Department of Clinical Biochemistry and Laboratory Sciences, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
Drug Applied Research Centre, Tabriz University of Medical Sciences, Tabriz, Iran.
J Cell Physiol. 2019 Apr;234(4):3197-3206. doi: 10.1002/jcp.26916. Epub 2018 Nov 23.
Bladder cancer is one of the most prevalent genitourinary cancers responsible for about 150,000 deaths per year worldwide. Currently, several treatments, such as endoscopic and open surgery, appended by local or systemic immunotherapy, chemotherapy, and radiotherapy are used to treat this malignancy. However, the differences in treatment outcome among patients suffering from bladder cancer are considered as one of the important challenges. In recent years, cancer stem cells, representing a population of undifferentiated cells with stem-cell like properties, have been eyed as a major culprit for the high recurrence rate in superficial papillary bladder cancer. Cancer stem cells have been reported to be resistant to conventional treatments, such as chemotherapy, radiation, and immunotherapy, which induce selective pressure on tumoral populations resulting in selection and growth of the resistant cells. Therefore, targeting the therapeutic aspects of cancer stem cells in bladder cancer may be promising. In this study, we briefly discuss the biology of bladder cancer and then address the possible relationship between molecular biology of bladder cancer and cancer stem cells. Subsequently, the mechanisms of resistance applied by cancer stem cells against the conventional therapeutic tools, especially chemotherapy, are discussed. Moreover, by emphasizing the biomarkers described for cancer stem cells in bladder cancer, we have provided, described, and proposed targets on cancer stem cells for therapeutic interventions and, finally, reviewed some immunotargeting strategies against bladder cancer stem cells.
膀胱癌是最常见的泌尿生殖系统癌症之一，全球每年约有 15 万人因此死亡。目前，有几种治疗方法，如内镜和开放手术，附加局部或全身免疫治疗、化疗和放疗，用于治疗这种恶性肿瘤。然而，患有膀胱癌的患者之间的治疗效果差异被认为是一个重要挑战。近年来，癌症干细胞作为一种具有干细胞样特性的未分化细胞群体，被认为是浅表性乳头状膀胱癌高复发率的主要罪魁祸首。据报道，癌症干细胞对常规治疗（如化疗、放疗和免疫治疗）具有抗性，这些治疗会对肿瘤群体产生选择性压力，导致耐药细胞的选择和生长。因此，针对膀胱癌中癌症干细胞的治疗方面可能具有前景。在本研究中，我们简要讨论了膀胱癌的生物学特性，然后探讨了膀胱癌的分子生物学与癌症干细胞之间的可能关系。随后，讨论了癌症干细胞对抗传统治疗工具（特别是化疗）的耐药机制。此外，通过强调膀胱癌中癌症干细胞的描述性生物标志物，我们为癌症干细胞的治疗干预提供、描述和提出了靶点，并最终综述了一些针对膀胱癌干细胞的免疫靶向策略。
