Abstract
Background. Urothelial carcinoma (UTC) is an aggressive disease with a known propensity for frequent recurrence. It is difficult to predict the velocity of the development of UTC recur using modern means of clinical diagnostics. Therefore, the development of the capabilities of histo-morphological study of tumor tissues is of particular relevance.Materials and methods. The materials of publications (PubMed, CrossRef) for 1990-2021, devoted to the choice of biomarkers for the diagnosis of UTC, the analysis of molecular pathways, progression and metastasis, were studied. The search was carried out for the key phrases "urothelial carcinoma", "recurrent UTK", "stem cells", "biomarkers of bladder cancer", "genetic changes in urothelium", "circulating tumor DNA".Results. Cancer stem cells serve as a source of UTC recurrence after removal from the primary focus, localizing in any areas of the urothelium, as well as outside the main tumor focus and are characterized by a common genotype, but different phenotypic manifestations. To predict the recurrence of the tumour is advisable to use gene expression signatures, since the subtypes of UTC are characterized by clear gene expression profiles. A larger sample and independent dataset is needed to confirm the clinical significance of the findings. Combined biomarkers predict UTC behavior, and FGFR3 and TP53 mutations can be components for a panel for predicting UTC recurrence. The use of the liquid biopsy method with the determination of the level of circulating tumor DNA is a promising diagnostic method that needs to evaluate the results of an initiated randomized trial.Conclusion. The accumulation of knowledge base about the molecular patterns of UTC will help bridge the gap between the results of molecular genetic and clinical diagnostics. Molecular changes in the transitional cell UTC demonstrates a high potential for determining the timing of tumor recurrence, assessing disease-free survival of patients and for planning the resource base of the healthcare system.
Highlights
Urothelial carcinoma (UTC) is an aggressive disease with a known propensity for frequent recurrence
It is difficult to predict the velocity of the development of UTC recur using modern means of clinical diagnostics
Cancer stem cells serve as a source of UTC recurrence after removal from the primary focus, localizing in any areas of the urothelium, as well as outside the main tumor focus and are characterized by a common genotype, but different phenotypic manifestations
Summary
Уротелиальная карцинома (УТК) – агрессивное заболевание со склонностью к частому рецидивированию. Прогноз развития рецидивов УТК с помощью современных средств клинической диагностики затруднен, поэтому особую актуальность приобретает развитие возможностей патоморфологического исследования опухолевых тканей. Изучены материалы публикаций (PubMed, CrossRef) за 1990–2021 гг., посвященных вопросам выбора биомаркеров для диагностики УТК, анализу молекулярных путей прогрессирования и метастазирования. Комбинированные биомаркеры обеспечивают прогнозирование поведения УТК, а мутации FGFR3 и TP53 могут служить компонентами для панели прогноза рецидива УТК. Накопление знаний о молекулярных паттернах УТК позволит преодолеть разрыв между результатами молекулярно-генетической и клинической диагностики. Молекулярные изменения УТК демонстрируют высокий потенциал для определения сроков рецидива опухоли, оценки безрецидивной выживаемости пациентов и планирования ресурсной базы системы здравоохранения. Ключевые слова: уротелиальная карцинома, рецидив рака мочевого пузыря, биомаркер, мутация, жидкостная биопсия, циркулирующая опухолевая ДНК. Для цитирования: Старцев В.Ю., Балашов А.Е., Мерзляков А.С.
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