Rink Michael, Schwarzenbach Heidi, Vetterlein Malte W, Riethdorf Sabine, Soave Armin
Department of Urology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Institute of Tumor Biology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Transl Androl Urol. 2019 Feb;8(1):61-75. doi: 10.21037/tau.2018.11.05.
Non-muscle invasive bladder cancer (NMIBC) is characterized by its high rate of disease recurrence and relevant disease progression rates. Up to today clinical models are insufficiently predicting outcomes for reliable patient counseling and treatment decision-making. This particularly is a serious problem in patients with high-risk NMIBC who are at high risk for failure of local treatment and thus candidates for early radical cystectomy or even systemic (neoadjuvant) chemotherapy. Next to its clinical variability, bladder cancer is genetically a highly heterogeneous disease. There is an essential need of biomarkers for improving clinical staging, real-time monitoring of disease with or without active treatment, as well as improved outcome prognostication. Liquid biopsies of circulating biomarkers in the blood and urine are promising non-invasive diagnostics that hold the potential facilitating these needs. In this review we report the latest data and evidence on cell-free circulating tumor desoxyribonucleic acid (ctDNA) and circulating tumor cells (CTC) in NMIBC. We summarize their current status in clinical diagnostics, discuss limitations and address future needs.
非肌层浸润性膀胱癌（NMIBC）的特点是疾病复发率高以及相关的疾病进展率高。直至今日，临床模型仍不足以预测结果，难以进行可靠的患者咨询和治疗决策。这在高危NMIBC患者中尤其严重，他们面临局部治疗失败的高风险，因此是早期根治性膀胱切除术甚至全身（新辅助）化疗的候选者。除了临床变异性外，膀胱癌在基因上是一种高度异质性疾病。迫切需要生物标志物来改善临床分期、对接受或未接受积极治疗的疾病进行实时监测以及改善预后预测。血液和尿液中循环生物标志物的液体活检是很有前景的非侵入性诊断方法，有可能满足这些需求。在本综述中，我们报告了关于NMIBC中游离循环肿瘤脱氧核糖核酸（ctDNA）和循环肿瘤细胞（CTC）的最新数据和证据。我们总结了它们在临床诊断中的现状，讨论了局限性并提出了未来的需求。
