ÖZBladder cancer (BC) is a very common cancer and it has high mortality rates, especially in late stages. BC is considered as a different disease in various stages and grades. Non-muscle-invasive BC and muscle-invasive BC have different properties. There are some prognostic factors for progression and recurrence rates of BC and we have some risk assessment methods. These factors are based on clinical findings and histopathological properties. We do not know which factors and molecular processes are effective in the invasion mechanism. In this review, we summarized possible invasion mechanisms of BC.
KeywordsBladder cancer, invasion, metastasis, molecularMesane kanseri farklı evrelerde farklı birer hastalık gibi kabul ve tedavi edilir. Her evre tekrarlama ve ilerleme açısından farklı riskler taşır. Günümüzde bu tekrarlama ve ilerleme risklerini gösteren değişik hesaplama sistemleri tanımlansa da altta yatan moleküler, genetik ve çevresel faktörler net olarak gösterilememiştir. Mevcut risk hesaplama sistemleri klinik, makroskopik ve patolojik değerlendirme temellerine oturmaktadır. Derlemede özetlemeye çalıştığımız olası invazyon mekanizmaları aydınlatıldıkça prognostik yeni moleküler faktörlerin tanımlanması, hatta bu temelde yeni tedavi metodlarının geliştirilmesi mümkün olacaktır.
Anahtar KelimelerMesane kanseri, invazyon, metastaz, moleküler
IntroductionUrothelial tumors are classified as papillary and nonpapillary (solid) tumors. Histopathologically, more than 90% of bladder cancers (BCs) are urothelial (transitional) cell carcinomas (UCC or TCC). At the time of diagnosis, about 75% of BCs are non-muscle-invasive bladder cancer (NMIBC) and remaining 25% are muscle-invasive bladder cancer (MIBC). Phenotypes and genotypes of these cancers in various stages are different. In this context, 30% to 50% of NMIBCs recur after transurethral resection of the primary tumor, and 10% to 20% progress to MIBC. Many of high-grade carcinomas (including carcinoma in situ) invade the bladder wall and may metastasize to other sites. Additionally, nearly 50% of patients with MIBCs have occult distant metastases at the time of diagnosis (1,2). Recently, in the literature, there are many studies in which molecular, genetic and physical factors have been investigated in the progression and recurrence of the BC but it has not been fully outlined. All these factors affect the process of metastasis, invasion and resistance to therapy. Generally, major characteristics of malignant cancer cells are defined as self-sufficiency in growth signals, insensitivity to anti-growth signals, tissue invasion and metastasis, limitless replicative potential, sustained angiogenesis, and evading apoptosis. Additionally, tumor metastasis includes detachment, migration, invasion, intravasation, anoikis, evasion, and extravasation steps. In this review, we aimed to summarize the possible genetic, molecular and physical factors that are responsible for the progression and recurrence.
Epithelial-Mesenchymal Transition and PlasticityMechanism of the...