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Origin of multifocal carcinomas of the bladder and upper urinary tract: Molecular analysis and clinical implications
Author(s) -
HABUCHI TOMONORI
Publication year - 2005
Publication title -
international journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.172
H-Index - 67
eISSN - 1442-2042
pISSN - 0919-8172
DOI - 10.1111/j.1442-2042.2005.01155.x
Subject(s) - urothelial cancer , medicine , urothelial cell , progenitor cell , bladder cancer , pathology , phenotype , urinary bladder , cancer research , cancer , urothelium , biology , stem cell , urology , genetics , gene
The simultaneous or metachronous development of multifocal tumors with identical or variable histological features in the urothelial tract in a single patient is a well‐known characteristic of urothelial cancer. To explain this phenomenon, two distinct concepts have been proposed: the ‘field defect’ hypothesis according to which urothelial cells in patients are primed to undergo transformation by previous carcinogenic insults and the ‘single progenitor cell’ hypothesis, which asserts that the multifocal development is caused by the seeding or intraepithelial spread of transformed cells. Results of recent molecular genetic studies support the ‘single progenitor cell’ hypothesis, and indicate that the genetic and phenotypic diversity observed in multifocal urothelial tumors is a consequence of clonal evolution from a single transformed cell. An understanding of the mechanism of the heterotopic recurrence of urothelial cancer may provide new prospects for early molecular detection and prevention of heterotopic recurrence of urothelial cancer.