Shi Ying, Mathis Bryan J, He Yayun, Yang Xiong
Department of Urology, Wuhan Union Hospital, Huazhong University of Science and Technology, Wuhan 430022, China.
International Medical Center, University of Tsukuba Hospital, Tsukuba 305-8576, Ibaraki, Japan.
Biomedicines. 2023 Feb 13;11(2):539. doi: 10.3390/biomedicines11020539.
Bladder cancer is a common disease in men and the elderly. Current treatment paradigms include radical resection of the bladder and lymph nodes or transurethral resection, both supported by chemotherapy and/or radiation. New modalities, such as illumination-based therapies are also being translationally pursued. However, while survival rates have increased due to combined therapies (particularly chemotherapy, radiation, immune checkpoint inhibitors, and surgery), a lack of diagnostic markers leads clinical professionals to rely on frequently invasive and expensive means of monitoring, such as magnetic resonance imaging or bladder cystoscopy. To improve real-time diagnostic capabilities, biomarkers that reflect both the metabolic and metastatic potential of tumor cells are needed. Furthermore, indicators of therapy resistance would allow for rapid changes in treatment to optimize survival outcomes. Fortunately, the presence of nanoscale extracellular vesicles in the blood, urine, and other peripheral fluids allow for proteomic, genomic, and transcriptomic analyses while limiting the invasiveness of frequent sampling. This review provides an overview of the pathogenesis and progression of bladder cancer, standard treatments and outcomes, some novel treatment studies, and the current status of biomarker and therapy development featuring exosome-based analysis and engineering.
膀胱癌是男性和老年人中的常见疾病。当前的治疗模式包括膀胱和淋巴结的根治性切除或经尿道切除，两者均辅以化疗和/或放疗。基于光照的疗法等新方法也正在进行转化研究。然而，尽管联合治疗（特别是化疗、放疗、免疫检查点抑制剂和手术）提高了生存率，但缺乏诊断标志物导致临床专业人员依赖于如磁共振成像或膀胱镜检查等频繁的侵入性且昂贵的监测手段。为了提高实时诊断能力，需要能够反映肿瘤细胞代谢和转移潜能的生物标志物。此外，治疗耐药性指标将有助于迅速改变治疗方案以优化生存结果。幸运的是，血液、尿液和其他外周液中存在纳米级细胞外囊泡，这使得蛋白质组学、基因组学和转录组学分析成为可能，同时限制了频繁采样的侵入性。本综述概述了膀胱癌的发病机制和进展、标准治疗方法及结果、一些新的治疗研究，以及以基于外泌体的分析和工程为特色的生物标志物和治疗方法的发展现状。
