{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"institution":[{"name":"medRxiv"}],"indexed":{"date-parts":[[2026,8,15]],"date-time":"2026-08-15T06:28:11Z","timestamp":1786775291145,"version":"build-2736575974"},"posted":{"date-parts":[[2026,8,13]]},"group-title":"Urology","reference-count":42,"publisher":"openRxiv","license":[{"start":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T00:00:00Z","timestamp":1786579200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.medrxiv.org\/about\/FAQ#license"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"crossref","award":["R01 GM134226"],"award-info":[{"award-number":["R01 GM134226"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"crossref","award":["P41 EB020594"],"award-info":[{"award-number":["P41 EB020594"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"crossref","award":["K25 HL133611"],"award-info":[{"award-number":["K25 HL133611"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"accepted":{"date-parts":[[2026,8,13]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                <jats:p>\n                  Urothelial carcinoma (UC) is among the most common malignancies worldwide and is known to exhibit a high recurrence rate. The relative lack of validated, non-invasive biomarkers for the disease challenges early detection and negatively impacts patient outcomes. The linear polysaccharide hyaluronan (HA) has been recognized as a potential source of diagnostic information for UC, with its urinary concentration shown to be predictive of disease severity. Here, we use solid-state nanopore (SSNP) sensing to investigate the value of urinary HA size distribution as an independent and complementary predictor of UC. We show that, when combined with urinary concentration, HA size distribution provides a significant improvement to the differentiation of healthy individuals from those with urinary tract diseases in general (AUC = 0.91,\n                  <jats:italic>p<\/jats:italic>\n                  &lt; 0.05), as well as differentiation of individuals with UC from those without (AUC = 0.87,\n                  <jats:italic>p<\/jats:italic>\n                  &lt; 0.05). These results establish the potential of SSNP-based HA profiling for non-invasive diagnostics of UC.\n                <\/jats:p>","DOI":"10.64898\/2026.08.12.26360208","type":"posted-content","created":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T20:25:12Z","timestamp":1786652712000},"source":"Crossref","is-referenced-by-count":0,"title":["Improved diagnostic identification of urothelial carcinoma through solid-state nanopore determination of urinary hyaluronan size distribution"],"prefix":"10.64898","author":[{"given":"Dorothea A.","family":"Erxleben","sequence":"first","affiliation":[{"name":"Virginia Tech-Wake Forest University School of Biomedical Engineering and Sciences, Wake Forest University School of Medicine, Winston-Salem, NC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suruchi","family":"Poddar","sequence":"additional","affiliation":[{"name":"Virginia Tech-Wake Forest University School of Biomedical Engineering and Sciences, Wake Forest University School of Medicine, Winston-Salem, NC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carla M.","family":"Rodriguez","sequence":"additional","affiliation":[{"name":"Department of Biochemistry and Molecular Biology, Wake Forest University, Winston-Salem, NC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul H.","family":"Williams","sequence":"additional","affiliation":[{"name":"Department of Biochemistry and Molecular Biology, Wake Forest University, Winston-Salem, NC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew A.","family":"Davis","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Section on Molecular Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ronald L.","family":"Davis","sequence":"additional","affiliation":[{"name":"Department of Urology, Wake Forest University School of Medicine, Winston-Salem, NC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dixy E.","family":"Green","sequence":"additional","affiliation":[{"name":"Department of Biochemistry and Physiology, University of Oklahoma Health Campus, Oklahoma City, OK, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul L.","family":"DeAngelis","sequence":"additional","affiliation":[{"name":"Department of Biochemistry and Physiology, University of Oklahoma Health Campus, Oklahoma City, OK, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elaheh","family":"Rahbar","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering, Texas A&M University, College Station, TX, USA"},{"name":"Department of Veterinary Physiology and Pharmacology, Texas A&M University, College Station, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ekaterina S.","family":"Khvatkova","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Data Science, Wake Forest University School of Medicine, Winston-Salem, NC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carl D.","family":"Langefeld","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Data Science, Wake Forest University School of Medicine, Winston-Salem, NC, USA"},{"name":"Atrium Health Wake Forest Baptist Comprehensive Cancer Center, Wake Forest University School of Medicine, Winston-Salem, NC, USA"},{"name":"Center for Precision Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA"},{"name":"Center for Artificial Intelligence Research, Wake Forest University School of Medicine, Winston-Salem, NC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam R.","family":"Hall","sequence":"additional","affiliation":[{"name":"Virginia Tech-Wake Forest University School of Biomedical Engineering and Sciences, Wake Forest University School of Medicine, Winston-Salem, NC, USA"},{"name":"Atrium Health Wake Forest Baptist Comprehensive Cancer Center, Wake Forest University School of Medicine, Winston-Salem, NC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"54368","reference":[{"key":"2026081423151844000_2026.08.12.26360208v1.1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.70043"},{"key":"2026081423151844000_2026.08.12.26360208v1.2","doi-asserted-by":"publisher","DOI":"10.3322\/CAAC.21834"},{"key":"2026081423151844000_2026.08.12.26360208v1.3","unstructured":"SEER*Explorer: An interactive website for SEER cancer statistics. 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