Origin of multifocal carcinomas of the bladder and upper urinary tract: Molecular analysis and clinical implications
Article first published online: 7 SEP 2005
International Journal of Urology
Volume 12, Issue 8, pages 709–716, August 2005
How to Cite
HABUCHI, T. (2005), Origin of multifocal carcinomas of the bladder and upper urinary tract: Molecular analysis and clinical implications. International Journal of Urology, 12: 709–716. doi: 10.1111/j.1442-2042.2005.01155.x
- Issue published online: 7 SEP 2005
- Article first published online: 7 SEP 2005
- Received 8 April 2005; accepted 16 May 2005.
- bladder cancer;
- molecular genetics;
- urothelial cancer
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.