RECENT ASPECTS IN THE DIAGNOSIS AND PROGNOSIS OF BLADDER-CANCER

Epidemiologic studies have stated the progressive increase of bladder tumors during the last decades. The aim of our review is to refer to f actors implicated in bladder carcinogenesis (such as activated oncogen es, growth factors and chromosomal aberrations) and to resistance to d rug uptake (i.e., multidrug resistance gene and P-glycoprotein). The r eview also provides information of diagnostic and prognostic significa nce, based on DNA analysts of transitional cancer cells. In addition t o cytometric data, alternative counterings for estimation of the S-pha se fraction, useful in indicating the biologic behavior of bladder can cer, are presented. Knowledge of such mechanisms results in a better a pproach to the diagnosis, prognosis and prevention of bladder carcinom as, especially those that do not respond to systemic intravesical chem otherapy. We have tried to mention all significant factors related to the development of bladder cancer. We conclude that the progress made in understanding the pathogenesis of bladder cancer has been significa nt. However, more studies are needed in order to introduce and adopt r eliable criteria to accurately predict the clinical behavior.