Lamarca Angela, Barriuso Jorge
Medical Oncology Department, Hospital Universitario La Paz, 28046 Madrid, Spain.
Adv Urol. 2012;2012:693631. doi: 10.1155/2012/693631. Epub 2012 Jul 25.
Bladder cancer has increased incidence during last decades. For those patients with nonmuscle involved tumors, noninvasive diagnosis test and surveillance methods must be designed to avoid current cystoscopies that nowadays are done regularly in a lot of patients. Novel urine biomarkers have been developed during last years. Telomerase is important in cancer biology, improving the division capacity of cancer cells. Even urinary telomerase could be a potentially useful urinary tumor marker; its use for diagnosis of asymptomatic and symptomatic patients or its impact during surveillance is still unknown. Moreover, there will need to be uniformity and standardization in the assays before it can become useful in clinical practice. It does not seem to exist a real difference between the most classical assays for the detection of urine telomerase (TRAP and hTERT). However, the new detection methods with modified TeloTAGGG telomerase or with gold nanoparticles must also be taken into consideration for the correct development of this diagnosis method. Maybe the target population would be the high-risk groups within screening programs. To date there is no enough evidence to use it alone and to eliminate cystoscopies from the diagnosis and surveillance of these patients. The combination with cytology or FISH is still preferred.
在过去几十年中，膀胱癌的发病率有所上升。对于那些患有非肌层浸润性肿瘤的患者，必须设计无创诊断测试和监测方法，以避免目前许多患者定期进行的膀胱镜检查。近年来已开发出新型尿液生物标志物。端粒酶在癌症生物学中很重要，它能提高癌细胞的分裂能力。即使尿端粒酶可能是一种潜在有用的尿液肿瘤标志物，但其在无症状和有症状患者诊断中的应用或在监测期间的影响仍不清楚。此外，在其可用于临床实践之前，检测方法需要统一和标准化。在检测尿端粒酶的最经典方法（TRAP和hTERT）之间似乎没有真正的差异。然而，为了正确开发这种诊断方法，也必须考虑使用改良的TeloTAGGG端粒酶或金纳米颗粒的新检测方法。也许目标人群是筛查项目中的高危人群。迄今为止，尚无足够证据单独使用它并在这些患者的诊断和监测中取消膀胱镜检查。与细胞学或荧光原位杂交（FISH）联合使用仍然是首选。
