Department of Pathology and Center for Personalized Medicine, University of Southern California Keck School of Medicine, Los Angeles, CA, USA.
Semin Oncol. 2012 Oct;39(5):524-33. doi: 10.1053/j.seminoncol.2012.08.008.
The determination of prognosis in bladder cancer is currently based on staging methods that rely primarily on the pathological stage of a tumor with limited objective correlates. The development and progression of bladder cancer involve alterations in several cellular pathways. Dysregulation in markers associated with cell-cycle regulation has been the most extensively examined molecular aberration in this cancer. Individual alterations of these markers have been associated with disease outcome, with several observations suggesting that their prognostic potential is independent of pathological stage. While many individual molecules in the cell growth receptor signaling, p53, and retinoblastoma (Rb) pathways have been identified, there is a general lack of consensus on which markers can be adopted in the clinical setting. More recent studies have suggested that the combination of markers as concise panels may be more beneficial in determining the degree of aggressiveness of a given tumor and its impending outcome than individual markers alone. This review will discuss alterations in molecules within pathways controlling cell-cycle regulation in the context of bladder cancer, and their impact on patient outcome when examined individually and in combination.
目前膀胱癌的预后判断主要基于以肿瘤的病理分期为基础的分期方法，但这些方法与客观指标相关性有限。膀胱癌的发生和发展涉及多个细胞通路的改变。在这种癌症中，与细胞周期调控相关的标志物失调是研究最广泛的分子异常。这些标志物的单独改变与疾病结局相关，有一些观察结果表明，它们的预后潜力独立于病理分期。虽然已经鉴定出细胞生长受体信号、p53 和视网膜母细胞瘤（Rb）通路中的许多单个分子，但对于可以在临床环境中采用哪些标志物，尚无普遍共识。最近的研究表明，标记物的组合作为简洁的标志物组合可能比单个标志物更有助于确定给定肿瘤的侵袭性程度及其预期结局。这篇综述将讨论控制细胞周期调控的通路中分子的改变，并讨论它们在膀胱癌中的作用，以及在单独和联合检查时对患者结局的影响。
