Vol.14, No 1, 2007 pp. 1 - 5
UC
616.61-006-073.75
BIOMARKERS FOR DETECTION, TREATMENT DECISION AND PROGNOSIS OF THE URINARY BLADDER CANCER
Zana Dolićanin1, Ljubinka Janković Veličković2, Vuka Katić2
11Institute of Pathology, Faculty of Medicine, Priština-Kosovska Mitrovica, Serbia
2Institute of Pathology, Faculty of Medicine, Nis, Serbia
E-mail: dolicanin_z@yahoo.com
Summary. Currently, there is no perfect test for the detection of bladder cancer. Even the gold standard cystoscopy is increasingly being demonstrated to miss both Tis and papillary bladder cancer. The oldest urine-based biomarker, cytology, has high specificity but has low sensitivity and significant variability in performance. Stage and grade of transitional cell carcinoma are currently the most useful tools for taking therapeutic decisions and evaluating the prognosis of bladder cancer patients. During the last two decades, the better understanding of the molecular mechanisms involved in carcinogenesis and tumor progression has provided a large number of molecular markers of bladder cancer, with a potential diagnostic and prognostic value. Markers that distinguish among bladder cancer, normal urothelium, and benign urothelial conditions are potentially diagnostic, prognostic, and therapeutic targets. Currently, there are many research bladder tumor markers, but only a few are commercially available. The ideal urinary bladder tumor test is still unavailable, but the eventual "gold standard" will consist of multiple assays that analyze nucleic acids and proteins for detection. In addition, these tests would also reveal to the clinician both prognostic information and therapeutic targets for personalized medical treatment.
Key words:
Urinary bladder cancer, biomarkers, diagnostic, prognostic
BIOMARKERI ZA OTKRIVANJE, LEČENJE I PROGNOZU
KARCINOMA MOKRAĆNE BEŠIKE
Kratak sadržaj:
Ne postoji savršen test za utvrđivanje karcinoma mokraćne bešike. Pokazano je da čak i cistoskopija, zlatni standard za dijagnostiku, ponekad ne prepozna tumor in situ i papilarni karcinom mokraćne bešike.Najstariji biomarker urina, citologija, ima visoku specifičnost a malu senzitivnost sa značajnim varijabilitetom u izvođenju. Stadijum i gradus karcinoma prelaznog epitela imaju najveći prognostički i terapijski značaj kod procene karcinoma bešike. Tokom poslednje dve decenije, bolje razumevanje molekulskih mehanizama u karcinogenezi i progresiji malignog procesa dalo je veliki broj molekulskih markera za moguću dijagnozu i prognozu karcinoma mokraćne bešike. Markeri koji prave razliku između karcinoma mokraćne bešike, normlnog urotelijuma i benignih oboljenja imaju dijagnosticki, prognosticki i terapijski znacaj. Trenutno se istražuje vise markera za karcinom mokraćne bešike ali je samo nekoliko dostupno na tržistu. Jos uvek ne postoji idealan test za otkrivanje karcinoma mokraćne bešike ali ce eventualni "zlatni standard" biti sačinjen od brojnih testova koji analiziraju proteine i nukleinske kiseline. Dodatno će ovi testovi moći da otkriju kliničke, prognostičke i terapijske ciljeve za lečenje, prilagođene svakom pacijentu.
Ključne reči:
Karcinom mokraćne bešike, biomarkeri, dijagnostika, prognoza
opstrukcije, sepsa, citokini
