Shariat Shahrokh F, Karam Jose A, Lerner Seth P
Department of Urology, UT Southwestern Medical Center, Dallas, Texas 75390-9110, USA.
Curr Opin Urol. 2008 Jan;18(1):1-8. doi: 10.1097/MOU.0b013e3282f1c5c1.
Bladder cancer is a diverse disease whose molecular phenotypes are being elucidated. In this review, we summarize currently known molecular pathways and associated markers in bladder cancer.
Genetic and epigenetic aberrations have been closely associated with tumor pathogenesis and prognosis. Cell cycle markers have been most extensively studied. More recently, apoptotic and angiogenic pathways are being investigated. Studying the role of multiple concurrent molecular alterations improves the prognostic ability of these markers. The use of tissue microarrays and high-throughput molecular profiling is accelerating the discovery of new markers.
Molecular biology is paramount to our understanding of bladder cancer pathogenesis. The search for new markers, and elucidating cross-talk between markers in different pathways, is warranted. Molecular markers have the potential benefit of improving detection, prognosis and treatment of bladder cancer. In addition, understanding the molecular profile of the individual patient could usher us into a new era of improving prediction of the natural history of the disease and providing a more personalized and tailored treatment. Prospective trials are still needed, however, to objectively establish the true benefit of these markers in prognostic and therapeutic arenas.
膀胱癌是一种异质性疾病,其分子表型正在被阐明。在本综述中,我们总结了目前已知的膀胱癌分子途径及相关标志物。
遗传和表观遗传异常与肿瘤发病机制及预后密切相关。细胞周期标志物的研究最为广泛。最近,凋亡和血管生成途径也在被研究。研究多种同时发生的分子改变的作用可提高这些标志物的预后判断能力。组织芯片和高通量分子谱分析的应用正在加速新标志物的发现。
分子生物学对于我们理解膀胱癌发病机制至关重要。寻找新标志物以及阐明不同途径中标志物之间的相互作用是很有必要的。分子标志物具有改善膀胱癌检测、预后和治疗的潜在益处。此外,了解个体患者的分子特征可能会引领我们进入一个新时代,即更好地预测疾病自然史并提供更个性化和精准的治疗。然而,仍需要进行前瞻性试验,以客观地确定这些标志物在预后和治疗领域的真正益处。