THE MOLECULAR PATHOLOGY OF UROLOGICAL MALIGNANCIES

Urological malignancies kill over 16 000 people annually in England an d Wales. There have been exciting recent developments in our understan ding of the molecular pathogenesis of these diseases, although many qu estions remain unanswered, Three separate genes (WT1, WT2, and WT3) ha ve been implicated in Wilms' tumour development, Patients with von Hip pel-Lindau (VHL) syndrome develop renal cell carcinoma and it has been shown that VHL protein inhibits elongin, a cellular transcription fac tor which controls RNA elongation. Use of molecular markers to identif y superficial bladder tumours likely to progress to muscle invasive di sease has met with some success, Increased epidermal growth factor rec eptor (EGFR) and p53 expression, and decreased E-cadherin expression a ll correlate with tumour progression. Tumours in patients with carcino ma in situ have distinct molecular features, Androgen ablation delays disease progression in men with prostate cancer, but relapse is inevit able. Research has been directed towards elucidating the mechanisms by which prostate cancer 'escapes' hormonal control, Mutations in the an drogen receptor have been identified, It is apparent that locally prod uced growth factors mediate androgen-dependent processes and these too have been implicated in prostate carcinogenesis. (C) 1997 John Wiley & Sons, Ltd.