Lam Thomas, Nabi Ghulam
University of Aberdeen, Academic Urology Unit, First floor, Health Sciences Building, Aberdeen AB25 2ZD, UK.
Expert Rev Anticancer Ther. 2007 Aug;7(8):1105-15. doi: 10.1586/14737140.7.8.1105.
Carcinoma of urinary bladder ranks among the top ten most common cancers worldwide. Approximately 80% of the disease is superficial (limited to mucosa and lamina propria) at the time of presentation. However, the majority of these tumors recur and 15-20% progress into muscle-invasive disease. Cystoscopic surveillance of the urinary bladder remains the standard of care to identify these recurrences on follow-up. Not only is this an invasive procedure, but the sensitivity of cystoscopy can be as low as 70%, so there can be up to 30% of tumors that are missed. Urinary cytology, with recognized limitations, has been used as an adjunct to this procedure, pending discovery of alternate urinary biomarkers. In the past decade there has been tremendous advancement in producing urinary biomarkers for urinary bladder cancer research, reflecting advancements in genomics and proteomics. An ideal biomarker should be able to replace cystoscopic examination and be cost effective. Unfortunately, most of the identified protein or molecular biomarkers have failed this test. This article critically appraises the status of these urinary biomarkers in urinary bladder cancer, in addition to highlighting some of the difficulties in this research area.
膀胱癌是全球十大常见癌症之一。在疾病初发时，约80%为表浅性（局限于黏膜和固有层）。然而，这些肿瘤大多数会复发，15%-20%会进展为肌层浸润性疾病。膀胱镜监测仍是随访中识别这些复发的标准治疗方法。这不仅是一种侵入性操作，而且膀胱镜检查的敏感性可能低至70%，因此可能有高达30%的肿瘤被漏诊。尿细胞学检查虽有公认的局限性，但在发现替代尿生物标志物之前，一直被用作该检查的辅助手段。在过去十年中，膀胱癌研究的尿生物标志物取得了巨大进展，这反映了基因组学和蛋白质组学的进步。理想的生物标志物应能够替代膀胱镜检查且具有成本效益。不幸的是，大多数已鉴定出的蛋白质或分子生物标志物都未能通过此项检验。本文除了强调该研究领域的一些困难外，还对这些尿生物标志物在膀胱癌中的现状进行了批判性评估。
