Advances in Urinary Biomarkers for the Early Detection of Urological Cancers: From Proteins and Epigenetics to Gene Mutations.

Urological malignancies, primarily including renal cell carcinoma, bladder cancer and prostate cancer, underscore the critical importance of early screening, diagnosis and treatment in inhibiting disease progression and improving patient prognosis. Advancements in molecular biology have established urinary biomarkers as promising noninvasive tools with considerable potential for early tumour detection and screening high-risk populations, potentially overcoming limitations associated with traditional invasive procedures and imaging. This review systematically summarises urinary biomarkers related to renal cell carcinoma, bladder cancer and prostate cancer. It focuses on protein biomarkers (e.g., cytokeratin and nuclear matrix protein 22), epigenetic and transcriptional biomarkers (e.g., microRNAs and long noncoding RNAs), genetic biomarkers (e.g., telomerase reverse transcriptase and fibroblast growth factor receptor 3) and emerging biomarkers (metabolomic markers, circulating tumour DNA and mass spectrometry-based high-throughput proteomics). This review provides an in-depth exploration of the molecular mechanisms, diagnostic performance (sensitivity and specificity), current clinical applications and limitations of various biomarkers, placing a particular emphasis on comparing the differential expression of the same biomarker across different cancer types. By building on this foundation, this review further outlines future development pathways, including multibiomarker combination strategies, AI-assisted analysis and standardised testing protocols, to offer comprehensive references for the early, noninvasive and precise diagnosis of urological tumours.