Murta-Nascimento Cristiane, Schmitz-Dräger Bernd J, Zeegers Maurice P, Steineck Gunnar, Kogevinas Manolis, Real Francisco X, Malats Núria
Centre de Recerca en Epidemiologia Ambiental (CREAL), Institut Municipal d'Investigació Medica (IMIM), Carrer del Dr. Aiguader 88, 08003, Barcelona, Spain.
World J Urol. 2007 Jun;25(3):285-95. doi: 10.1007/s00345-007-0168-5.
Urinary bladder cancer (UBC) ranks ninth in worldwide cancer incidence. It is more frequent in men than in women. We review the main established/proposed factors, both environmental and genetic, associated with bladder cancer etiology and prognosis. Data were extracted from previous reviews and original articles identified from PubMed searches, reference lists, and book chapters dealing with the reviewed topics. Evaluation and consensus of both the contribution of each factor in bladder cancer burden and the appropriateness of the available evidences was done during an ad hoc meeting held during the 18th Congress of the European Society for Urological Research. Cigarette smoking and specific occupational exposures are the main known causes of UBC. Phenacetin, chlornaphazine and cyclophosphamide also increase the risk of bladder cancer. Chronic infection by Schistosoma haematobium is a cause of squamous cell carcinoma of the bladder. NAT2 slow acetylator and GSTM1 null genotypes are associated with an increased risk of this cancer. Vegetables and fresh fruits protect against this tumor. Regarding prognosis, there is little knowledge on the predictive role of environmental exposures and genetic polymorphisms on tumor recurrence and progression and patient's death. Although active tobacco smoking is the most commonly studied factor, no definitive conclusion can be drawn from the literature. More research is needed regarding the effect of complex etiological factors in bladder carcinogenesis. Subgroup analysis according to stage, grade, and molecular features may help in identifying specific etiological and prognostic factors involved in different bladder cancer progression pathways.
膀胱癌（UBC）在全球癌症发病率中排名第九。男性比女性更易患膀胱癌。我们综述了与膀胱癌病因和预后相关的主要既定/提出的环境和遗传因素。数据来自先前的综述以及通过PubMed搜索、参考文献列表和涉及相关主题的书籍章节确定的原始文章。在欧洲泌尿学研究学会第18届大会期间举行的一次特别会议上，对每个因素在膀胱癌负担中的作用以及现有证据的适当性进行了评估和达成共识。吸烟和特定职业暴露是已知的膀胱癌主要病因。非那西丁、氯萘嗪和环磷酰胺也会增加患膀胱癌的风险。埃及血吸虫的慢性感染是膀胱鳞状细胞癌的一个病因。NAT2慢乙酰化基因型和GSTM1无效基因型与患这种癌症的风险增加有关。蔬菜和新鲜水果可预防这种肿瘤。关于预后，对于环境暴露和基因多态性对肿瘤复发、进展及患者死亡的预测作用了解甚少。尽管主动吸烟是研究最普遍的因素，但从文献中无法得出明确结论。关于复杂病因因素在膀胱癌发生中的作用，还需要更多研究。根据分期、分级和分子特征进行亚组分析可能有助于确定参与不同膀胱癌进展途径的特定病因和预后因素。
