Kim Young Kyoon, Kim Wun-Jae
Department of Urology, College of Medicine, Seoul National University, Seoul, Korea.
Int J Urol. 2009 Jan;16(1):17-22. doi: 10.1111/j.1442-2042.2008.02143.x. Epub 2008 Aug 20.
Transitional cell carcinomas of the urinary bladder have diverse biological and functional characteristics. Surveillance strategies for bladder cancer recurrence have historically relied on the diagnostic combination of cystoscopy and urinary cytology. However, the accuracy of both tests depends on subjective and operator-dependent interpretations of the visible findings. In contrast, promoter hypermethylation of CpG islands is strongly associated with tumor development and prognosis of bladder cancer. Detection of DNA methylation in voided urine may be feasible and more sensitive than conventional urine cytology. Ultimately, all types of urological cancers may be screened in urine using a candidate panel of hypermethylated genes. The epigenetic silencing of tumor suppressor genes is interest from a clinical point of view because it is possible to reverse epigenetic changes and restore gene function to a cell. Methylation markers might therefore be more useful than conventional molecular markers for the treatment and prevention of bladder cancer.
膀胱移行细胞癌具有多样的生物学和功能特征。膀胱癌复发的监测策略历来依赖于膀胱镜检查和尿液细胞学检查的联合诊断。然而，这两种检查的准确性都取决于对可见结果的主观判断以及操作人员的经验。相比之下，CpG岛的启动子高甲基化与膀胱癌的肿瘤发生和预后密切相关。检测晨尿中的DNA甲基化可能是可行的，并且比传统的尿液细胞学检查更敏感。最终，所有类型的泌尿系统癌症都可以使用一组高甲基化基因候选物在尿液中进行筛查。从临床角度来看，肿瘤抑制基因的表观遗传沉默很有意义，因为有可能逆转表观遗传变化并恢复细胞的基因功能。因此，甲基化标志物在膀胱癌的治疗和预防方面可能比传统分子标志物更有用。
