Abstract
Bladder cancer is the fourth most common solid malignancy in men and fifth most common overall with an estimated 70,000 new cases of urothelial carcinoma (UC) and over 14,000 deaths from the disease expected in 2010 in the United States. Although the majority of patients with invasive bladder cancer present without radiographic or clinical evidence of disease beyond the bladder, up to 56% of patients die from the result of occult metastasis not detected by current staging modalities. The potential of microRNAs (miRNAs) as novel tumor markers has been the focus of recent scrutiny because of their tissue specificity, stability, and association with clinical-pathological parameters. Prognostic tools based on conventional clinical and pathologic staging can quantify the risk of death from UC, but their accuracy is imperfect due to the heterogeneous biologic behavior of tumors. Use of biomarkers specific to the tumor and/or patient can provide prognostic utility over that available from routine clinical features. Data have emerged documenting altered systemic miRNAs expression across a spectrum of cancers including urothelial carcinoma of the bladder. Examples include miR-21 (up-regulated), miR-200 family (associated with epithelial-mesenchymal transition and Zeb1/2), and miR-145 (apoptosis). Assessing the expression of all known and predicted non-coding RNAs species and contrasting the miRNAs in the circulation of patients with superficial or invasive disease has great potential in determining whether we can identify systemic miRNAs as screening tools for bladder cancer.
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