MOLECULAR-BIOLOGY OF DISSEMINATION IN BLADDER-CANCER - LABORATORY FINDINGS AND CLINICAL-SIGNIFICANCE

Recent molecular biology Investigations have demonstrated that tumor p rogression and dissemination in bladder cancer is a highly complicated phenomenon, consisting of multiple distinct steps and regulated by a great number of different genes. Some of these genes involved in the s pecific steps of tumor progression and dissemination have been identif ied. Several oncogenes, e.g., the epithelial growth factor receptor (E CF-R), and tumor-suppressor genes, e.g., the p53 gene, have been found to correlate significantly with tumor progression. The decreased expr ession of cell-adhesion molecules such as E-cadherin appears to facili tate tumor-cell detachment in the primary tumor? whereas expression of the intercellular adhesion molecule (ICAM)-1 might be of relevance fo r tell attachment at the metastatic site. Tumor invasion through the b asement membrane has been correlated with a decreased expression of la minin and elevated urinary levels of acidic fibroblast growth factor: Although the complex professes related to dissemination are far from b eing completely understood, the finding of differential expression of distinct genes appears to provide the first targets for therapeutic in tervention.