Zaghloul Mohamed S
Radiation Oncology Department, Children's Cancer Hospital and National Cancer Institute, Cairo University, Cairo, Egypt.
J Egypt Natl Canc Inst. 2012 Dec;24(4):151-9. doi: 10.1016/j.jnci.2012.08.002. Epub 2012 Sep 20.
Schistosoma-associated bladder cancer was believed, for several decades, to be a completely unique entity of disease, different from urothelial cancer. This was probably due to its distinct clinicopathologic and demographic features that varied from those of urothelial entity. The carcinogenesis is an extremely complex process resulting from the accumulation of many genetic and epigenetic changes leading to alterations in the cell proliferation regulation process. In bladder cancer, many of these carcinogenic cascades were not fully documented or somewhat conflicting. Inspite of the efforts performed, much is still needed to explore the presence or absence of the carcinogenic difference with a different etiology. The control of schistosomiasis in certain countries and the subsequent decrease in the intensity of infestation showed changing of features approaching that of urothelial tumors. However the schistosoma-associated bladder cancer presented in more advanced stages than schistosoma-non associated urothelial cancer. More recently, data are gathered that, upon applying the same treatment protocol and management care, stage by stage comparison of the treatment end-results were found to be similar in bladder cancer patients with a different etiology. All treatment options; including radical cystectomy with or without adjuvant or neoadjuvant chemo- or radiotherapy or trimodality bladder preserving treatment seem to lead to similar end-results regardless of etiologic factor(s) implicated in bladder cancer development.
几十年来，血吸虫相关性膀胱癌一直被认为是一种完全独特的疾病实体，与尿路上皮癌不同。这可能是由于其独特的临床病理和人口统计学特征与尿路上皮实体不同。致癌作用是一个极其复杂的过程，由许多遗传和表观遗传变化的积累导致细胞增殖调节过程的改变。在膀胱癌中，许多这些致癌级联反应没有得到充分记录或存在一些冲突。尽管已经做出了努力，但仍需要做大量工作来探索不同病因的致癌差异的存在与否。某些国家血吸虫病的控制以及随后感染强度的降低显示出其特征向尿路上皮肿瘤的特征转变。然而，血吸虫相关性膀胱癌比非血吸虫相关性尿路上皮癌出现的阶段更晚。最近收集的数据表明，在应用相同的治疗方案和管理护理时，发现不同病因的膀胱癌患者治疗最终结果的逐阶段比较是相似的。所有治疗选择，包括有或没有辅助或新辅助化疗或放疗的根治性膀胱切除术或三联保膀胱治疗，似乎都能导致相似的最终结果，而不管膀胱癌发生所涉及的病因因素如何。
