in 23 bladder cancer (BC)–associated genes.

Objective
We aimed to assess the diagnostic performance of GALEAS Bladder in real-world patients with haematuria and its utility as a molecular triage tool in this setting.

Methods
Patients referred for urgent investigation of haematuria were prospectively enrolled across seven UK National Health Service urology departments between October 2024 and June 2025. Urine samples were collected prior to cystoscopy and analysed by GALEAS Bladder. Assay results were compared with cystoscopy and biopsy/transurethral resection of bladder tumour findings.

Key findings and limitations
Cystoscopic findings and GALEAS Bladder results were available for 964 participants (575 visible and 294 non-visible haematuria, 95 unknown), including 77 (8.0%) newly diagnosed with pathology-confirmed BC. The assay detected 71 of the 77 BCs, including all 17 muscle-invasive BCs and 35 of the 36 high-grade BCs, with negative predictive value >99% (95% confidence interval [CI] 98–100), positive predictive value 50% (95% CI 42–58), positive likelihood ratio (LR) 11.5, and negative LR 0.09. Decision curve analysis showed net benefit over cystoscopy for all referrals. Limitations include observational study design over a limited timeframe and absence of subsequent diagnoses for participants with positive GALEAS Bladder test results without cystoscopically visible tumour.

Conclusions and clinical implications
GALEAS Bladder is a clinically implementable molecular urine test that detects new cases of BC with high negative predictive value and favourable LRs in patients undergoing urgent investigation of haematuria. These data show that GALEAS Bladder can be used now to triage patients with haematuria to immediate or deferred cystoscopy.

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