Urinary Exosomes Diagnosis of Urological Tumors: A Systematic Review and Meta-Analysis

PurposeExosomes could be released directly into the urine by the urological tumoral cells, so testing urinary exosomes has great potential for non-invasive diagnosis and monitor of urological tumors. The objective of this study is to systematically review and meta-analysis of urinary exosome for urological tumors diagnosis.Materials and MethodsA systematic review of the recent English-language literature was conducted according to the PRISMA statement recommendations (CRD42021250613) using PubMed, Embase, Cochrane Library, Web of Science, and Scopus databases up to April 30, 2021. Risk-of-bias assessment was performed according to the QUADAS 2 tool. The true diagnostic value of urinary exosomes by calculating the number of true positive, false positive, true negative, and false negative, diagnoses by extracting specificity and sensitivity data from the selected literature.ResultsSixteen eligible studies enrolling 3224 patients were identified. The pooled sensitivity and specificity of urinary exosomes as a diagnostic tool in urological tumors were 83% and 88%, respectively. The area under the summary receiver operating characteristic curve was 0.92 (95% CI: 0.89–0.94). Further subgroup analyses showed that our results were stable irrespective of the urinary exosome content type and tumor type.ConclusionUrinary exosomes may serve as novel non-invasive biomarkers for urological cancer detection. Future clinical trial designs must validate and explore their utility in treatment decision-making.Systematic Review Registration[ https://www.crd.york.ac.uk/prospero/], identifier [CRD42021250613].

A new urinary exosome enrichment method by a combination of ultrafiltration and TiO2 nanoparticles

The workflow of separation and enrichment of exosomes by ultrafiltration–TiO2. We proposed a new strategy for facile exosome isolation from human urine by utilizing the ultrafiltration technique and TiO2, which can significantly reduce urine volumes, increase exposure of the material to exosomes in urine and obtain high purity exosomes.