Introduction: The increasing incidence of colorectal cancer (CRC) in young adults warrants early and preferably noninvasive diagnostic modalities. Although the current stool-based assays have had good performance indicators for CRC detection, the overall poor uptake remains a challenging issue. However, alternative blood and urine markers are emerging.Areas covered: This paper discusses the various urinary biomarkers available for the detection of CRC. The more commonly encountered drawbacks are the small number of studies and the size of the study population. We discuss the role of microRNA and ProstaglandinE2 in CRC detection. The emergence of new, low-cost technologies, specifically in the detection of volatile organic compounds (VOCs), presents a promising future. We postulate possible mechanisms for the origin of these VOCs in urine and their role in carcinogenesis.Expert opinion: Urinary biomarkers provide an alternative option to the stool-based screening tests. MicroRNA and ProstaglandinE2 have shown utility in CRC detection. Evidence so far suggests that VOCs could also be a potential biomarker for the detection of CRC. In addition to its interaction within the colon lumen, this altered 'VOC signature' might also play a role in carcinogenesis. Low-cost technology may enable such diagnostic methods to be utilized at the point of care.

中文翻译：

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尿液作为结直肠癌检测的生物学方式。

简介： 年轻成人结直肠癌 (CRC) 的发病率不断增加，需要早期和最好是无创诊断方式。尽管目前基于粪便的检测方法具有良好的 CRC 检测性能指标，但整体吸收不良仍然是一个具有挑战性的问题。然而，替代的血液和尿液标志物正在出现。涵盖的领域：本文讨论了可用于检测 CRC 的各种尿液生物标志物。更常见的缺点是研究数量少和研究人群的规模。我们讨论了 microRNA 和 ProstaglandinE2 在 CRC 检测中的作用。新的低成本技术的出现，特别是在检测挥发性有机化合物 (VOC) 方面，前景广阔。我们推测尿液中这些 VOC 的可能机制及其在致癌作用中的作用。专家意见：尿液生物标志物为基于粪便的筛查测试提供了一种替代选择。MicroRNA 和 ProstaglandinE2 已显示出在 CRC 检测中的效用。迄今为止的证据表明，VOC 也可能是检测 CRC 的潜在生物标志物。除了它在结肠腔内的相互作用之外，这种改变的“VOC 特征”也可能在致癌作用中起作用。低成本技术可以使这种诊断方法能够在护理点使用。迄今为止的证据表明，VOC 也可能是检测 CRC 的潜在生物标志物。除了它在结肠腔内的相互作用之外，这种改变的“VOC 特征”也可能在致癌作用中起作用。低成本技术可以使这种诊断方法能够在护理点使用。迄今为止的证据表明，VOC 也可能是检测 CRC 的潜在生物标志物。除了它在结肠腔内的相互作用之外，这种改变的“VOC 特征”也可能在致癌作用中起作用。低成本技术可以使这种诊断方法能够在护理点使用。