Molecular pathogenesis and diagnostics of bladder cancer.
Despite elaborate characterization of the risk factors, bladder cancer is still a major epidemiological problem whose incidence continues to rise each year. Urothelial carcinoma is now recognized as a disease of alterations in several cellular processes. The more prevalent, less aggressive, recurrent, noninvasive tumors are characterized by constitutive activation of the Ras-MAPK pathway. The less common but more aggressive invasive tumors, which have a higher mortality rate, are characterized by alterations in the p53 and retinoblastoma pathways. Several diagnostic tests have attempted to identify these molecular alterations in tumor cells exfoliated in the urine, whereas prognostic tests have tried to identify aberrations so as to predict tumor behavior and identify therapeutic targets. The future of bladder cancer patient management will rely on the use of molecular tests to reliably diagnose the presence of disease, predict individual tumor behavior, and suggest potential targeted therapeutics.
Mitra
Anirban P
AP
Department of Pathology, Keck School of Medicine and Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA 90033, USA. amitra@usc.edu
Cote
Richard J
RJ
D014408:Biomarkers, Tumor / Q000235:genetics / Q000378:metabolism; D002277:Carcinoma / Q000175:diagnosis* / Q000235:genetics / Q000378:metabolism / Q000628:therapy; D015972:Gene Expression Regulation, Neoplastic; D005820:Genetic Testing; D005838:Genotype; D006801:Humans; D009361:Neoplasm Invasiveness; D018579:Patient Selection; D010641:Phenotype; D011237:Predictive Value of Tests; D011379:Prognosis; D011933:Reagent Kits, Diagnostic; D018570:Risk Assessment; D012307:Risk Factors; D001749:Urinary Bladder Neoplasms / Q000175:diagnosis* / Q000235:genetics / Q000378:metabolism / Q000628:therapy; D019459:Urothelium / Q000378:metabolism / Q000473:pathology*
D014408:Biomarkers, Tumor; D011933:Reagent Kits, Diagnostic