肌层浸润性膀胱癌分子预后标记物研究进展

Progress in prognostic biomarkers of muscle-invasive bladder cancer

膀胱癌是泌尿系统常见肿瘤,可分为非肌层浸润性膀胱癌、肌层浸润性膀胱癌和转移性膀胱癌。临床上患者多为非肌层浸润性膀胱癌,易于复发,复发后大多数细胞分化良好,预后佳。但10%～30%患者肿瘤复发时转变为具有侵袭性的浸润性膀胱癌,预后不良。目前临床上采用的分级分期方法很难准确预测具有复杂生物学行为的浸润性膀胱癌的预后。近年许多肿瘤标记物相继被发现并用于浸润性膀胱癌的诊断和预后判断。这些分子标记物不仅对浸润性膀胱癌患者预后的判断有提示作用,同时决定着患者是否适合行保留膀胱的放化疗、新辅助化疗和以铂类为基础的辅助化疗等治疗方式。本文对影响浸润性膀胱癌预后的分子标记物进行综述。

Bladder cancer is one of the most common urothelial tumors. Bladder cancer can be categorized as non - muscular invasive bladder cancer, muscular-invasive bladder cancer （MIBC）, or metastatic bladder cancer. Patients with non-muscular invasive bladder cancer suffer from a high rate of recurrence and disease progression （10% to 30%）. Current staging and grading systems fail to provide accurate prognoses of most MIBCs, which have complicated biological behaviors. Over the past few years, comprehensive developments on molecular mechanisms concerning the onset and progression of tumors have enabled the discovery of a host of tumor molecular markers that could be used for the diagnosis and prognosis of MIBC. These markers may not only provide suggestions on the prognoses of MIBC patients but also help determine appropriate therapeutic methods, such as bladder-conserved chemo-radiotherapy, neo-adjuvant chemotherapy, and cisplatin-based adjuvant chemotherapy. We aim to summarize the molecular markers that affect the prognosis of MIBCs in this review article.