title: Comparison of the clonality of urothelial carcinoma developing in the upper urinary tract and those developing in the bladder.
abstract: OBJECTIVE
  To identify the origin of synchronous and metachronous urothelial carcinoma (UC) of the bladder and upper urinary tract to get a better understanding of the basic mechanism behind the multifocality of UC, which may provide a sound bases for the future development of new strategies for detection, prevention and therapy.
  
  
  METHODS
  Six patients with UC of the bladder and synchronous or metachronous UC of the upper urinary tract were studied. Genetic analysis involving the study of loss of heterozygosity (LOH) has been evaluated on their tumours using well characterised and new markers of UC (D9S171, D9S177, D9S303 and TP53).
  
  
  RESULTS
  Five of the six patients demonstrated informative results. Four of five (80%) of patients had synchronous or metacharonous UC tumour and showed patterns of LOH consistent with tumorigenesis from monoclonal tumour origin. One of five (20%) patients exhibited a LOH consistent with oligoclonal tumorigenesis.
  
  
  CONCLUSIONS
  These findings suggest that both the monoclonal and field cancerization theory of tumorigenesis may play a role in tumors of the urothelial tract. However, more data is needed.
authors.affiliation: Department of Surgery, The Schulich School of Medicine and Dentistry, London Health Sciences Centre-Victoria Hospital London, The University of Western Ontario, London, ON Canada.
authors.forename: Yuding
authors.initials: Y
authors.lastname: Wang
authors.forename: Michael R
authors.initials: MR
authors.lastname: Lang
authors.forename: Christopher L
authors.initials: CL
authors.lastname: Pin
authors.forename: Jonathan I
authors.initials: JI
authors.lastname: Izawa
keywords: Bladder cancer; Transitional cell carcinoma; Upper urinary tract cancer; Urothelial carcinoma
references.citation: J Clin Oncol. 2013 Apr 10;31(11):1422-7
references.pmid: 23460707
references.citation: Eur Urol. 2007 May;51(5):1185-93; discussion 1193
references.pmid: 17123702
references.citation: Clin Cancer Res. 2005 Sep 15;11(18):6512-9
references.pmid: 16166427
references.citation: Cancer Res. 1993 Sep 1;53(17):4066-70
references.pmid: 8358736
references.citation: Int J Cancer. 2002 Sep 1;101(1):1-6
references.pmid: 12209580
references.citation: Cancer Lett. 2010 Aug 28;294(2):139-46
references.pmid: 20363069
references.citation: Lab Invest. 2000 May;80(5):709-18
references.pmid: 10830781
references.citation: N Engl J Med. 1992 Mar 12;326(11):737-40
references.pmid: 1445507
references.citation: Am J Pathol. 1999 Mar;154(3):721-7
references.pmid: 10079249
references.citation: Scand J Urol Nephrol Suppl. 2008 Sep;(218):154-65
references.pmid: 18815930
references.citation: Expert Rev Anticancer Ther. 2008 Jan;8(1):75-85
references.pmid: 18095885
references.citation: Cancer Genet Cytogenet. 2010 Jul 1;200(1):16-22
references.pmid: 20513529
references.citation: J Urol. 1996 Nov;156(5):1846-9
references.pmid: 8863629
references.citation: J Urol. 2004 Jan;171(1):419-25
references.pmid: 14665946
references.citation: Pathobiology. 2000;68(4-5):165-72
references.pmid: 11279342
references.citation: Clin Cancer Res. 1996 Oct;2(10):1795-800
references.pmid: 9816132
references.citation: J Urol. 2001 Feb;165(2):672-7
references.pmid: 11176456
references.citation: Cancer. 2003 Oct 15;98(8):1620-6
references.pmid: 14534877
references.citation: Carcinogenesis. 1998 May;19(5):855-60
references.pmid: 9635874
references.citation: Lancet. 1993 Oct 30;342(8879):1087-8
references.pmid: 8105314
references.citation: Oncogene. 2001 Aug 9;20(35):4910-5
references.pmid: 11521204
references.citation: Int J Urol. 2005 Aug;12(8):709-16
references.pmid: 16174043
references.citation: Eur Urol. 2011 Oct;60(4):703-10
references.pmid: 21684068